The impact of the COVID-19 pandemic on diagnoses of common mental health disorders in adults in Catalonia, Spain

Raventos, B.; Pistillo, A.; Reyes, C.; Fernandez-Bertolin, S.; Aragon, M.; Berenguera, A.; Jacques-Avino, C.; Medina-Perucha, L.; Burn, E.; Duarte-Salles, T.

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.