The impact of the COVID-19 pandemic on diagnoses of common mental health disorders in adults in Catalonia, Spain
Authors: Raventós Berta , Pistillo Andrea , Reyes Carlen , Fernández-Bertolín Sergio , Aragón María , Berenguera Anna , Jacques-Aviñó Constanza , Medina-Perucha Laura , Burn Edward , Duarte-Salles Talita 
Published: August 2021

Objectives

To investigate how incidence trends of anxiety and depressive disorders have been affected by the COVID-19 pandemic.

Design

Population-based cohort study.

Setting

Observational cohort study from 2018 to 2021 using the Information System for Research in Primary Care (SIDIAP) database in Catalonia, Spain.

Participants

4,255,847 individuals aged 18 or older in SIDIAP on 1 March, 2018 with no prior history of anxiety and depressive disorders.

Primary and secondary outcomes measures

Incidence of anxiety and depressive disorders prior to COVID-19 (March, 2018 to February, 2020), during the COVID-19 lockdown (March to June, 2020) and post-lockdown periods (from July, 2020 to March, 2021) were calculated. Forecasted rates over COVID-19 periods were estimated using negative binomial regression models based on previous data. The percentage reduction was estimated by comparing forecasted versus observed events, overall and by age, sex and socioeconomic status.

Results

The incidence rates per 100,000 person-months of anxiety and depressive disorders were 171.0 (95%CI: 170.2-171.8) and 46.6 (46.2-47.0), respectively, during the pre-lockdown period. We observed an increase of 39.7% (95%PI: 26.5 to 53.3) in incident anxiety diagnoses compared to the expected in March, 2020, followed by a reduction of 16.9% (8.6 to 24.5) during the post-lockdown periods. A reduction of incident depressive disorders occurred during the lockdown and post-lockdown periods (46.6% [38.9 to 53.1] and 23.2% [12.0 to 32.7], respectively). Reductions were higher among adults aged 18 to 34 and individuals living in most deprived areas.

Conclusions

The 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.

Summary box

What is already known on this topic

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While previous self-reported studies have provided evidence of increased mental health burden during the initial phase of the COVID-19 pandemic, a number of studies observed that fewer diagnoses were made in primary care settings than would have been expected during the initial stages of the pandemic.

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Population data that examine the impact of COVID-19 on temporal trends of incident cases of common mental health disorders are lacking in Catalonia, Spain.

What this study adds

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This study has quantified the impact of the COVID-19 pandemic on trends of incidence of anxiety and depressive disorders among adults living in Catalonia.

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Reductions in incident cases of anxiety and depressive disorders were higher for young adults and people living in most deprived areas.

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Incident diagnoses of anxiety and depressive disorders have not been fully recovered to what would have been expected.