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PLoS Medicine

COVID-19 and Mental Health in 8 Low- and Middle-Income Countries: A Prospective Cohort Study

We track the effects of the COVID-19 pandemic on mental health in eight Low and Middle Income Countries (LMICs) in Asia, Africa, and South America utilizing repeated surveys of 21,162 individuals. Many respondents were interviewed over multiple rounds pre- and post-pandemic, allowing us to control for time trends and within-year seasonal variation in mental health. We demonstrate how mental health fluctuates with agricultural crop cycles, deteriorating during pre-harvest "lean" periods. Ignoring this seasonal variation leads to unreliable inferences about the effects of the pandemic. Controlling for seasonality, we document a large, significant, negative impact of the pandemic on mental health, especially during the early months of lockdown. In a random effects aggregation across samples, depression symptoms increased by around 0.3 standard deviations in the four months following the onset of the pandemic. The pandemic could leave a lasting legacy of depression. Absent policy interventions, this could have adverse long-term consequences, particularly in settings with limited mental health support services, which is characteristic of many LMICs.

Aksunger, N., C. Vernot, R. Littman, M. Voors, N. Meriggi, A. Abajobir, B. Beber PhD, K. Dai, D. Egger, A. Islam, J. Kelley, A. Kharel, A. Matabaro, A. Moya, P. Mwachofi, C. Nekesa, E. Ochieng, T. Rahman, A. Scacco, Y. van Dalen, M. Walker, W. Janssens and A. Mobarak (2023), COVID-19 and Mental Health in 8 Low- and Middle-Income Countries: A Prospective Cohort Study. PLoS Medicine, 20(4), e1004081

DOI: 10.1371/journal.pmed.1004081