A global longitudinal study of social-ecological factors affecting depression and anxiety during COVID-19

• Within the study sample, depression and anxiety levels were overall stable and low over the first 15 months of the pandemic. • Most (79%) respondents reported low-to-moderate distress levels. • Reported levels of household chaos were also stable across the study period. • Factors associated with anxiety and depression were at individual, relational, community and societal levels. This study models depression and anxiety over time and the effect of individual, relational, community and societal-level predictors during the initial COVID-19 outbreak, to explore important factors for research or clinical practice. Pre-registered analysis was conducted on longitudinal survey data from The Global Social Trust and Mental Health Study conducted between April 2020 and July 2021. There were 2345 respondents with data available for analysis across 6 continents (70.6 % female, 24.7 % male, mean age 36.4 years). Anxiety and depression symptoms were stable and low (below clinical cut-offs) on average. Random Intercept Cross-lagged Panel Models and Latent Transition Analysis estimated the effects of parental status, household chaos, household crowding, outdoor access, demographic variables, and lockdown stringency on depression and anxiety symptoms. In line with the Social Ecological Model, multi-level factors were associated with anxiety and depression. Female gender, younger age, non-marginalised ethnicity, lower socioeconomic status, not being a parent, higher household chaos, less outdoor access and lower lockdown stringency were associated with the greater levels of depression and anxiety across the study.