# Trajectories of depression and anxiety in adults with rare disorders across 13 months during the COVID-19 pandemic

## TL;DR

This study tracked mental health in adults with rare disorders during the pandemic and found consistently high anxiety and depression levels.

## Contribution

The study provides longitudinal mental health data for adults with rare disorders during the pandemic, revealing stable elevated symptoms.

## Key findings

- Anxiety and depression levels remained elevated and stable over 13 months during the pandemic.
- Covid fear was significantly associated with higher levels of anxiety and depression.
- Pandemic restrictions did not predict changes in mental health symptoms.

## Abstract

Adults with rare disorders experience multiple psychosocial risk factors beyond their medical symptoms, including impaired quality of life, social isolation, loneliness, and mental health problems. These risk factors were amplified during the COVID-19 pandemic, when health care appointments and social/vocational activities were reduced or cancelled. There is a lack of longitudinal data tracking this population over time, making the long term consequences uncertain.

We conducted a monthly survey of 58 adults aged between 19 and 71 years (M = 45.1 years, SD = 12.6) with rare disorders across 13 months during the COVID-19 pandemic in Norway. We measured symptoms of anxiety and depression with the Hopkins Symptom Checklist-5. Covid fear was measured with the Coronavirus Anxiety Scale. We examined the mental health and covid fear trajectories across the 13 months with multi-level growth curve models with repeated measures at Level 1 and individuals at Level 2. To account for differences in governmental restrictions throughout the 13 months, we used the stringency index from The Oxford Covid-19 Government Response Tracker.

The growth models indicated stable levels of anxiety and depression over 13 months that were elevated compared to existing population data and were unpredicted by pandemic restrictions. The level of covid fear was significantly associated with the levels of anxious and depressive symptoms.

The current study found elevated and stable trajectories of mental health symptoms throughout the pandemic for persons with rare disorders. This highlights the necessity of investigating the long-lasting influence of the pandemic on mental health among individuals with rare disorders.