Depression and anxiety increased by a quarter worldwide in 2020, study says

By Samuel Lovett
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Global cases of depression and anxiety increased by more than a quarter throughout 2020 due to the pandemic, with countries hardest hit by Covid-19 and lockdown restrictions most affected, according to new research.

Scientists collected and assessed data from pre-existing studies to estimate the impact of Covid on the mental health of the world population, concluding that there was an additional 53 million cases of major depressive disorders and 76 million cases of anxiety last year.

Women and younger people were disproportionately affected, while countries that recorded high infection rates and experienced major reductions in the movement of people – a result of lockdown – had the greatest increases in prevalence of these conditions.

Lead author Dr Damian Santomauro, of the Queensland Centre for Mental Health Research, said the findings of the report, published in The Lancet, highlighted “an urgent need to strengthen mental health systems in order to address the growing burden of major depressive disorder and anxiety disorders worldwide.

“Meeting the added demand for mental health services due to Covid-19 will be challenging, but taking no action should not be an option,” he added.

In the absence of the pandemic, model estimates suggest there would have been 193 million cases of depression and 298 million cases of anxiety. However, the study estimates that these figures rose by 28 per cent and 26 per cent respectively last year, with women accounting for the bulk of these increases.

Until now, no studies had analysed the global impact of the pandemic on the prevalence of these mental health disorders in 2020. Most previous work consisted of surveys in specific locations over a short time period.

The research led by Dr Santomauro drew from 48 studies, most of which had been conducted in western Europe (22) and North America (14), with others from Australasia (5), Asia Pacific (5), East Asia (2), and central Europe (1).

Using a disease modelling meta-analysis tool, data from the studies was used to estimate changes in prevalence of depressive and anxiety disorders due to Covid based on age, sex and location – including in those nations for which no eligible studies were available.

Younger people were more affected by mental health disorders than older age groups, the research found. There was an additional 1,118 cases of depression per 100,000 people aged 20 to 24, and an additional 1,331 cases of anxiety.

Co-author Alize Ferrari, of the Queensland Centre for Mental Health Research, said: “The Covid-19 pandemic has exacerbated many existing inequalities, and social determinants of mental health.

“Sadly, for numerous reasons, women were always more likely to be worse affected by the social and economic consequences of the pandemic. Additional caring and household responsibilities tend to fall on women, and because women are more likely to be victims of domestic violence, which increased at various stages of the pandemic.”

The authors acknowledged that their study was limited by a lack of high quality data on the effects of the pandemic on mental health in many parts of the world, particularly low- and middle-income countries.

As a result, they say extrapolated estimates generated for countries where data was lacking should be interpreted with caution.

Most available data was based on self-reported symptom scales that only estimate probable cases of major depressive disorder and anxiety disorders.

In a joint comment, Dr Maxime Taquet and Professor Paul Harrison, from the University of Oxford, who were not involved in the study, said: “The first global insight into the burden of depressive and anxiety disorders during the pandemic by Santomauro and colleagues starkly highlights the impact of the pandemic on mental health globally.”


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