The Effect of COVID-19 on Mood Disorders in Urban and Suburban Detroit

Abstract

Introduction: The COVID-19 pandemic has increased the global experience of anxiety and depression due to social isolation and government-mandated quarantine for transmission reduction. To date, literature surrounding the mental health effects of COVID-19 for the US population is limited. Methods: This is a retrospective study from a large metropolitan Detroit health system. Patient encounters between December 23, 2018, and June 22, 2021, with March 23, 2020, the start of Michigan state-wide lockdown, were used to define pre- and post-COVID-19. The data was divided into Detroit and non-Detroit based on patient zip code. All patients aged 13+ years old with a visit with a family medicine provider were included. Outcome variables included Patient Health Questionnaires-2 and -9 and General Anxiety Disorder-7 scores, diagnoses of depression, anxiety, adjustment and grief disorders, antidepressant prescriptions, and behavioral health referrals. Logistic regression was used to determine the incidence of composite mood disorder, depression, and anxiety. Results: A total of 20,970 individuals were included in this study: 10,613 in the Detroit subgroup and 10,357 in the non-Detroit subgroup. 88.2% of the Detroit population were Black and 70% were female. Logistic regression shows that the incidence of composite mood disorder decreased with increasing age (odds ratio [OR] 0.787, 0.608, 0.422, and 0.392; p<0.001). Male gender is a protective factor (OR 0.646, p<0.001). Federal insurance is the only factor presenting a statistically significant increased risk (OR 1.395, p<0.001). There was no statistical difference between residing in urban and suburban on incidence of composite mood disorder [OR 0.996 p=0.953] Conclusions: Our research demonstrates that residing in an urban setting did not increase the risk of developing a mental health disorder during the COVID-19 period.