Abstract
BackgroundConfinement due to COVID-19 has increased mental ill-health. Few studies unpack the risk and protective factors associated with mental ill-health and addictions that might inform future preparedness.MethodsCross-sectional on-line survey with 37,810 Catalan residents aged 16+ years from 21 April to 20 May 2020 reporting prevalence of mental ill-health and substance use and associated coping strategies and behaviours.ResultsWeighted prevalence of reported depression, anxiety and lack of mental well-being was, respectively, 23, 26, and 75%, each three-fold higher than before confinement. The use of prescribed hypnosedatives was two-fold and of non-prescribed hypnosedatives ten-fold higher than in 2018. Women, younger adults and students were considerably more likely, and older and retired people considerably less likely to report mental ill-health. High levels of social support, dedicating time to oneself, following a routine, and undertaking relaxing activities were associated with half the likelihood of reported mental ill-health. Worrying about problems living at home, the uncertainty of when normality would return, and job loss were associated with more than one and a half times the likelihood of mental ill-health. With the possible exception of moderately severe and severe depression, length of confinement had no association with reported mental ill-health.ConclusionsThe trebling of psychiatric symptomatology might lead to either to under-identification of cases and treatment gap, or a saturation of mental health services if these are not matched with prevalence increases. Special attention is needed for the younger adult population. In the presence of potential new confinement, improved mental health literacy of evidence-based coping strategies and resilience building are urgently needed to mitigate mental ill-health.
Highlights
Confinement due to COVID-19 has increased mental ill-health
The trebling of psychiatric symptomatology might lead to either to under-identification of cases and treatment gap, or a saturation of mental health services if these are not matched with prevalence increases
Special attention is needed for the younger adult population
Summary
Confinement due to COVID-19 has increased mental ill-health. Few studies unpack the risk and protective factors associated with mental ill-health and addictions that might inform future preparedness. At the beginning of the COVID-19 pandemic, the World Health Organization alerted about the serious consequences of COVID-19 confinements on mental ill-health and addictions such as potential high-risk drinking [1]. A later meta-analysis of both the general population and health care providers with 162,639 respondents indicated an average prevalence during the beginning of confinement of 33% for anxiety and of 28% for depression across 62 studies [4]. Systematic reviews, including European studies, albeit largely of relatively small sample sizes, using symptom-based scales, have found during COVID-19 confinement prevalence rates of depression of 25% (95% confidence intervals, 18–33%) [9], and prevalence rates of anxiety of 25% (95% confidence intervals, 21–29%) [10] With less clear output, early attention was been drawn to possible increases in tobacco and alcohol use [5], with one Chinese study reporting increases in hazardous alcohol drinking [6], and others reporting decreases in alcohol and tobacco consumption [7, 8].
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