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Increase in mental disorders during the COVID-19 pandemic -- the role of occupational and financial strains. An analysis of the German National Cohort (NAKO) Study

Item Type:Article
Title:Increase in mental disorders during the COVID-19 pandemic -- the role of occupational and financial strains. An analysis of the German National Cohort (NAKO) Study
Creators Name:Dragano, N. and Reuter, M. and Peters, A. and Engels, M. and Schmidt, B. and Greiser, K.H. and Bohn, B. and Riedel-Heller, S. and Karch, A. and Mikolajczyk, R. and Krause, G. and Lang, O. and Panreck, L. and Rietschel, M. and Brenner, H. and Fischer, B. and Franzke, C.W. and Gastell, S. and Holleczek, B. and Jöckel, K.H. and Kaaks, R. and Keil, T. and Kluttig, A. and Kuß, O. and Legath, N. and Leitzmann, M. and Lieb, W. and Meinke-Franze, C. and Michels, K.B. and Obi, N. and Pischon, T. and Feinkohl, I. and Rospleszcz, S. and Schikowski, T. and Schulze, M.B. and Stang, A. and Völzke, H. and Willich, S.N. and Wirkner, K. and Zeeb, H. and Ahrens, W. and Berger, K.
Abstract:BACKGROUND: Numerous studies have reported an increase in mental disorders during the COVID-19 pandemic, but the exact reasons for this development are not well understood. In this study we investigate whether pandemic-related occupational and financial changes (e.g., reduced working hours, working from home, financial losses) were associated with increased symptoms of depression and anxiety compared with the situation before the pandemic. METHODS: We analyzed data from the German National Cohort (NAKO) Study. Between May and November 2020, 161 849 study participants answered questions on their mental state and social circumstances. Their responses were compared with data from the baseline survey before the pandemic (2014-2019). Linear fixed-effects models were used to determine whether individual changes in the severity of symptoms of depression (PHQ-9) or anxiety (GAD-7) were associated with occupational/financial changes (controlling for various covariates). RESULTS: The prevalence of moderate or severe symptoms of depression and anxiety increased by 2.4% and 1.5%, respectively, during the COVID-19 pandemic compared with the preceding years. The mean severity of the symptoms rose slightly. A pronounced increase in symptoms was observed among those who became unemployed during the pandemic (+ 1.16 points on the depression scale, 95% confidence interval [0.91; 1.41], range 0-27). Increases were also seen for reduced working hours with no short-time allowance, increased working hours, working from home, insecurity regarding employment, and financial strain. The deterioration in mental health was largely statistically explained by the occupational and financial changes investigated in the model. CONCLUSION: Depressive symptoms and anxiety disorders increased slightly in the study population during the first year of the COVID-19 pandemic. Occupational and financial difficulties were an essential contributory factor. These strains should be taken into account both in the care of individual patients and in the planning of targeted prevention measures.
Keywords:Anxiety, COVID-19, Depression, Mental Disorders, Pandemics, SARS-CoV-2
Source:Deutsches Arzteblatt International
ISSN:1866-0452
Publisher:Deutscher Ärzte-Verlag
Volume:119
Number:11
Page Range:179-187
Date:18 March 2022
Official Publication:https://doi.org/10.3238/arztebl.m2022.0133
PubMed:View item in PubMed

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