Abstract
BackgroundThe COVID-19 pandemic is affecting people’s mental health worldwide. Patients with diabetes are at risk for a severe course of illness when infected with SARS-CoV-2. The present study aims to retrospectively examine mental health changes in patients with diabetes in Germany before and after the initial COVID-19 outbreak, and to furthermore explore potential predictors of such changes.MethodsOver the course of eight weeks from April to June 2020, 253 individuals diagnosed with diabetes participated in an online cross-sectional study. Participants completed an anonymous survey including demographics, depression (PHQ-2) and generalized anxiety symptoms (GAD-2), distress (DT), and health status (EQ-5D-3L). In addition, all instruments used were modified to retrospectively ask participants to recall their mental health and health status before the outbreak had started. Additionally examined factors were COVID-19-related fear, trust in governmental actions to face the pandemic, and the subjective level of information about COVID-19.ResultsThis study shows a significant increase in prevalence of depression symptoms, generalized anxiety symptoms and distress, as well as significantly decreased health statuses in diabetes patients after the initial COVID-19 outbreak. Increased depression symptoms, generalized anxiety symptoms and distress were predicted by COVID-19-related fear, whereas trust in governmental actions to face COVID-19 predicted higher depression symptoms.ConclusionsThe results indicate a negative impact of the initial COVID-19 outbreak on mental health and health status in patients with diabetes. In order to improve the efficacy of psychological support strategies for diabetes patients during the pandemic, possible predictors of mental health impairment such as the aforementioned should be examined more thoroughly and addressed more openly.
Highlights
The COVID-19 pandemic is affecting people’s mental health worldwide
Differences in mental health and health status before and after the initial outbreak of COVID-19 The results of paired t-tests comparing mean values of patient health questionnaire (PHQ)-2, generalized anxiety disorder (GAD)-2, DT, and EQ-5D-3L before and after the initial outbreak of COVID-19 revealed a significant increase in depression symptoms, t(252) = 5.70, p < .001, d = 0.185, generalized anxiety symptoms, t(252) = 4.64, p < .001, d = 0.263, distress, t(252) = 7.06, p < .001, d = 0.330, and a decrease in health status, t(252) = − 3.51, p = .002, d = 0.127
This study shows that increased COVID-19-related fear is a risk factor for the increase of depression symptoms, generalized anxiety symptoms and distress, which is in accordance with previous research showing similar results in the general population in Germany [14] and in cancer patients [39]
Summary
The COVID-19 pandemic is affecting people’s mental health worldwide. Patients with diabetes are at risk for a severe course of illness when infected with SARS-CoV-2. The present study aims to retrospectively examine mental health changes in patients with diabetes in Germany before and after the initial COVID-19 outbreak, and to explore potential predictors of such changes. To reduce the transmission of SARS-CoV-2, many countries announced several restrictions, as vaccinations and medications were still lacking in the beginning. These restrictions included, among others, the shutdown of public facilities, a partial prohibition of social gatherings, the restriction of entry and intensification of border controls, as well as the promotion of safety behaviour. The restrictions, while abrupt and unprecedented, were considered necessary to reduce infections in order to prevent capacity overload in hospitals and to protect risk groups [5]
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