Investigating the effect of national government physical distancing measures on depression and anxiety during the COVID-19 pandemic through meta-analysis and meta-regression
Top Cited Papers
Open Access
- 31 March 2021
- journal article
- review article
- Published by Cambridge University Press (CUP) in Psychological Medicine
- Vol. 51 (6), 881-893
- https://doi.org/10.1017/S0033291721000933
Abstract
Background COVID-19 physical distancing measures can potentially increase the likelihood of mental disorders. It is unknown whether these measures are associated with depression and anxiety. Objectives To investigate meta-analytic global levels of depression and anxiety during the COVID-19 pandemic and how the implementation of mitigation strategies (i.e. public transportation closures, stay-at-home orders, etc.) impacted such disorders. Data sources PubMed, MEDLINE, Web of Science, BIOSIS Citation Index, Current Content Connect, PsycINFO, CINAHL, medRxiv, and PsyArXiv databases for depression and anxiety prevalences; Oxford Covid-19 Government Response Tracker for the containment and closure policies indexes; Global Burden of Disease Study for previous levels of depression and anxiety. Study eligibility criteria Original studies conducted during COVID-19 pandemic, which assessed categorical depression and anxiety, using PHQ-9 and GAD-7 scales (cutoff > 10). Participants and interventions General population, healthcare providers, students, and patients. National physical distancing measures. Study appraisal and synthesis methods Meta-analysis and meta-regression. Results In total, 226 638 individuals were assessed within the 60 included studies. Global prevalence of both depression and anxiety during the COVID-19 pandemic was 24.0% and 21.3%, respectively. There were differences in the prevalence of both anxiety and depression reported across regions and countries. Asia (17.6% and 17.9%), and China (16.2% and 15.5%) especially, had the lowest prevalence of both disorders. Regarding the impact of mitigation strategies on mental health, only public transportation closures increased the prevalence of anxiety, especially in Europe. Limitations Country-level data on physical distancing measures and previous anxiety/depression may not necessarily reflect local (i.e. city-specific) contexts. Conclusions and implications of key findings Mental health concerns should not be viewed only as a delayed consequence of the COVID-19 pandemic, but also as a concurrent epidemic. Our data provide support for policy-makers to consider real-time enhanced mental health services, and increase initiatives to foster positive mental health outcomes.This publication has 76 references indexed in Scilit:
- Beyond generalized anxiety disorder: Psychometric properties of the GAD-7 in a heterogeneous psychiatric sampleJournal of Anxiety Disorders, 2014
- Cross-national epidemiology of DSM-IV major depressive episodeBMC Medicine, 2011
- Cultural aspects in social anxiety and social anxiety disorderDepression and Anxiety, 2010
- Posttraumatic stress and social anxiety: the interaction of traumatic events and interpersonal fearsDepression and Anxiety, 2010
- A Brief Measure for Assessing Generalized Anxiety DisorderArchives of Internal Medicine, 2006
- Controlling the risk of spurious findings from meta‐regressionStatistics in Medicine, 2004
- The PHQ-9Journal of General Internal Medicine, 2001
- Meta-analysis of Observational Studies in EpidemiologyA Proposal for ReportingJAMA, 2000
- Social Relationships and HealthScience, 1988