Impact of the COVID-19 pandemic on diagnoses of common mental health disorders in adults in Catalonia, Spain: a population-based cohort study

Abstract

ObjectiveTo investigate how trends in incidence of anxiety and depressive disorders have been affected by the COVID-19 pandemic.DesignPopulation-based cohort study.SettingRetrospective cohort study from 2018 to 2021 using the Information System for Research in Primary Care (SIDIAP) database in Catalonia, Spain.Participants3 640 204 individuals aged 18 or older in SIDIAP on 1 March 2018 with no history of anxiety and depressive disorders.Primary and secondary outcomes measuresThe incidence of anxiety and depressive disorders during the prelockdown period (March 2018–February 2020), lockdown period (March–June 2020) and postlockdown period (July 2020–March 2021) was calculated. Forecasted rates over the COVID-19 periods were estimated using negative binomial regression models based on prelockdown data. The percentage of reduction was estimated by comparing forecasted versus observed events, overall and by sex, age and socioeconomic status.ResultsThe incidence rates per 100 000 person-months of anxiety and depressive disorders were 151.1 (95% CI 150.3 to 152.0) and 32.3 (31.9 to 32.6), respectively, during the prelockdown period. We observed an increase of 37.1% (95% prediction interval 25.5 to 50.2) in incident anxiety diagnoses compared with the expected in March 2020, followed by a reduction of 15.8% (7.3 to 23.5) during the postlockdown period. A reduction in incident depressive disorders occurred during the lockdown and postlockdown periods (45.6% (39.2 to 51.0) and 22.0% (12.6 to 30.1), respectively). Reductions were higher among women during the lockdown period, adults aged 18–34 years and individuals living in the most deprived areas.ConclusionsThe COVID-19 pandemic in Catalonia was associated with an initial increase in anxiety disorders diagnosed in primary care but a reduction in cases as the pandemic continued. Diagnoses of depressive disorders were lower than expected throughout the pandemic.

Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study

“…Previous literature has reported different age and sex dependent pattern of CMD changes. Similar to what we observed in Netherlands, both in UK (11) and Spain (14) the largest declines in CMD PRs during 2020 occurred among young females (and particularly among people living in the most deprived urban areas).…”

“…However, Carr et al ( 11 ) only report on data until September 2020, preventing any conclusions on the long-term effects of the enduring pandemic. Initial decreases in depressive disorders have also been reported in Germany ( 12 ), Norway ( 13 ), Spain ( 14 ), where in the latter case levels stayed low until early 2021.…”

“…During April 2020 in the UK, Carr et al ( 11 ) reported reductions in treated incidence of depression and anxiety by 43% and 47%, respectively, and Williams et al ( 26 ) reported a 50% decrease for the same period. Although ( 14 ) reported an initial increase (19%) of anxiety during March 2020 in a Spanish population, this was soon replaced by a large decrease. Furthermore, depression immediately showed a sharp decrease (64%) during the first months (March to June 2020) of the pandemic, and first by early 2021 CMD incidences reached pre lockdown levels.…”

“…Bohlken et al ( 12 ) reported on 1 year incidence, i.e., only included patients that had no diagnoses at least 1 year prior to the date they were included. Similarly, Raventós et al ( 14 ) removed all cases with less than 1 year of CMD free registrations to the database. However, the most common measure was number of encounters for a given period of time, regardless of patients previous CMD history ( 13 , 15 , 16 ).…”

Impact of the COVID‐19 pandemic on eating disorders diagnoses among adolescents and young adults in Catalonia: A population‐based cohort study

“…Incidence rates peaked in March and November, 2021, with substantial drops in August and December of the same year. We hypothesize that these fluctuations could be partially explained by seasonal effects (i.e., low utilization of services during the holidays), as other diagnoses recorded in SIDIAP have exhibited similar patterns (Raventós et al, 2022 ). While seasonal patterns were also observed during the pre‐pandemic period, these variations seemed to be more pronounced during the post‐lockdown period, which could respond to an accentuated effect of seasonality due to higher incidence rates (Moltchanova et al, 2009 ).…”