Prevalence of major depressive and anxiety disorders has increased during the COVID-19 pandemic

1. Female sex, younger age, daily SARS-CoV-2 infection rate and reduced mobility were associated with increased prevalence of major depressive disorder and anxiety disorders.

2. 53 million new cases of major depressive disorder and 76 million new cases of anxiety disorders were reported in 2020 due to the COVID-19 pandemic.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Prior to the pandemic, mental health conditions accounted for a large proportion of global health-related burden. The onset of the COVID-19 pandemic has only worsened this with social restrictions, lockdowns, school and business closures, and loss of livelihood. Now more than ever, the need for up-to-date information on global prevalence of mental health disorders is crucial. This systematic review aimed to identify the impact of COVID-19 pandemic on global burden of major depressive disorder (MDD) and anxiety disorders in 2020. The primary outcome was the change in prevalence of mental disorders between pre-pandemic and mid-pandemic, using the following impact indicators: mobility, SARS-CoV-2 infection rate, and mortality rate. According to study results, young age, female sex, and indicators such as SARS-CoV-2 infection rate as well as a reduction in human mobility were associated with an increased prevalence of both MDD and anxiety disorders. Furthermore, a positive correlation was noted between locations hit hardest by COVID-19 and burden of mental health disorders. This study was strengthened by a comprehensive review with a broad search criterion which included results from various databases.

Click to read the study in The Lancet

Relevant Reading: Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic

In-depth [systematic review and meta-analysis]: This systematic review searched articles published between Jan 1, 2020, and Jan 29, 2021. Included studies reported the prevalence of MDD and anxiety in the general population during the COVID-19 pandemic and had a pre-pandemic baseline. Altogether, 48 studies were included. In general, female sex (regression coefficient [B] 0.1, 95% uncertainty interval [UI] 0.1 to 0.2, p=0.000; B 0.1, 95% UI 0.1 to 0.2, p=0.0001) and younger age (B -0.007, 95% UI -0.009 to -0.006, p=0.0001; B -0.003, 95% UI -0.005 to -0.002, p=0.0001) were linked to greater incidence of MDD and anxiety disorders, respectively. Furthermore, two of four COVID-19 impact indicators showed increased prevalence for MDD and anxiety disorders: daily SARS-CoV-2 infection rates (B 18.1, 95% UI 7.9 to 28.3, p=0.0005; B 13.8, 95% UI 10.7 to 17.0, p<0.0001) and reductions in human mobility (B 0.9, 95% UI 0.1 to 1.8, p=0.029; B 0.9, 95% UI 0.1 to 1.7, p=0.022). Approximately 53.2 million new cases of MDD were reported due to the pandemic – an increase of 27.6% (29.8% for females and 24.0% for males) from pre-pandemic levels, compared to 76.2 million new cases of anxiety disorders – an increase of 25.6% 27.9% for females and 21.7% for males from pre-pandemic levels. Overall, findings from this study suggest that the COVID-19 pandemic has escalated the global prevalence of mental disorders and the need to strengthen mental health resources is more urgent than ever before.

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