Skip to main content

Table 4 Results of subgroup analyses for those populations and outcomes with at least k = 4 studies in main analysis

From: Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses

Subgroup analysis (subgroups)

Outcome

Test for subgroup differencesa

Population

Subgroup difference: elevated effectb

Subgroup difference: reduced effectb

Population characteristics (main studies)

Age

• 30 years

• > 30 ≤ 35 years

• > 35 ≤ 40 years

• > 40 ≤ 45 years

• multiple age groups

• age not specified

Anxiety

Chi2 = 9.5, df = 5 (p = .09)

GP

/

/

Depression

Chi2 = 29.3, df = 5 (p < .001)

GP

≤30 years; > 40 ≤ 45 years

/

Stress

Chi2 = 1043.3, df = 4 (p < .001)

GP

/

> 40 ≤ 45 years

Anxiety

Chi2 = 8.7, df = 4 (p = .07)

HCW

/

/

Depression

Chi2 = 2.2, df = 1 (p = .14)

HCW

/

/

Sleep

Chi2 = 0.3, df = 1 (p = .57)

HCW

/

/

Anxiety

Chi2 = 17.14, df = 4 (p = .002)

P

> 40 ≤ 45 years

 

Depression

Chi2 = 3.74, df = 4 (p = .44)

P

/

/

Stressor exposure

• General population

• Students

• Others

• Special exposure

Anxiety

Chi2 = 2.8, df = 3 (p = .42)

GP

/

/

Depression

Chi2 = 1.9, df = 3 (p = .60)

GP

/

/

Stress

Chi2 = 0.12, df = 3 (p = .99)

GP

/

/

Covid-19 patient contact

• Low contact risk

• High contact risk

Anxiety

Chi2 = 0, df = 1 (p = .95)

HCW

/

/

Depression

Chi2 = 1.0, df = 1 (p = .31)

HCW

/

/

Sleep

Chi2 = 0.2, df = 1 (p = .69)

HCW

/

/

Subgroup of patients

• COVID-19 patients

• Pregnant women

• Psychiatric patients

Anxiety

Chi2 = 0.3, df = 2 (p = .88)

P

/

/

Depression

Chi2 = 1.3, df = 2 (p = .51)

P

/

/

Pandemic study characteristics

Survey startc

• ≤4 weeks

• > 4 ≤ 6 weeks

• > 6 ≤ 8 weeks

• > 8 weeks

• not specified

Anxiety

Chi2 = 3.55, df = 4 (p = .47)

GP

/

/

Depression

Chi2 = 10.15, df = 4 (p = .04)

GP

> 8 weeks

/

Stress

Chi2 = 0.31, df = 4 (p = .99)

GP

/

/

Anxiety

Chi2 = 7.91, df = 4 (p = .10)

HCW

/

/

Depression

Chi2 = 0.95, df = 2 (p = .62)

HCW

/

/

Sleep

Chi2 = 4.21, df = 2 (p = .12)

HCW

/

/

Anxiety

Chi2 = 4.58, df = 2 (p = .10)

P

/

/

Depression

Chi2 = 3.08, df = 3 (p = .38)

P

/

/

Study conduction China

• China

• Non-China

Anxiety

Chi2 = 0.10, df = 1 (p = .75)

GP

/

/

Depression

Chi2 = 0.60, df = 1 (p = .44)

GP

/

/

Stress

Chi2 = 0.10, df = 1 (p = .76)

GP

/

/

Anxiety

Chi2 = 2.84, df = 1 (p = .09)

HCW

/

/

Depression

Chi2 = 0.08, df = 1 (p = .78)

HCW

/

/

Sleep

Chi2 = 0.32, df = 1 (p = .57)

HCW

/

/

Anxiety

Chi2 = 3.35, df = 1 (p = .07)

P

/

/

Depression

Chi2 = 0.62, df = 1 (p = .43)

P

/

/

Outcome measure

• AIS

• BDI

• DASS-21

• EDPS

• EPDS-3A

• GAD-2; GAD-7

• HADS

• HAMA

• HAMD

• ISI

• PHQ-2; PHQ-9

• PSQI

• PSS

• SAS

• SDS

• SCL-90

• STAI-Y

Anxiety

Chi2 = 10.7, df = 6 (p = .10)

GP

/

/

Depression

Chi2 = 11.46, df = 5 (p = .04)

GP

PHQ-2

/

Stress

Chi2 = 0.16, df = 1 (p = .69)

GP

/

/

Anxiety

Chi2 = 2.80, df = 4 (p = .59)

HCW

/

/

Depression

Chi2 = 2.91, df = 3 (p = .41)

HCW

/

/

Sleep

Chi2 = 0.32, df = 1 (p = .57)

HCW

/

/

Anxiety

Chi2 = 1.18, df = 4 (p = .88)

P

/

/

Depression

Chi2 = 16.95, df = 5 (p = .005)

P

SDS; PHQ-9

/

Sample size

• < 1000

• ≥1000

Anxiety

Chi2 = 1.86, df = 1 (p = .17)

GP

/

/

Depression

Chi2 = 0.03, df = 1 (p = .86)

GP

/

/

Stress

Chi2 = 2.31, df = 1 (p = .13)

GP

/

/

Anxiety

Chi2 = 2.83, df = 1 (p = .09)

HCW

/

/

Depression

Chi2 = 0, df = 1 (p = .96)

HCW

/

/

Sleep

not possible

HCW

/

/

Anxiety

Chi2 = 3.60, df = 1 (p = .06)

P

/

/

Depression

Chi2 = 0.09, df = 1 (p = .77)

P

/

/

Comparative study characteristics

Sample size

• ≤500

• > 1000 ≤ 5000

• > 5000 ≤ 10,000

• > 10,000

Anxiety

Chi2 = 0.9, df = 3 (p = .83)

GP

/

/

Depression

Chi2 = 3.5, df = 4 (p = .48)

GP

/

/

Stress

Chi2 = 8.6, df = 3 (p = .03)

GP

/

> 5000 ≤ 10,000 participants

Anxiety

Chi2 = 9.93, df = 3 (p = .02)

HCW

> 5000 ≤ 10,000 participants

 

Depression

Chi2 = 4.3, df = 2 (p = .12)

HCW

/

/

Sleep

Chi2 = 0.3, df = 1 (p = .57)

HCW

/

/

Anxiety

Chi2 = 0.1, df = 2 (p = .97)

P

/

/

Depression

Chi2 = 3.9, df = 2 (p = .14)

P

/

/

Publication year

• ≤1 year ago

• ≤2 years ago

• > 2 ≤ 5 years ago

• > 5 ≤ 10 years ago

• > 10 years ago

Anxiety

Chi2 = 8.0, df = 5 (p = .16)

GP

/

/

Depression

Chi2 = 12.4, df = 5 (p = .03)

GP

> 10 years ago

/

Stress

Chi2 = 11.6, df = 4 (p = .02)

GP

/

≤1 year ago

Anxiety

Chi2 = 14.5, df = 3 (p = .002)

HCW

> 10 years ago

≤2 years ago

Depression

Chi2 = 4.6, df = 1 (p = .03)

HCW

/

≤2 years ago

Sleep

not possible

HCW

/

/

Anxiety

Chi2 = 0.1, df = 2 (p = .94)

P

/

/

Depression

Chi2 = 17.0, df = 5 (p = .005)

P

≤1 year ago; > 5 ≤ 10 years ago

/

Pandemic and comparative study characteristics

Relationship samples sizesd

• Ratio ≥ 2

• Ratio ≥ 0.5 < 2

• Ratio ≥ 0.1 < 0.5

• Ratio < 0.1

Anxiety

Chi2 = 10.0, df = 3 (p = .02)

GP

Ratio ≥ 0.5 < 2

/

Depression

Chi2 = 4.8, df = 3 (p = .19)

GP

/

/

Stress

Chi2 = 0.4, df = 2 (p = .84)

GP

/

/

Anxiety

Chi2 = 4.2, df = 2 (p = .12)

HCW

/

/

Depression

Chi2 = 3.8, df = 2 (p = .15)

HCW

/

/

Sleep

Chi2 = 0.32, df = 1 (p = .57)

HCW

/

/

Anxiety

Chi2 = 17.7, df = 3 (p < .001)

P

Ratio ≥ 0.5 < 2; Ratio < 0.1

/

Depression

Chi2 = 3.0, df = 3 (p = .39)

P

/

/

  1. Abbreviations: AIS Athens Insomnia Scale, BDI Beck Depression Inventory, DASS-21 Depression Anxiety Stress Scale-21, df degrees of freedom, EPDS Edinburgh Postnatal Depression Scale, EPDS-3A Edinburgh Postnatal Depression Scale-Anxiety subscale, GAD Generalized Anxiety Disorder Scale, GP general population, HADS Hospital Anxiety and Depression Scale, HAMA Hamilton Anxiety Rating Scale, HAMD Hamilton Depression Rating Scale, HCW healthcare workers, p p value, P patients, PHQ Patient Health Questionnaire, PSS Perceived Stress Scale, SAS Self-Rating Anxiety Scale, SCL-90 Symptom Checklist-90, SDS Zung Self-Rating Depression Scale, STAI-Y, State Trait Anxiety Inventory-Y
  2. a Chi2 = test for subgroup differences
  3. b ordered by size of effect estimate (SMD)
  4. c since first COVID-19 cases in the respective country or, in case of China, since January 20, 2020
  5. d ratio of sample size in pandemic study vs comparative study