New Delhi: The Covid-19 pandemic caused the cases of major depressive disorder and anxiety disorders to increase by more than a quarter globally in 2020, according to the first global estimates of impacts of the pandemic on mental health, published in The Lancet.


Women suffered from these disorders more than men, and the younger generation was more affected than the older population, the study found. 


Over 25% Increase In Cases Worldwide


Due to measures such as lockdowns and school closures in countries with high Covid-19 infection rates, there were major reductions in the movement of people. Such countries showed the greatest increase in the prevalence of major depressive disorder and anxiety disorders.


Cases of major depressive disorder increased by 28 per cent, and those of anxiety disorders by 26 per cent in the year 2020, the report said.


Major depressive disorder and anxiety disorders affected millions of men and women of all ages around the world, even before the Covid-19 pandemic. Such disorders were major contributors to the global burden of disease and increased the risk of suicide in people suffering from the disorders.


Dr Damian Santomauro, the lead author of the study, said their findings indicate that it is extremely important to strengthen mental health systems so the growing burden of major depressive disorder and anxiety disorders can be addressed. 


She said the ways of improving support services include promoting mental well-being, targeting factors which trigger poor mental health, and improving treatment for those with mental disorders. 


Even before the pandemic, mental health-care systems in most countries were either not organised properly or did not have the required resources. She concluded that taking no action to meet the added demand for mental health services should not be an option.


The Findings


While there have been studies in past about the impact of the pandemic on mental health, the previous studies had not analysed how it globally impacted the prevalence of these mental disorders in 2020. 


The past studies were conducted over a short period of time, and mostly included surveys in specific locations.


The new study is the first to assess the global impacts, while quantifying the prevalence and burden of the disorders by age, sex, and location in 204 countries and territories in 2020.


The highest number of studies were conducted in Western Europe and high-income North America — 22 from Western Europe and 14 from North America. Five studies were conducted in Australasia, five in high-income Asia Pacific, two in East Asia, and one in Central Europe.


The prevalence of major depressive and anxiety disorders was the greatest in countries that suffered the most severe impact from the Covid-19 pandemic, due to increased Covid-19 infection rate and reduced movement of people in those countries, according to the meta-analysis.


The number of cases of major depressive disorder worldwide in 2020 would have been 193 million (2,471 cases per 100,000 population) had the pandemic not happened, model estimates suggest. However, there was an increase of 28 per cent in the cases, resulting in 246 million cases (3,153 per 100,000), the study found. 


There were 53 million additional cases, of which more than 35 million cases were found in women, and around 18 million cases were observed in men.


When model estimates were compared with results from the analysis of the prevalence of anxiety disorders in the absence of the pandemic, a 26 per cent increase was observed, making the number of cases 374 million from an estimated 298 million. There were 76 million additional cases, of which 52 million were found in women and 24 million in men.


People belonging to the age group of 20 to 24 showed additional prevalence of major depressive disorder and anxiety disorders. For every group of 100,000 individuals, there were 1,118 additional cases of major depressive disorder and 1,331 additional cases of anxiety disorders.


Alize Ferrari, a co-author of the study, said the global pandemic worsened the social determinants of mental health. Due to the social and economic consequences of the pandemic, women were more likely to be worse affected, she added. 


Also, women take care of household activities, and some were even subjected to domestic violence during the pandemic, resulting in an increased prevalence of depression and anxiety disorders.


The increased risk of unemployment, and school closures had a major role to play in the increased prevalence of mental disorders in younger people, she noted.


Why More Mental Health Surveys Are Required


The authors noted some of the limitations of the study, such as there was no high-quality data on the effects of the global pandemic on the mental health of people in many parts of the world, particularly in low- and middle-income countries. As a result, some estimates had to be extrapolated. 


Also, self-reported data formed the basis of the data, indicating that many of the cases could just be estimates or assumptions. 


In order to better understand the pandemic's effects on mental health, more data from diagnostic mental health surveys should be included, as they represent the general population, the authors state, adding that new mental health surveys should be conducted that take into consideration other mental disorders such as eating disorders.


Dr Maxime Taquet and Professor Paul Harrison, who were not involved in the study, wrote in a linked comment that more research should be conducted to determine the fuller geographic distribution of depression and anxiety, and the prevalence of these disorders, and that these studies must highlight mechanisms necessary to improve mental health in the context of the Covid-19 pandemic globally.