Cases of anxiety and depression around the world increased dramatically in 2020, researchers have found, with an estimated 76m extra cases of anxiety and 53m extra cases of major depressive disorder than would have been expected had Covid not struck.
The study is the latest to suggest the pandemic has taken a serious toll on mental health, and that women and young people are more likely to be affected than men or older people.
“We believe [that] is because women are more likely to be affected by the social and economic consequences of the pandemic,” said the lead author, Dr Damian Santomauro of the University of Queensland.
“Women are more likely to take on additional carer and household responsibilities due to school closures or family members becoming unwell. Women also tend to have lower salaries, less savings, and less secure employment than men, and so are more likely to be financially disadvantaged during the pandemic,” he said, adding a rise in domestic violence may also play a role.
Young people have also been faced with a series of challenges.
“Youth have been impacted by the closures of schools and higher education facilities, and wider restrictions inhibiting young people from peer interactions,” said Santomauro, adding that young people were also more likely to become unemployed after an economic crisis.
Writing in the Lancet, the international team of researchers report how they drew on 48 studies published between 1 January 2020 and 29 January 29 2021 that included survey data on the prevalence of depressive or anxiety disorders in various countries both before and during the Covid pandemic.
The team analysed how these changes in prevalence were associated with markers of the impact of the Covid pandemic – such as human mobility and daily infection rate.
They then used this information to create a model that allowed them to extrapolate the change in prevalence of the mental health disorders from before to during the pandemic by age, sex, and location on a global scale – even covering countries where no mental health survey information during the pandemic was available, although the team caution these estimates should be taken with caution.
Combining these shifts with country-specific estimates of pre-pandemic levels of major depressive disorder and anxiety disorders from another model, the team estimate there were 246m cases of major depressive disorder and 374m cases of anxiety disorders worldwide in 2020, with the figure for the former 28% higher, and for the latter 26% higher, than would have been expected had the crisis not happened.
About two-thirds of these extra cases of major depressive disorder and 68% of the extra cases of anxiety disorders were among women, while younger people were affected more than older adults, with extra cases greatest among people aged 20-24.
“We estimated that the locations hit hardest by the pandemic in 2020, as measured with decreased human mobility and daily Sars-CoV-2 infection rate, had the greatest increases in prevalence of major depressive disorder and anxiety disorders,” the team said. Parts of western Europe and the Middle East appear to be among such regions.
Santomauro said the pandemic has placed a large burden on mental health systems that were already struggling to cope.
“We have to seriously re-evaluate how we respond to the mental health needs of the population moving forward,” he said. “I’m hoping that our results can provide some guidance to those needing to make decisions around what needs to be prioritised and what populations are most impacted.”