Health care workers, patients with noninfectious chronic disease, patients with COVID-19, and quarantined persons all showed a much higher risk of depression, anxiety, distress, and insomnia in this meta-analysis, compared to historic rates sampled in the general population (J Affect Disorder. 2021 Feb 15. Epub ahead of print)
“The global COVID-19 pandemic has generated major mental and psychological health problems worldwide,” Tianchen Wu, PhD, Peking University, Beijing, China, and coinvestigators wrote as the basis for their research. They conducted a meta-analysis to assess the prevalence of depression, anxiety, distress, and insomnia during the COVID-19 pandemic among different populations.
A total of 66 studies (221,970 participants) were analyzed to determine the prevalence of mental health problems from January 2020 to March 2020, early in the COVID-19 pandemic, across different populations.
The overall population was categorized into seven subgroups: general population; noninfectious chronic disease patients (including cancer, diabetes, or chronic kidney disease); students (including middle school to university students); physicians and nurses in clinical settings; non-medical staff in non-clinical settings; quarantined people; and patients with COVID-19. Researchers went a step further to divide physicians and nurses into front-line and second-line worker subgroups for further analysis.
In this analysis, the overall pooled prevalence of depression, anxiety, distress, and insomnia were 31.4%, 31.9%, 41.1%, and 37.9%, respectively. The rates of mental health problems experienced across populations in this analysis are much higher than historic rates sampled from general populations worldwide.
Previous studies cited found that 6.2% of the adult indigenous population of Panama reported serious psychological distress in normal circumstances; 6.6% of the general population of the United States were affected by major depressive disorder; and 10.8-14.7% of a random sample of Swedish residents experienced depression and anxiety.
Populations found to have the highest risk of depression and anxiety included patients with noninfectious chronic disease, quarantined individuals, and patients with COVID-19.
Physicians and nurses also had a higher prevalence of depression and anxiety. Conversely, non-medical staff had the lowest prevalence of depression, anxiety, distress, and insomnia.
No significant differences in the prevalence of depression and anxiety were observed between front and second-line medical personnel groups. However, both had a high prevalence of depression and anxiety.
This is the first systematic review and meta-analysis of four different mental health issues related to the COVID-19 pandemic to the researchers' knowledge. The acknowledged limitations included most studies published early in the pandemic were conducted among the Chinese population where the outbreaks began. Further analyses on additional populations through all phases of the pandemic would provide additional data. Furthermore, most studies included focused on depression and anxiety; distress and insomnia were not studied comprehensively, which may limit the analyses of those symptoms.
These findings provide evidence the ongoing COVID-19 pandemic has increased the mental health burden on society. In particular, health care workers, patients with noninfectious chronic disease, patients with COVID-19, and quarantined persons all showed a much higher risk of depression, anxiety, distress, and insomnia in this meta-analysis compared to historical rates in the general population.
“Interventions for mental health are urgently needed,” stated Dr Wu and coinvestigators. “We recommend that preventative interventions for mental health problems [are] part of the global response to the pandemic,” they concluded. —Kaitlyn Manasterski