Mental-health before and during the COVID-19 pandemic in adults with neurodevelopmental disorders

Amy Shakeshaft, Rachel Blakey, Alex Siu Fung Kwong, Lucy Riglin, George Davey Smith, Evangelia Stergiakouli , Kate M Tilling, Anita Thapar*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

2 Citations (Scopus)


The COVID-19 pandemic negatively impacted mental health globally. Individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), are at elevated risk of mental health difficulties. We investigated the impact of the pandemic on anxiety, depression and mental wellbeing in adults with NDDs using data from the Avon Longitudinal Study of Parents and Children (n = 3058). Mental health data were collected pre-pandemic (age 21–25) and at three timepoints during the pandemic (ages 27–28) using the Short Mood and Feelings Questionnaire, Generalized Anxiety Disorder Assessment-7, and Warwick Edinburgh Mental Wellbeing Scale. ADHD and ASD were defined using validated cut-points of the Strengths and Difficulties Questionnaire and Autism Spectrum Quotient, self-reported at age 25. We used multi-level mixed-effects models to investigate changes in mental health in those with elevated ADHD/ASD traits compared to those without. Prevalences of depression, anxiety and poor mental wellbeing were higher at all timepoints (pre-pandemic and during pandemic) in those with ADHD and ASD compared to those without. Anxiety increased to a greater extent in those with ADHD (β = 0.8 [0.2,1.4], p = 0.01) and ASD (β = 1.2 [-0.1,2.5], p = 0.07), while depression symptoms decreased, particularly in females with ASD (β = −3.1 [-4.6,-1.5], p = 0.0001). On average, mental wellbeing decreased in all, but to a lesser extent in those with ADHD (β = 1.3 [0.2,2.5], p = 0.03) and females with ASD (β = 3.0 [0.2,5.9], p = 0.04). To conclude, anxiety disproportionately increased in adults with NDDs during the pandemic, however, the related lockdowns may have provided a protective environment for depressive symptoms in the same individuals.
Original languageEnglish
Pages (from-to)230-239
Number of pages10
JournalJournal of Psychiatric Research
Early online date30 Jan 2023
Publication statusPublished - 1 Mar 2023

Bibliographical note

Funding Information:
The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z ) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and AT and KT will serve as guarantors for the contents of this paper. This research was funded in whole, or in part, by the Wellcome Trust ( 204895/Z/16/Z ). For the purpose of Open Access, the author has applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. A comprehensive list of grants funding is available on the ALSPAC website ( ). ES, RB and KT work in a unit that receives funding from the University of Bristol and the UK Medical Research Council ( MC_UU_00011/1 and MC_UU_00011/3 ).

Publisher Copyright:
© 2023 The Authors

Structured keywords

  • Bristol Population Health Science Institute


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