Abstract
The United Nations warned of COVID-19-related mental health crisis; however, it is unknown whether there is an increase in the prevalence of mental disorders as existing studies lack a reliable baseline analysis or they did not use a diagnostic measure. We aimed to analyse trends in the prevalence of mental disorders prior to and during the COVID-19 pandemic. We analysed data from repeated cross-sectional surveys on a representative sample of non-institutionalised Czech adults (18+ years) from both November 2017 (n = 3306; 54% females) and May 2020 (n = 3021; 52% females). We used Mini International Neuropsychiatric Interview (MINI) as the main screening instrument. We calculated descriptive statistics and compared the prevalence of current mood and anxiety disorders, suicide risk and alcohol-related disorders at baseline and right after the first peak of COVID-19 when related lockdown was still in place in CZ. In addition, using logistic regression, we assessed the association between COVID-19-related worries and the presence of mental disorders. The prevalence of those experiencing symptoms of at least one current mental disorder rose from a baseline of 20.02 (95% CI = 18.64; 21.39) in 2017 to 29.63 (95% CI = 27.9; 31.37) in 2020 during the COVID-19 pandemic. The prevalence of both major depressive disorder (3.96, 95% CI = 3.28; 4.62 v. 11.77, 95% CI = 10.56; 12.99); and suicide risk (3.88, 95% CI = 3.21; 4.52 v. 11.88, 95% CI = 10.64; 13.07) tripled and current anxiety disorders almost doubled (7.79, 95% CI = 6.87; 8.7 v. 12.84, 95% CI = 11.6; 14.05). The prevalence of alcohol use disorders in 2020 was approximately the same as in 2017 (10.84, 95% CI = 9.78; 11.89 v. 9.88, 95% CI = 8.74; 10.98); however, there was a significant increase in weekly binge drinking behaviours (4.07% v. 6.39%). Strong worries about both, health or economic consequences of COVID-19, were associated with an increased odds of having a mental disorder (1.63, 95% CI = 1.4; 1.89 and 1.42, 95% CI = 1.23; 1.63 respectively). This study provides evidence matching concerns that COVID-19-related mental health problems pose a major threat to populations, particularly considering the barriers in service provision posed during lockdown. This finding emphasises an urgent need to scale up mental health promotion and prevention globally.
Highlights
As COVID-19 became a global pandemic, countries responded with nationwide lockdowns in attempt to slow and prevent further spread of the virus
We focused on the prevalence of current mental disorders; i.e. the presence of examined symptoms within the past 2 weeks for major depressive episode; the past month for panic, posttraumatic stress disorder, social phobia and suicide risk; the past 6 months for generalised anxiety disorder (GAD); and the past 12 months for alcohol use disorders
Having been tested for COVID-19 was associated with elevated risk of at least one mental disorder (2.13, 95% confidence intervals (95% CIs) = 1.21; 3.73), risk of suicide (2.36, 95% CI = 1.23; 4.32) and anxiety disorders (2.11, 95% CI = 1.08; 3.95), but not for major depressive episode or alcohol use disorders
Summary
As COVID-19 became a global pandemic, countries responded with nationwide lockdowns in attempt to slow and prevent further spread of the virus. With over half of the world population on some form of lockdown in April 2020, mental health of populations became a growing concern as individuals faced unprecedented levels of established mental health risk factors including social isolation, stress and anticipated economic hardship (Monroe and Simons, 1991; Mazure, 1998; Hammen, 2004; Ahnquist and Wamala, 2011; Matthews et al, 2016; Herbolsheimer et al, 2018; Economou et al, 2019; Brooks et al, 2020) These risk factors disproportionately affect individuals with a history of mental health problems (Hao et al, 2020; Yao et al, 2020), high-risk groups such as health care workers (Kang et al, 2020; Liu et al, 2020; Lu et al, 2020), COVID-19 patients and survivors (Zhang et al, 2020a), individuals with pre-existing chronic diseases (Ohliger et al, 2020; Wang et al, 2020b) or unemployed individuals (Zhang et al, 2020b), and could trigger the onset of mental disorders in previously healthy populations. A nationwide online survey of participants from China recruited through convenience sampling
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