Networks of patients, families and friends affected by 1918 pandemic equally affect young and old, scientists discover
Study on pandemic’s impact on families shows depression, anxiety this year worse than in the first wave
A study of the 1918 Spanish flu pandemic has confirmed “substantial, and in some cases severe, effects” on the psychological well-being of its patients, especially in younger people.
The age group most affected was younger adults, those aged between 16 and 35, almost double the proportion of people aged 16 to 49 with poor mental health, according to the study, to be published in the journal Nature Medicine.
A report in the British Medical Journal in June said just 9% of sufferers in Britain were aged 50 or older.
The team of researchers at Stanford University in California, said: “I was surprised by the size of the association between age and poor mental health.”
Each of the two epidemiological subgroups analysed showed similar levels of mental health consequences, ranging from depression to anxiety to a higher than average suicide rate.
Sue Town and her son Samuel, 65, in California. Samuel had a fairytale childhood but retired and the family’s finances were poor, Sue says. Photograph: Martin Godwin for the Guardian
“Historically we thought that people over 60 were immune to this, but we’ve found that there were noticeable effects at a very young age.”
However, the researchers found no correlation between older people and poorer mental health compared with their peers from the younger groups, suggesting that many were not suitable candidates for care in long-term psychological rehabilitation.
The study, which analyses the physical and mental well-being of people living through the pandemic, tracked more than 650 people who in 1918 were treated in a San Francisco children’s hospital at the time, and 1,000 people who lived through the pandemic and met criteria for diagnoses of depression and anxiety, with controls.
The team found that the “permanent increase in mental health vulnerability” experienced by the higher age groups may have been associated with symptoms of future chronic disease and poor health status. They concluded that the way in which children, adolescents and younger adults accessed mental health services at the time of the pandemic, as well as their reports of psycho-social care among the carers of their relatives, could have contributed to the effect.
The last census found that 44% of the UK population was under 16 and most sufferers were young women, according to the report. The report noted: “Numerous institutional settings with permanent deprivations of access to healthcare including primary, community and remand hospitals, mental hospitals, children’s homes, workhouses, reformatories and psychiatric institutions, were established in the UK during the pandemic.”
The study found that the depression and anxiety affected both men and women differently. “Certain types of depression among those who were younger tended to be milder and prone to recovering quickly, while those with severe forms were seen as having lifelong effects,” the authors said.
It found no evidence that parental involvement with the treatment of their children had any significant effect on the mental health of children. The researchers said the finding that that a greater proportion of young adults under 35 were affected by depression or anxiety suggests that “individuals more likely to encounter such depression may have less opportunities to be educated in coping with such symptoms”.
The paper authors did not believe the impact of the pandemic was continuing today. “Since the first wave was mostly in children, it may be that now children are more healthy than in 1918 and so not seeking help,” said Town.
The report suggests that the risks of having a mental health problem should be considered in the decision-making process of support for families and relationships.