1. Main points

  • Almost one in five adults (19.2%) were likely to be experiencing some form of depression during the coronavirus (COVID-19) pandemic in June 2020; this had almost doubled from around 1 in 10 (9.7%) before the pandemic (July 2019 to March 2020).

  • One in eight adults (12.9%) developed moderate to severe depressive symptoms during the pandemic, while a further 6.2% of the population continued to experience this level of depressive symptoms; around 1 in 25 adults (3.5%) saw an improvement over this period.

  • Adults who were aged 16 to 39 years old, female, unable to afford an unexpected expense, or disabled were the most likely to experience some form of depression during the pandemic.

  • Feeling stressed or anxious was the most common way adults experiencing some form of depression felt their well-being was being affected, with 84.9% stating this.

  • Over two in five (42.2%) adults experiencing some form of depression during the pandemic said their relationships were being affected, compared with one in five (20.7%) adults with no or mild depressive symptoms.

Statistician's comment

“Today’s research provides an insight into the mental health of adults during the coronavirus pandemic. Revisiting this same group of adults before and during the pandemic provides a unique insight into how their symptoms of depression have changed over time.

Almost 1 in 5 adults were experiencing some form of depression during the pandemic, almost doubling from around one in 10 before the pandemic. Adults who were young, female, unable to afford an unexpected expense or disabled were the most likely to experience some form of depression during the pandemic.”

Tim Vizard, Principal Research Officer, Office for National Statistics

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2. Introduction

This article looks at depressive symptoms in adults in Great Britain before the coronavirus (COVID-19) pandemic (July 2019 to March 2020) and during the pandemic (June 2020). It looks at the same group of adults over a 12-month period, providing a unique perspective of how depression has changed over time.

Depression is among the most common types of mental disorders experienced by adults in Great Britain. It can affect people in different ways and can cause a wide variety of symptoms. These symptoms range from lasting feelings of unhappiness and hopelessness, to losing interest in the things they used to enjoy and feeling very tearful.

This article builds on research that suggests there has been an increase in levels of mental distress in adults during the coronavirus pandemic, compared with before the pandemic. Our analysis is based on data from the Opinions and Lifestyle Survey (OPN), a nationally representative survey of adults in Great Britain.

Adults taking part in the OPN were asked a series of questions to produce a score of depressive symptoms, using the eight-item Patient Health Questionnaire (PHQ-8) depression screener. This provides a self-reported measure of depression that gives an indication of the degree of an individual's depressive symptoms over the previous two weeks. These questions were asked of adults at two points in time over a 12-month period: before the coronavirus pandemic (July 2019 to March 2020) and during the coronavirus pandemic (June 2020). This means we can take a longitudinal look at whether their depressive symptoms had changed over time.

This article looks specifically at the characteristics of adults who were likely to be experiencing some form of depression before and during the pandemic. This is based on adults who reported having moderate to severe depressive symptoms, based on their response to the PHQ-8. Further information on how this has been calculated can be found in Section 8: Measuring the data.

In addition, this article looks at those adults who have experienced a change in depression before and during the pandemic. This includes adults who:

  • were likely to have developed moderate to severe depressive symptoms: having no or mild depressive symptoms before the pandemic and moderate to severe depressive symptoms during the pandemic

  • continued to have moderate to severe depressive symptoms: having moderate to severe symptoms both before and during the pandemic

  • have seen an improvement in depressive symptoms: having moderate to severe depressive symptoms before the pandemic and no to mild depressive symptoms during the pandemic

Finally, a logistic regression analysis has been conducted to look at the characteristics of adults likely to have some form of depression during the pandemic. This allows us to take a more detailed look at the characteristics of adults with depression while considering multiple characteristics at the same time.

Interpreting the findings in this report

When interpreting the findings in this release, it is important to note that the associations between characteristics and the presence of depression cannot explain causality. While the presence of a given characteristic may contribute to the development of depressive symptoms in adults, the presence of depression in adults may affect the characteristic in question. It is also important to note that there could be a variety of reasons for change in depressive symptoms before and during the pandemic, rather than this solely being a result of the coronavirus pandemic.

Further information on the PHQ-8, definitions of depression and regression analysis can be found in Section 8: Measuring the data.

Where to go for help

If you are affected by the topics covered in this article, the NHS provides useful information on the symptoms of depression and support available. Every Mind Matters also provides helpful advice on looking after your mental health during the coronavirus pandemic.

More about coronavirus

  • Find the latest on coronavirus (COVID-19) in the UK.
  • All ONS analysis, summarised in our coronavirus roundup.
  • View all coronavirus data.
  • Find out how we are working safely in our studies and surveys.

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    3. Symptoms of depression before and during the coronavirus pandemic

    Almost one in five adults (19.2%) were likely to be experiencing some form of depression, indicated by moderate to severe depressive symptoms, during the coronavirus (COVID-19) pandemic (June 2020). This had almost doubled from around 1 in 10 (9.7%) before the pandemic (July 2019 to March 2020).

    Looking at change in depressive symptoms before and during the pandemic, one in eight adults (12.9%) developed moderate to severe depressive symptoms during this period, while a further 6.2% of the population continued to experience this level of depressive symptoms. Around 1 in 25 adults (3.5%) saw an improvement over this period. Figure 1 illustrates the change of depressive symptoms in adults before and during the pandemic.

    Figure 1: Depressive symptoms before and during the coronavirus (COVID-19) pandemic

    Great Britain, July 2019 to June 2020

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    4. Characteristics of adults with depressive symptoms before and during the coronavirus pandemic

    Age

    Adults aged 16 to 39 years old were more likely than other adults to be experiencing some form of depression during the coronavirus (COVID-19) pandemic. Around one in three (31.0%) 16- to 39-year-olds experienced moderate to severe depressive symptoms during this time. This compared with one in nine (10.9%) before the pandemic (Figure 2).

    Looking at change in depressive symptoms before and during the pandemic, younger adults were more likely than other adults to have experienced an increase in moderate to severe depressive symptoms. Around one in five (22.8%) developed moderate to severe depressive symptoms during this period, with a further 8.2% continuing to experience this level of depressive symptoms. During this period, 1 in 40 (2.8%) saw an improvement in their depressive symptoms.

    Figure 2: Younger adults were more likely than other adults to have some form of depression during the coronavirus (COVID-19) pandemic

    Great Britain, July 2019 to June 2020

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    Sex

    Women were more likely than men to be experiencing some form of depression during the coronavirus pandemic. Figure 3 shows that almost a quarter of women (23.3%) experienced moderate to severe depressive symptoms during this time. This compared with one in eight (11.9%) before the pandemic.

    Looking at change in depressive symptoms before and during the pandemic, around one in six (15.3%) women developed moderate to severe depressive symptoms, with a further 8.0% continuing to experience this level of depressive symptoms during this period. In comparison, around 1 in 10 (10.5%) men developed moderate to severe depressive symptoms during this period, with a further 4.4% continuing to experience this level of depressive symptoms. There was no statistically significant difference between the rates of women and men developing moderate to severe depressive symptoms before and during the pandemic.

    Figure 3: Women were more likely than men to be experiencing some form of depression during the coronavirus (COVID-19) pandemic

    Great Britain, July 2019 to June 2020

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    Ability to afford an unexpected expense

    Adults were asked if their household could afford an unexpected but necessary expense of £850. This gives us an indication of adults who may be struggling financially. Adults who said their household could not afford this expense were more likely to be experiencing some form of depression during the pandemic, compared with adults who said their household was able to afford this expense. Figure 4 shows that just over one in three adults (34.9%) who could not afford this had moderate to severe depressive symptoms during the pandemic. This compared with one in five (21.1%) adults before the pandemic.

    Looking at change in depressive symptoms before and during the pandemic, adults who said they were unable to afford this unexpected expense were more likely to have experienced an increase in moderate to severe depressive symptoms than adults who said they could afford this expense. Around one in five (21.2%) adults developed moderate to severe depressive symptoms during this period, while 13.7% continued to experience this level of depressive symptoms during this time.

    Figure 4: Around one in three adults who were unable to afford an unexpected expense were likely to be experiencing some form of depression during the coronavirus (COVID-19) pandemic

    Great Britain, July 2019 to June 2020

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    Note

    1. Information on an individual’s ability to afford an unexpected expense is based on their response in June 2020 only because this information was not available before the pandemic.

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    Disability

    Disabled adults were more likely than non-disabled adults to be experiencing some form of depression during the pandemic. Around one in three (34.8%) disabled adults experienced moderate to severe depressive symptoms during the pandemic. There was no statistically significant difference compared with before pandemic (27.5%) (Figure 5).

    Looking at change in depressive symptoms before and during the pandemic, disabled adults were more likely than non-disabled adults to have experienced an increase in moderate to severe depressive symptoms. Around one in six (15.8%) disabled adults developed moderate to severe depressive symptoms during this period, with a further 19.0% continuing to experience this level of depressive symptoms.

    Figure 5: Around a third of disabled adults were experiencing moderate to severe depressive symptoms during the pandemic

    Great Britain, July 2019 to June 2020

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    Note

    1. Information on an individual’s disability status is based on their response in June 2020 only because this information was not available before the pandemic.

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    A recent publication on Coronavirus and the social impacts on disabled people highlights the experiences of disabled people during the pandemic, in terms of their personal well-being, loneliness and anxiety, in comparison to non-disabled people.

    Working status

    Of adults aged 16 to 64 years who had not worked in the seven days prior to completing the survey in June 2020, around one in four (26.6%) experienced moderate to severe depressive symptoms during the pandemic. This was similar to their rates of depressive symptoms before the pandemic (24.8%).

    In comparison, adults aged 16 to 64 years who had worked in the seven days prior to completing the survey in June 2020 saw an increase in moderate to severe depressive symptoms when compared with their symptoms of depression before the pandemic. Figure 6 shows that there was a similar increase in depressive symptoms for both key workers and non-key workers.

    Figure 6: There was an increase in the proportion of working adults experiencing some form of depression during the pandemic

    Great Britain, July 2019 to June 2020

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    Note

    1. Information on an individual’s working status in the past seven days is based on their response in June 2020 only because this information was not available before the pandemic.

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    Because of sample sizes, it has not been possible to analyse the impact of working adults who have been furloughed or had changes to their working hours as a result of the pandemic.

    Underlying health condition

    During the pandemic, 27.1% of adults with an underlying health condition experienced moderate to severe depressive symptoms, compared with 17.0% of adults without an underlying health condition.

    Household size

    Around one in five (19.0%) adults living with others experienced moderate to severe depressive symptoms during the pandemic, compared with one in 12 (8.1%) adults before the pandemic.

    Those living alone were more likely to experience depressive symptoms before the pandemic (15.1%) than those living with others (8.1%), but this was not the case during the pandemic, when similar proportions were observed.

    Parental status

    Around one in five (20.3%) adults with at least one child under the age of 16 years had depressive symptoms during the pandemic, increasing from 1 in 18 (5.8%) adults before the pandemic. Of these, 15.9% developed moderate to severe depressive symptoms during this period, while 4.4% continued to experience this level of depressive symptoms during this time.

    Country

    No statistically significant differences were found in depressive symptoms in England, Wales and Scotland.

    Rural Urban Classification

    No statistically significant differences were found in depressive symptoms in cities, towns, and suburbs and rural areas in Great Britain.

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    5. Well-being and loneliness of adults during the coronavirus pandemic

    Well-being

    Of adults experiencing some form of depression during the coronavirus (COVID-19) pandemic, four in five adults (80.0%) reported that the coronavirus pandemic was affecting their well-being (either in a positive or negative way). This compared with two in five (39.2%) adults with no or mild depressive symptoms.

    Figure 7 shows the six aspects of well-being with the biggest percentage point differences between adults experiencing moderate to severe depressive symptoms during the coronavirus pandemic and those experiencing no to mild depressive symptoms. Of those who said the coronavirus pandemic was affecting their well-being, 84.9% with moderate to severe depressive symptoms reported feeling stressed or anxious, compared with just over half (52.3%) of those with no or mild depressive symptoms.

    Figure 7: Feeling stressed or anxious was the most common way adults experiencing some form of depression felt their well-being was being affected

    Great Britain, June 2020

    Base: Adults who reported their well-being was being affected by the coronavirus (COVID-19) pandemic

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    Figure 8 shows that more than half of adults with moderate to severe depressive symptoms (58.0%) reported high anxiety (a score of between 6 and 10) during the coronavirus pandemic, compared with just over a quarter (25.8%) of adults with no or mild depressive symptoms.

    Analysis by the Office for National Statistics (ONS) has previously looked at the factors most strongly associated with high levels of anxiety during the pandemic. More information on Coronavirus and anxiety is available.

    Figure 8: More than half of adults experiencing some form of depression had high levels of anxiety during the coronavirus (COVID-19) pandemic

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    Loneliness

    Of those experiencing moderate to severe depressive symptoms during the pandemic, 61.7% reported that they felt lonely "often or always", compared with 14.9% of those with no or mild depressive symptoms. Recent analysis by the ONS also found that adults who felt lonely "often or always" in the past seven days had lower personal well-being scores and higher levels of anxiety. Further information is available in the Coronavirus and loneliness article.

    Perceived "impact of coronavirus" on different aspects of life

    Adults were also asked "In which way is the coronavirus (COVID-19) outbreak affecting your life?". Figure 9 shows the six areas of life with the biggest percentage point differences in adults experiencing some form of depression during the coronavirus pandemic and the rest of the adult population.

    Adults experiencing moderate to severe depressive symptoms during the pandemic were more likely to report their relationships were being affected (42.2%) than those with no or mild depressive symptoms (20.7%). Over a third (35.1%) of adults with moderate to severe depressive symptoms said that access to health care and treatment for non-coronavirus-related issues was being affected, compared with 21.5% of adults with no or mild depressive symptoms.

    Figure 9: Four in five adults experiencing some form of depression said their well-being was being affected during the coronavirus pandemic

    Base: All adults

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    6. Factors associated with adults experiencing some form of depression during the coronavirus pandemic

    Regression analysis was used to assess the presence and strength of association in adults experiencing some form of depression during the coronavirus (COVID-19) pandemic and their personal characteristics and circumstances.

    These results show differences within sub-groups of the population while controlling for 9 personal characteristics and circumstances. A full list of these characteristics can be found in the Coronavirus and depression in adults in Great Britain dataset. For more information on the regression technique used, please see Section 8: Measuring the data.

    Presence of moderate to severe depressive symptoms in adults during the coronavirus pandemic (June 2020)

    Regression analysis indicated four characteristics and circumstances were associated with moderate to severe depressive symptoms during the pandemic (June 2020):

    • age: adults aged 16 to 39 years were more likely to have moderate to severe depressive symptoms when compared with other adults

    • sex: women were more likely than men to report moderate to severe depressive symptoms, with women having 1.7 times the odds of men

    • finance: the odds of adults unable to afford an unexpected but necessary expense of £850 reporting moderate to severe depressive symptoms were around four times greater (4.4) than those able to afford this expense

    • disability: the odds of adults who were classified as disabled reporting moderate to severe depressive symptoms were six times greater (6.0) than those who were not classed as disabled

    Figure 10 presents the characteristics and circumstances associated with moderate to severe depressive symptoms during the pandemic (June 2020), along with odds ratios to explain the strength of association.

    Figure 10: Factors associated with the presence of moderate to severe depressive symptoms during the coronavirus (COVID-19) pandemic

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    Change in moderate to severe depressive symptoms before and during the pandemic

    Regression analysis indicated three factors were associated with a change in moderate to severe depressive symptoms before and during the pandemic (between July 2019 and June 2020). This provides an indication of the types of adults who have seen a change in depressive symptoms during this period. The regression analysis found the following factors to be associated with developing moderate to severe depressive symptoms during this period:

    • age: adults aged 16 to 39 years were more likely to have developed moderate to severe depressive symptoms during this period when compared with other adults

    • finance: the odds of adults who were unable to afford an unexpected but necessary expense of £850 developing moderate to severe depressive symptoms during this period were over three times greater (3.7) than those able to afford this expense

    • disability: the odds of adults who were classified as disabled developing moderate to severe depressive symptoms during this period were twice (2.2) those who were not classed as disabled

    Figure 11 presents the factors associated with developing moderate to severe depressive symptoms during this period, along with odds ratios to explain the strength of association.

    Figure 11: Factors associated with the development of moderate to severe depressive symptoms before and during the Coronavirus (COVID-19) pandemic

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    7. Glossary

    Depression

    Depression is among the most common types of mental disorders experienced by adults in Great Britain. It can affect people in different ways and can cause a wide variety of symptoms. These symptoms range from lasting feelings of unhappiness and hopelessness to losing interest in the things they used to enjoy and feeling very tearful. Further information can be found on the NHS website.

    Disability

    The definition of disability used is consistent with the core definition of disability in the Equality Act 2010. A person is considered to have a disability if they have a long-standing illness, disability or impairment that causes difficulty with day-to-day activities.

    This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.

    Ability to afford an unexpected expense

    Adults were asked if their household could afford an unexpected but necessary expense of £850. This gives us an indication of adults who may be struggling financially.

    This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.

    Underlying health condition

    An underlying health condition is a chronic or long-term illness that can cause the individual to be more at risk of the coronavirus (COVID-19) infection. This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.

    Working status

    For this article, a person is said to be a "working adult" if:

    • they had a paid job, either as an employee or self-employed

    • they did any casual work for payment

    • they did any unpaid or voluntary work in the previous week

    Working adults were split into self-reported key worker and non-key worker status, provided during information collected in June 2020.

    Adults who were not working were split into those who were aged 16 to 64 years old and those aged 65 years and older.

    This was based on information collected in wave 2 of data collection in June 2020. This was because the information was not available at wave 1 of data collection. This should be considered when assessing change over time.

    Rural Urban Classification

    The Rural Urban Classification is an official statistic used to distinguish rural and urban areas. The Classification defines areas as rural if they are outside settlements with more than 10,000 resident population. Further information can be found in Rural Urban Classification.

    Household size

    Household size is a binary measure to indicate those who were living alone or living with others when they completed the survey. This measure was captured before (between July 2019 and March 2020) and during (June 2020) the coronavirus pandemic.

    Parental status

    Parental status is a binary measure to indicate those who had no children under the age of 16 years or at least one child under the age of 16 years.

    This was based on information collected in June 2020. This was because the information was not available during data collection in July 2019 to March 2020. This should be considered when assessing change over time.

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    8. Measuring the data

    Opinions and Lifestyle Survey

    Analysis in this report was based on the Opinions and Lifestyle Survey (OPN). Interviews initially took place between July 2019 and March 2020, with data collection taking place via telephone interview. Additional interviews took place between 4 and 14 June 2020, which was an online survey with an option for telephone interviewing for those unable to take part online. An achieved sample of 3,527 adults took place with data weighted to be a nationally representative sample for Great Britain.

    More quality and methodology information on strengths, limitations, appropriate uses, and how the data were created is available in the OPN QMI.

    Defining depression in adults

    Adults taking part in the OPN were asked a series of questions to produce a score of depressive symptoms, using the eight item Patient Health Questionnaire (PHQ-8) depression screener. This is an established measure of depression that assesses the degree of an individual's depressive symptoms over the previous two weeks. These questions were asked of adults at two points in time over a 12-month period: before the coronavirus pandemic (July 2019 to March 2020) and during the coronavirus pandemic (June 2020).

    The depression score is derived using eight questions from the PHQ-8. Respondents were asked the following eight questions, with four response options ranging from zero to three:

    • Over the last two weeks, how often have you been bothered by having little interest or pleasure in doing things?

    • Over the last two weeks, how often have you been bothered by feeling down, depressed or hopeless?

    • Over the last two weeks, how often have you been bothered by having trouble falling or staying asleep, or sleeping too much?

    • Over the last two weeks, how often have you been bothered by feeling tired or having little energy?

    • Over the last two weeks, how often have you been bothered by having a poor appetite or overeating?

    • Over the last two weeks, how often have you been bothered by feeling negative about yourself or that you are a failure or have let yourself or your family down?

    • Over the last two weeks, how often have you been bothered by having trouble concentrating on things, such as reading the newspaper or watching television?

    • Over the last two weeks, how often have you been bothered by moving or speaking so slowly that other people could have noticed; or being so fidgety or restless that you have been moving around a lot more than usual?

    The score is then derived by summing all responses chosen, resulting in a score ranging from 0 to 24, which could be interpreted as follows:

    • 0 to 4 - no depression

    • 5 to 9 - mild depression

    • 10 to 14 - moderate depression

    • 15 to 19 - moderately severe depression

    • 20 or more - severe depression

    According to the NHS, adults with a PHQ-8 score of 10 or more are likely to be experiencing some form of depression. Therefore, adults have been grouped into those receiving a score of 10 or more (referred to as moderate to severe depressive symptoms in this article) and those experiencing a score of zero to nine (referred to as no or mild depressive symptoms in this article).

    In addition, this article looks at those adults who have experienced a change in depression before and during the pandemic (July 2019 to June 2020). This includes adults who:

    • were likely to have developed moderate to severe depressive symptoms, indicated by a score of 0 to 9 before the pandemic and 10 or more during the pandemic

    • continued to have moderate to severe depressive symptoms, indicated by a score of 10 or more before and during the pandemic

    • have seen an improvement in depressive symptoms, indicated by a score of 10 or more before the pandemic and a score of zero to nine during the pandemic

    Regression model

    Two binomial logistic regression models were produced to explain the relationships between the presence and development of moderate to severe depressive symptoms and a range of factors. The logistic regression models allow us to explore which factors remain associated with moderate to severe depressive symptoms, while controlling for multiple factors at the same time, and how the likelihood of having some form of depression differs for each level within a factor (indicated by odds ratios).

    Each model was produced based on nine factors of interest and a further two factors to control for mode of data collection and time of year of interview. These nine factors can be found in the accompanying dataset. Prior to selection of these factors, a test for multicollinearity was conducted to ensure factors in the model were not highly correlated with each other (potentially leading to biased outcomes in the model). All factors were included in the final model, to identify which factors were associated with moderate to severe depressive symptoms in adults. Data were also weighted prior to entering the logistic regression model to account for non-response bias and to sum to population totals.

    Statistical significance

    This article presents a summary of results, with further data including confidence intervals for the estimates contained in the associated datasets. Where comparisons between groups are presented, 95% confidence intervals should be used to assess the statistical significance of the change.

    For the regression analysis, factors were found to be significant based on the p-value associated (Wald Chi-Squared Test) with each factor. The odds ratios were then assessed alongside a confidence interval around each category of interest.

    Causality

    It is important to note that the associations between characteristics in this article and the presence of depressive symptoms cannot explain causality. While the presence of a given characteristic may contribute to the development of depressive symptoms in adults, the presence of depressive symptoms in adults may affect the characteristic in question.

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    9. Strengths and limitations

    The main strengths of this analysis include:

    • collecting data from the same group of adults before and during the pandemic has enabled longitudinal analysis of the likelihood of some form of depression in adults before the pandemic and during the pandemic

    • the use of the Patient Health Questionnaire (PHQ-8) provides a robust measure of the presence of some form of depression in the population

    • robust methods are adopted for the survey's sampling and weighting strategies to limit the impact of bias

    • quality assurance procedures are undertaken throughout the analysis stages to minimise the risk of error

    The main limitations of this analysis include:

    • the sample sizes for some groups of the population are relatively small, particularly for younger adults, which means that confidence intervals around some estimates are larger, providing less certainty around the estimate; consequently, detailed analyses for subnational geographies and some sub-groups are not possible

    • data collected before the pandemic (July 2019 to March 2020) were achieved via a telephone interview, while data collected during the pandemic (June 2020) were predominantly online, with an option for telephone interview where online data collection was not possible; this means mode of data collection may have had an effect on the response given by adults to the survey questions

    • some characteristics of adults were based on outcomes of adults during data collection in June 2020 because the information was not available at their first interview in July 2019 to March 2020; it is possible that their characteristics may have been different between these two periods, these characteristics are mentioned in the glossary section of this article

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    Contact details for this Article

    Tim Vizard, Jodie Davis, Emmie White, Bella Beynon
    policy.evidence.analysis@ons.gov.uk
    Telephone: +44 (0)1633 455278