ArticleJMIR mental health2020
Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders Are Associated With Alterations in Mental Health Search Behavior in the United States.
Article in JMIR mental health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
99 citing papers in PubMed, 5 syntheses or guidelines pooled it, 202 citations in OpenAlex.
- Digital phenotyping for predicting relapse in psychiatric disorders: a systematic review of passive sensing approaches.BMC psychiatry · 2026Pooled it
- What can internet users' behaviours reveal about the mental health impacts of the COVID-19 pandemic? A systematic review.Public health · 2021Pooled it
- Suicide, self-harm and thoughts of suicide or self-harm in infectious disease epidemics: a systematic review and meta-analysis.Epidemiology and psychiatric sciences · 2021Pooled it
- Investigating the effect of national government physical distancing measures on depression and anxiety during the COVID-19 pandemic through meta-analysis and meta-regression.Psychological medicine · 2021Pooled it
- The impact of the COVID-19 pandemic on self-harm and suicidal behaviour: update of living systematic review.F1000Research · 2020Pooled it
- Effectiveness of Mobile Applications for Suicide Prevention: A Systematic Review and Meta-Analysis.Behavioral sciences (Basel, Switzerland) · 2025Review
- The effect of emotion regulation training on anxiety in college students in Egypt (Randomized control trial).Journal of public health research · 2025Article
- Promises and Pitfalls of Internet Search Data in Mental Health: Critical Review.JMIR mental health · 2025Review
- A cross-sectional investigation on remote working, loneliness, workplace isolation, well-being and perceived social support in healthcare workers.BJPsych open · 2024Article
- The relationship between academic stress and depression among college students during the COVID-19 pandemic: a cross-sectional study from China.BMC psychiatry · 2024Article
- Do Scholars Respond Faster Than Google Trends in Discussing COVID-19 Issues? An Approach to Textual Big Data.Health data science · 2024Article
- Association between COVID-19-related loneliness or worry and symptoms of anxiety and depression among first-year college students.Journal of American college health : J of ACH · 2023Article
- Examining the Relationships Between Fear of Coronavirus, State Anxiety, and Relationship Happiness Among Married Turkish Individuals During COVID-19.Journal of family issues · 2023Article
- The Effectiveness of Virtual Reality Intervention for COVID-19-Related Psychological Distress: A Systematic Review.Psychiatry investigation · 2023Article
- Moderation effects of loneliness between fatalism and wellbeing during the COVID-19 pandemic.Scientific reports · 2023Article
- Evaluating the Impact of Mask Mandates and Political Party Affiliation on Mental Health Internet Search Behavior in the United States During the COVID-19 Pandemic: Generalized Additive Mixed Model Framework.Journal of medical Internet research · 2023Article
- Becoming a secondary actor of one's own life: A qualitative study of the experiences of informal caregivers in the care of people with chronic pain.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- A global portrait of expressed mental health signals towards COVID-19 in social media space.International journal of applied earth observation and geoinformation : ITC journal · 2023Article
- Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic: Results of a web-based multinational cross-sectional study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023Article
- Delivering a psychosocial program for older people living in retirement homes during the Covid-19 pandemic: A process evaluation and recommendations for community interventions.Journal of community psychology · 2023Article
39 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe coronavirus disease (COVID-19) has led to dramatic changes worldwide in people's everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health.
objectiveThe goal of this study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries on a national scale.
methodsIn the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, 11 of the 50 states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the United States allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. This paper examines the changes in mental health search queries on Google between March 16-23, 2020, across each state and Washington, DC. Specifically, this paper examines differential changes in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. The participants were all the people who searched mental health terms in Google between March 16-23. Between March 16-23, 11 states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation.
resultsAnalyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances, with the most prominent flattening associated with suicidal ideation and anxiety.
conclusionsThese results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediate leveling off following the issuance of stay-at-home orders.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.