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What is the percentage increase in cases of major depressive disorder (MDD) worldwide in 2020?
What is the unit of measurement for the additional disability-adjusted life years (DALYs) caused by MDD and AD?
Which age group was most affected by MDD and AD?
What is the limitation of the GBD 2020 prevalence rates?
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Which group was more affected by MDD and AD, males or females?
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What is the main source of data for the GBD 2020?
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In which type of countries were the GBD study estimates based on?
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What is the percentage increase in cases of anxiety disorders (AD) worldwide in 2020?
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What is the pooled effect size for mental health problems comparing before vs. during pandemic in the general population?
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How many studies were included in the analysis of mental health problems before vs. during pandemic in the mixed population?
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What is the pooled effect size for anxiety comparing before vs. March–April 2020 in the mixed population?
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How many comparisons were made in the analysis of mental health problems before vs. during pandemic in the mixed population?
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What is the pooled effect size for mental health problems comparing before vs. during pandemic in individuals with pre-existing physical health conditions?
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What is the pooled effect size for PSHM vs. no PHSM in the general adult population?
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How many studies were included in the analysis of anxiety comparing before vs. May–July 2020 in the mixed population?
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What is the pooled effect size for mental health problems comparing before vs. during pandemic in university students?
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What was the standardized mean difference for depression in the general population found by Kunzler et al.?
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What was the Hedges' g for anxiety found by Prati & Mancini in the general population?
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What was the change in mental health symptoms for people with pre-existing mental disorders found by one meta-analysis?
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What was the change in mental health symptoms for health care workers found by one meta-analysis?
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What was the standardized mean change for anxiety and depression in health care workers found by one meta-analysis?
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What was the standardized mean change for depression and anxiety in the general population found by Prati & Mancini?
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What was the change in mental health symptoms for people with pre-existing physical health conditions found by one meta-analysis?
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What type of studies were used to examine mental health in the general population in most of the meta-analyses?
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What was the outcome of the interrupted time series analysis of monthly trends in 21 countries during the first four months of the COVID-19 pandemic?
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How many countries reported a drop in suicide rates by the end of October 2020?
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Which of the following countries reported an increase in suicide rates?
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How many studies from LMICs were included in the systematic review?
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What was the outcome of the time series analyses from seven countries?
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What was the outcome of the studies on sex and age differences in suicide rates during the COVID-19 pandemic?
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Which of the following countries reported an increase in suicide mortality in a study published after the update?
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What was the limitation of the studies from LMICs in the systematic review?
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What was the pooled effect of the study?
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What was the limitation of the studies included in the meta-analysis?
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Which group of people was found to have an increase in mental health problems during the pandemic?
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What was found to be a risk factor for mental health problems during the pandemic?
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What was a limitation of the prevalence rates reported in the studies?
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What is a gap in the research identified in the study?
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What was found to be associated with higher prevalence rates of mental health problems?
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What is a recommendation for future research?
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Study Notes
Process and Methodology
- The brief summarizes the Global Burden of Disease 2020 study (GBD 2020) and evidence from research commissioned by WHO.
- The research includes an umbrella review of systematic reviews and meta-analyses, an update to a living systematic review, and other relevant WHO publications.
- Literature searches were not restricted by language.
Mental Health Problems
- The GBD 2020 estimated a 27.6% increase in cases of major depressive disorder (MDD) and a 25.6% increase in cases of anxiety disorders (AD) worldwide in 2020 due to the COVID-19 pandemic.
- The pandemic was estimated to have caused 137.1 additional disability-adjusted life years (DALYs) per 100,000 population for MDD and 116.1 per 100,000 population for AD.
- The greatest increases in MDD and AD were found in places highly affected by COVID-19, with females and younger people (especially those aged 20-24 years) more affected.
- Many low- and middle-income countries (LMICs) were also majorly affected.
- GBD 2020 prevalence rates are based on statistical modeling from survey data, which can lead to over- or under-estimates and uncertainties.
- Estimates are based largely on data from high-income countries and may generalize less to LMICs.
Increases in Symptoms of Depression and Mood Disorders
- Increases in symptoms of depression and mood disorders remained significant over time.
- Symptoms of anxiety did not increase significantly over time.
- Moderate symptom increases in depression and small but significant increases in symptoms of anxiety were found in the general population.
Health Care Workers
- Only cross-sectional studies were conducted on health care workers.
- One meta-analysis found no increase in symptoms of anxiety and depression in health care workers during the pandemic compared to pre-pandemic prevalence rates.
Specific Populations
- Only two out of 26 eligible meta-analyses reported changes in mental health symptoms based on longitudinal data or a comparison with pre-pandemic cross-sectional prevalence rates.
- The first found no increase in mental health symptoms for people with pre-existing mental disorders, non-significant increases for university students and children and adolescents, and a significant increase for people with pre-existing physical health conditions.
- The second found significant increases in mental health symptoms for people with pre-existing physical health conditions.
Limitations
- There is a lack of studies with longitudinal designs.
- Most eligible meta-analyses were rated as low quality, with a high risk of bias.
- Prevalence rates were often based on diverse screening tools that were not always validated and used different cut-off scores to reflect mild, moderate, or severe symptoms.
- Meta-regression analyses revealed that studies with high risk of bias often yielded higher prevalence rates.
Key Findings
- There was a significant increase in mental health problems in the general population in the first year of the pandemic.
- Younger age, female gender, and pre-existing health conditions were often reported risk factors.
- Further research on mental health and COVID-19 among specific at-risk populations and in LMICs is needed.
Suicide
- The update to an ongoing living systematic review identified 51 time-series studies or reports comparing national or subnational suicide rates before and during the COVID-19 pandemic.
- None of the 21 countries reported evidence of an increase in suicide rates in the first four months of the pandemic (April–July 2020).
- There was evidence of a fall in rates in 12 countries.
- By the end of October 2020, areas in another three countries showed a drop in suicide rates, while there was evidence of suicide rate increases (5–31%) in Vienna, Austria, Japan, and Puerto Rico.
- Few studies were from LMICs, with a systematic review of studies from LMICs finding only 22 studies, mostly low-quality, with no data from Africa.
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Description
This quiz is based on the Global Burden of Disease 2020 study and research commissioned by WHO, providing recent estimates of mental disorders and their frequency.
