BackgroundTimes of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce.MethodsWe analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education.ResultsWhile mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022.ConclusionElevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.

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Dieser Rapid Review untersucht Veränderungen der psychischen Gesundheit von Kindern und Jugendlichen in der Allgemeinbevölkerung in Deutschland während der COVID-19-Pandemie auf Grundlage von 39 Publikationen, die mittels systematischer Literaturrecherche (Stand 19.11.2022) und Handrecherche identifiziert wurden. Die Datengrundlagen der eingeschlossenen Publikationen wurden bezüglich ihrer Repräsentativität für die Allgemeinbevölkerung systematisiert, die verwendeten Indikatoren hinsichtlich der abgebildeten Konstrukte und ihrer Verlässlichkeit kategorisiert. Die große Mehrzahl der Studien bezog sich auf den Pandemiebeginn bis zum Sommerplateau 2020. Aus repräsentativen Studien wurde überwiegend ein hohes Ausmaß an pandemiebezogenen Belastungen, Zunahmen psychischer Auffälligkeiten und Beeinträchtigungen der Lebensqualität berichtet. Nichtrepräsentative Studien zeigten gemischte Ergebnisse. Vulnerable Gruppen ließen sich nur eingeschränkt identifizieren. Routine- und versorgungsbezogene Daten wiesen Rückgänge der ambulanten und stationären Inanspruchnahme während der Pandemiewellen mit Nachholeffekten aus. Kinder und Jugendliche erweisen sich in der Pandemie als vulnerabler im Vergleich zu Erwachsenen, ihre Belastung variierte jedoch mit den Pandemiewellen und den assoziierten Eindämmungsmaßnahmen. Ein zukünftiges vorausschauendes Krisen- und Pandemiemanagement erfordert eine engmaschige und kontinuierliche Surveillance der psychischen Kindergesundheit sowie eine bessere Identifikation von Risikogruppen.

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The COVID-19 pandemic has brought about great changes to the everyday lives of the population in Germany. Social distancing, working from home and other measures to contain the pandemic are essentially dominating everyday life. With data from the CORONA HEALTH App study we analysed the quality of life of the adult population in Germany during the COVID-19 pandemic and identified possible risk factors for a poor quality of life. In the app-based survey carried out between July and December 2020, 1,396 respondents (women 46.5%, men 52.7%, diverse 0.9%; mean age (mean) 42.0 years (standard deviation=13.4)) provided information on their quality of life using the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Univariate and multivariate regression was used to examine differences in quality of life between different groups of people during the COVID-19 pandemic and their associations with selected predictors. In summary, women, younger persons and job seekers or those who saw their work hours reduced or who could not pursue their regular jobs presented a lower quality of life in individual areas of life than the respective reference group. On the other hand, a setting that combines working from home and at the regular workplace, as well as living together with other people, showed partly positive associations with quality of life. The results have implications for public health interventions as they highlight groups requiring closer attention and sufficient support services.