Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains

Nico Dragano; Marvin Reuter; Annette Peters; Miriam Engels; Börge Schmidt; Karin H Greiser; Barbara Bohn; Steffi Riedel-Heller; André Karch; Rafael Mikolajczyk; Gérard Krause; Olga Lang; Leo Panreck; Marcella Rietschel; Hermann Brenner; Beate Fischer; Claus-Werner Franzke; Sylvia Gastell; Bernd Holloczek; Karl-Heinz Jöckel; Rudolf Kaaks; Thomas Keil; Alexander Kluttig; Oliver Kuß; Nicole Legath; Michael Leitzmann; Wolfgang Lieb; Claudia Meinke-Franze; Karin B Michels; Nadia Obi; Tobias Pischon; Insa Feinkohl; Susanne Rospleszcz; Tamara Schikowski; Matthias B Schulze; Andreas Stang; Henry Völzke; Stefan N Willich; Kerstin Wirkner; Hajo Zeeb; Wolfgang Ahrens; Klaus Berger

doi:10.3238/arztebl.m2022.0133

Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains

Nico Dragano, Marvin Reuter, Annette Peters, Miriam Engels, Börge Schmidt, Karin H Greiser, Barbara Bohn, Steffi Riedel-Heller, André Karch, Rafael Mikolajczyk, Gérard Krause, Olga Lang, Leo Panreck, Marcella Rietschel, Hermann Brenner, Beate Fischer, Claus-Werner Franzke, Sylvia Gastell, Bernd Holloczek, Karl-Heinz JöckelRudolf Kaaks, Thomas Keil, Alexander Kluttig, Oliver Kuß, Nicole Legath, Michael Leitzmann, Wolfgang Lieb, Claudia Meinke-Franze, Karin B Michels, Nadia Obi, Tobias Pischon, Insa Feinkohl, Susanne Rospleszcz, Tamara Schikowski, Matthias B Schulze, Andreas Stang, Henry Völzke, Stefan N Willich, Kerstin Wirkner, Hajo Zeeb, Wolfgang Ahrens, Klaus Berger

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	179-187
Number of pages	9
Journal	Deutsches Arzteblatt International
Volume	119
Issue number	11
DOIs	https://doi.org/10.3238/arztebl.m2022.0133
Publication status	Published - 2022

Keywords

Anxiety/epidemiology
COVID-19/epidemiology
Depression/diagnosis
Humans
Mental Disorders/epidemiology
Pandemics
SARS-CoV-2

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10.3238/arztebl.m2022.0133

Cite this

Dragano, N., Reuter, M., Peters, A., Engels, M., Schmidt, B., Greiser, K. H., Bohn, B., Riedel-Heller, S., Karch, A., Mikolajczyk, R., Krause, G., Lang, O., Panreck, L., Rietschel, M., Brenner, H., Fischer, B., Franzke, C.-W., Gastell, S., Holloczek, B., ... Berger, K. (2022). Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains. Deutsches Arzteblatt International, 119(11), 179-187. https://doi.org/10.3238/arztebl.m2022.0133

@article{2aa92c56ce12439bbfedef870b1bc1d6,

title = "Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains",

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/epidemiology, COVID-19/epidemiology, Depression/diagnosis, Humans, Mental Disorders/epidemiology, Pandemics, SARS-CoV-2",

author = "Nico Dragano and Marvin Reuter and Annette Peters and Miriam Engels and B{\"o}rge Schmidt and Greiser, {Karin H} and Barbara Bohn and Steffi Riedel-Heller and Andr{\'e} Karch and Rafael Mikolajczyk and G{\'e}rard Krause and Olga Lang and Leo Panreck and Marcella Rietschel and Hermann Brenner and Beate Fischer and Claus-Werner Franzke and Sylvia Gastell and Bernd Holloczek and Karl-Heinz J{\"o}ckel and Rudolf Kaaks and Thomas Keil and Alexander Kluttig and Oliver Ku{\ss} and Nicole Legath and Michael Leitzmann and Wolfgang Lieb and Claudia Meinke-Franze and Michels, {Karin B} and Nadia Obi and Tobias Pischon and Insa Feinkohl and Susanne Rospleszcz and Tamara Schikowski and Schulze, {Matthias B} and Andreas Stang and Henry V{\"o}lzke and Willich, {Stefan N} and Kerstin Wirkner and Hajo Zeeb and Wolfgang Ahrens and Klaus Berger",

note = "Funding This project was conducted with data of the German National Cohort (NAKO) Study (www.nako.de). The German National Cohort (NAKO) Study has been funded by the German Federal Ministry of Education and Research (BMBF, Bundesministerium f{\"u}r Bildung und Forschung) (grant number 01ER1301A/B/C und 01ER1511D), the Federal States (“L{\"a}nder”) and the Helmholtz Association, as well as the participating universities and institutes of the Leibniz Association. The analysis was developed within the context of the MethodCoV method platform, which has been funded by the Federal Ministry of Education and Research (BMBF) (grant number 01KX2021). We thank all participants and staff members of the German National Cohort (NAKO) Study.",

year = "2022",

doi = "10.3238/arztebl.m2022.0133",

language = "English",

volume = "119",

pages = "179--187",

journal = "Deutsches Arzteblatt International",

issn = "1866-0452",

publisher = "Deutscher Arzte-Verlag GmbH",

number = "11",

}

Dragano, N, Reuter, M, Peters, A, Engels, M, Schmidt, B, Greiser, KH, Bohn, B, Riedel-Heller, S, Karch, A, Mikolajczyk, R, Krause, G, Lang, O, Panreck, L, Rietschel, M, Brenner, H, Fischer, B, Franzke, C-W, Gastell, S, Holloczek, B, Jöckel, K-H, Kaaks, R, Keil, T, Kluttig, A, Kuß, O, Legath, N, Leitzmann, M, Lieb, W, Meinke-Franze, C, Michels, KB, Obi, N, Pischon, T, Feinkohl, I, Rospleszcz, S, Schikowski, T, Schulze, MB, Stang, A, Völzke, H, Willich, SN, Wirkner, K, Zeeb, H, Ahrens, W & Berger, K 2022, 'Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains', Deutsches Arzteblatt International, vol. 119, no. 11, pp. 179-187. https://doi.org/10.3238/arztebl.m2022.0133

TY - JOUR

T1 - Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains

AU - Dragano, Nico

AU - Reuter, Marvin

AU - Peters, Annette

AU - Engels, Miriam

AU - Schmidt, Börge

AU - Greiser, Karin H

AU - Bohn, Barbara

AU - Riedel-Heller, Steffi

AU - Karch, André

AU - Mikolajczyk, Rafael

AU - Krause, Gérard

AU - Lang, Olga

AU - Panreck, Leo

AU - Rietschel, Marcella

AU - Brenner, Hermann

AU - Fischer, Beate

AU - Franzke, Claus-Werner

AU - Gastell, Sylvia

AU - Holloczek, Bernd

AU - Jöckel, Karl-Heinz

AU - Kaaks, Rudolf

AU - Keil, Thomas

AU - Kluttig, Alexander

AU - Kuß, Oliver

AU - Legath, Nicole

AU - Leitzmann, Michael

AU - Lieb, Wolfgang

AU - Meinke-Franze, Claudia

AU - Michels, Karin B

AU - Obi, Nadia

AU - Pischon, Tobias

AU - Feinkohl, Insa

AU - Rospleszcz, Susanne

AU - Schikowski, Tamara

AU - Schulze, Matthias B

AU - Stang, Andreas

AU - Völzke, Henry

AU - Willich, Stefan N

AU - Wirkner, Kerstin

AU - Zeeb, Hajo

AU - Ahrens, Wolfgang

AU - Berger, Klaus

N1 - Funding This project was conducted with data of the German National Cohort (NAKO) Study (www.nako.de). The German National Cohort (NAKO) Study has been funded by the German Federal Ministry of Education and Research (BMBF, Bundesministerium für Bildung und Forschung) (grant number 01ER1301A/B/C und 01ER1511D), the Federal States (“Länder”) and the Helmholtz Association, as well as the participating universities and institutes of the Leibniz Association. The analysis was developed within the context of the MethodCoV method platform, which has been funded by the Federal Ministry of Education and Research (BMBF) (grant number 01KX2021). We thank all participants and staff members of the German National Cohort (NAKO) Study.

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - Anxiety/epidemiology

KW - COVID-19/epidemiology

KW - Depression/diagnosis

KW - Humans

KW - Mental Disorders/epidemiology

KW - Pandemics

KW - SARS-CoV-2

U2 - 10.3238/arztebl.m2022.0133

DO - 10.3238/arztebl.m2022.0133

M3 - Article

C2 - 35197188

SN - 1866-0452

VL - 119

SP - 179

EP - 187

JO - Deutsches Arzteblatt International

JF - Deutsches Arzteblatt International

IS - 11

ER -

Increase in Mental Disorders During the COVID-19 Pandemic-The Role of Occupational and Financial Strains

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