1 in 3 adults has COVID-19-related anxiety, depression

Anxiety and depression due to COVID-19 affected one in three adults in the general population, with women, younger adults, and those of lower socioeconomic status being particularly at risk, a study finds — thus highlighting the need for mental health interventions in high-risk groups.

“The unparalleled rate of transmission and the interruption of routine life by the institution of containment interventions [such as] lockdown, quarantine, [and] social distancing have resulted in an adverse psychological impact on the mental well-being of populations across the globe,” said the researchers led by Professor Tazeen Jafar from Duke-NUS Medical School, Singapore. 

“Understanding these factors is of significant clinical and public health importance worldwide for risk stratification and designing psychosocial intervention programmes,” they stated.

In the systematic review and meta-analysis study, Jafar and team culled data from 68 studies involving 288,830 participants who self-reported on anxiety and depressive symptoms. [PLoS ONE 2020;doi:10.1371/journal.pone.0244630]  

Overall, anxiety and depression were reported in 33 percent and 30 percent of the participants, respectively. 

The researchers found that women were more likely than men to have anxiety (odds ratio [OR], 1.48, 95 percent confidence interval [CI], 1.29–1.71). Also, younger adults (aged <35 years) were more likely to show anxiety than those who were older (aged ≥35 years; OR, 1.20, 95 percent CI, 1.13–1.26).

In addition, lower socioeconomic status was associated with a higher likelihood of anxiety vs higher socioeconomic status (OR, 1.45, 95 percent CI, 1.24–1.69), so was staying in rural vs urban areas (OR, 1.13, 95 percent CI, 1.00–1.29).

All the factors mentioned above were also independent predictors for depression, with the exception of residential areas. 

According to the researchers, the findings that factors such as women and low socioeconomic status were associated with COVID-19-related psychological distress were consistent with observations during previous infectious outbreak such as SARS.

“The lower social status of women and less preferential access to healthcare compared to men could potentially be responsible for the exaggerated adverse psychosocial impact on women,” Jafar and co-authors suggested. “Thus, outreach programs for mental health services must target women proactively.”

“[In addition,] as rural areas during the COVID-19 pandemic may be a reflection of the poorer healthcare infrastructure, economy, sanitation, and educational resources, the observed rural-urban gradient has important public health implication of ensuring equitable healthcare resources in rural and resource-restraint areas during the COVID-19 pandemic,” they added.

For young adults, their greater access to information about COVID-19 on the media might exposed them to greater likelihood of psychological distress.

“Our findings highlight the urgent need for offering mental health services and interventions to target high-risk populations to reduce socioeconomic and gender disparities of psychological distress during the COVID-19 pandemic globally,” concluded the researchers.

“Our results also show that improving family and social support and positive coping strategies are associated with reduced risk of psychological distress,” they noted.