One-Third of Adults Show Signs of Depression, Anxiety Due to COVID-19

Yeli Wang, PhD

Researchers have not yet properly untangled the drastic burden the coronavirus disease 2019 (COVID-19) pandemic is having on the collective psychological distress for individuals worldwide.

A team, led by Yeli Wang, Program in Health Services and Systems Research, Duke-NUS Medical School, evaluated the factors linked to psychological distress among the general population during the ongoing pandemic.

In the cross-sectional study, the researchers searchers various literature databases and included in the analysis studies that reported factors associated with psychological distress during the COVID-19 pandemic.

The investigators sought primary outcomes of self-reported symptoms of anxiety and depression and used random-effects models to pool odds ratios (OR) and 95% confidence intervals (CI).

Overall, the investigators identified 68 studies involving 288,830 individuals from 19 countries.

Factors Linked to Depression and Anxiety

The overall prevalence of anxiety and depression was 33% (95% CI, 28-39%) and 30% (95% CI, 26-36%), respectively.

The researchers found other demographic factors contributed to this rate as well.

For example, women compared to men (OR, 1.48; 95% CI, 1.29–1.71; I2 = 90.8%), younger versus older (< versus ≥35 years) adults (OR, 1.20l 95% CI, 1.13–1.26; I2 = 91.7%), living in rural compared to urban areas (OR, 1.13; 95% CI, 1.00–1.29; I2 = 82.9%), lower versus higher socioeconomic status (lower versus higher income: OR, 1.45; 95% CI, 1.24–1.69; I2 = 82.3%) were associated with higher anxiety odds.

Other than residential area, all of these factors were associated with higher odds of depression.

In addition, higher COVID-19 infection risk—classified as suspected or confirmed cases, living in hard-hit areas, or having pre-existing physical or mental conditions—as well as longer media exposure were associated with higher odds of anxiety or depression.

“One in 3 adults in the predominantly general population have COVID-19 related psychological distress,” the authors wrote. “Concerted efforts are urgently needed for interventions in high-risk populations to reduce urban-rural, socioeconomic and gender disparities in COVID-19 related psychological distress.”

An Opportunity to Improve Mental Health Services

Clinicians are preparing for different psychiatric issues related to the pandemic to be an issue moving forward.

In an interview with HCPLive®, George S. Everly, Jr., PhD, of The Johns Hopkins University Bloomberg School of Public Health, explained how the pandemic could be a chance to change how mental health is treated.

“This is an opportunity,” Everly, who is an expert in psychological crisis intervention, said. “It's an opportunity to approach the epidemic of mental health challenges that faces this nation. When I say this is an opportunity, I mean it gives us a reason that is more socially acceptable to look at [this] in a world where mental healthcare still carries a stigma.”

While viewing this as an opportunity for the future, Everly admitted there is some concern over patients being trepidations over whether or not to go and seek out mental health advice in person. This was particularly evident during the early parts of the ongoing pandemic.

However, to really take the opportunity to improve mental health services in the US and improve the conditions of millions, there must be some action items that go beyond persuading people to seek out professional help.

One action item would be for large organizations to create and cultivate employee support programs. These would be staff support groups that would be filled with other peer staff members and not mental health professionals.

The study, “Factors associated with psychological distress during the coronavirus disease 2019 (COVID-19) pandemic on the predominantly general population: A systematic review and meta-analysis,” was published online in Plos One.