A study conducted at Columbia University’s Mailman School of Public Health reports a global incidence of depression and anxiety during COVID-19 epidemic and shows how the implementation of mitigation strategies has led to public transport and school closures, and stay-at-home orders affect such disorders. The results are published in Psychological treatment.
Our research found a higher global incidence of these mental health issues during COVID-19 and also showed that each varied widely at a regional and country level. “
João Castaldelli-Maia, MD, PhD, NIDA-INVEST Postdoctoral Fellowship and L Studybetween Author, Department of Epidemiology,
In particular, Asia (most studies came from China) reported lower levels of anxiety and depression, compared to other regions of the world. The closure of public transport raised levels of concern, whether it was two or four weeks beyond a closure act, particularly in Europe. “
Using a July 29, 2020 expiration date, the researchers analyzed data from Pubmed, MEDLINE, Web of Science, and medRxiv, among other databases, for depression and anxiety frequency. They also reviewed the Oxford Government Covid-19 Response Tracker for restriction and closure policy indices; and the Global Study of Disease for Disease for previous levels of depression and anxiety. A WHO database comprising COVID literature for studies published before the same date was also used.
In total, 226,638 people were assessed within 60 including studies. The global incidence of both depression and anxiety during COVID-19 pandemics was 24 percent and 21 percent, respectively. Asia with rates of 18 percent per head, and China in particular, had the lowest incidence of both disorders.
Regarding the impact of mitigation strategies on mental health – whether it be the closure of public transport, the closure of schools, the closure of a workplace, the cancellation of public events, or restrictions on collection – only the closure of public transport increased the frequency of anxiety unique in Europe.
Castaldelli-Maia and colleagues found a 21 percent global frequency of anxiety. Anxiety rates were lower in Asia (18 percent) compared to other regions of the world (29 percent). In this case, Europe was no different from Asia and other regions of the world. Again, a subgroup study at the country level showed that China had a lower anxiety rate at 15.5 percent compared to all other countries at 26 percent.
“Our study highlights the need to examine levels of mental health problems and the potential effects of social distance measures on mental health outcomes, according to Silvia Martins, MD, PhD, senior associate professor of Epidemiology at Columbia Mailman School, and senior author. “Mental health concerns should not be viewed not only as a result of delayed COVID-19 pandemic, but also as a contemporary pandemic.”
Within the subgroup of Asian countries, estimates of the frequency of depression ranged from 15 percent to 20 percent. When comparing the frequency of depression in the pre- and post-COVID-19 episodes, the estimates range from 1.3–3.4 percent, obviously more after the onset of COVID-19.
Declines have been seen among 26 per cent of the population in Europe, and among 39 per cent in other parts of the world that are not in Asia. Another study showed that the frequency of decline was lower in China, 16 percent compared to 29 percent in other countries.
Similarly, the frequency of anxiety, as reported in the subgroup of Asian countries is higher after COVID-19. Anxiety levels before COVID-19 ranged from 2.1 to 4.1 percent compared to 18 percent in the current study. An increase in anxiety can be seen in countries outside Asia and Europe (3 to 7 percent compared to 29 percent).
“The low levels of depression and anxiety we find in Asian countries could be culturally dependent,” Martins observes.
The impact of public transport closures on levels of confusion highlights the importance of these systems to global numbers, particularly the results in Europe but not in Asia. “These decisions could be linked to the fact that, on average, Europe has a more efficient and active public transport network, making Europeans more comfortable with public transport than people in Asian countries,” he said. Martins.
“The COVID-19 pandemic, and the resulting physical distance measures to reduce viral transmission, have certainly affected the mental health of populations worldwide, and the high incidence of mental health disorders is a major concern during the COVID era, “said Castaldelli – Maia. “These findings have a significant impact on policy makers and demonstrate the urgent need for the healthcare sector to increase support now for the prevention and early intervention of depression and anxiety. “
Source:
Columbia University Mailman School of Public Health