COVID-19 diagnosis does not increase incidence of depression, anxiety

COVID-19 diagnosis did not appear linked to a significant increase in depression and anxiety disorder incidence compared with diagnosis of acute upper respiratory infections, according to a retrospective cohort study conducted in Germany.

“A substantial body of literature has also investigated the potential impact of COVID-19 diagnosis on mental health, and most of these studies have shown that COVID-19 diagnosis increases the risk of subsequent psychiatric disorders,” Louis Jacob, PhD, of the Research and Development Unit at Parc Sanitari Sant Joan de D´eu in Spain, and colleagues wrote in Journal of Psychiatric Research. “Although these studies have advanced the field, they are subject to a number of limitations that need to be acknowledged.”

According to Jacob and colleagues, these limitations include most prior studies having been conducted at the pandemic’s onset, thus leaving out later data; literature up to this point has not compared the effects of COVID-19 on psychiatric disorders with the effects of other common respiratory conditions; and most prior studies having had small sample sizes.

In the current study, researchers analyzed data from all patients diagnosed with symptomatic or asymptomatic COVID-19 for the first time across 1,198 general practices in Germany between March 2020 and May 2021. They matched those with an acute upper respiratory diagnosis (n = 56,350) with those with COVID-19 (n = 56,350) via propensity scores based on sex, age, index month and Charlson Comorbidity Index. A total of 52.3% of participants were women and the mean age was 43.6 years. Using conditional Poisson regression models, Jacob and colleagues examined differences in depression and anxiety disorder incidence between the two groups.

Results showed incidence of depression (IRR = 1.02; 95% CI, 0.95-1.1) and anxiety disorder (IRR = 0.94; 95% CI, 0.83-1.07) did not significantly differ between the groups.

Jacob and colleagues noted incidence of depression of 88.6 cases per 1,000 person-years among those with COVID-19 and 86.5 cases per 1,000 person-years among those with acute upper respiratory infection. COVID-19 diagnosis did not significantly correlate with incidence of depression in all sex and age subgroups.

Incidence of anxiety disorder was 30.1 cases per 1,000 person-years among those with COVID-19 and 31.9 cases per 1,000 person-years among those with acute upper respiratory infection. COVID-19 diagnosis and subsequent anxiety disorder incidence was non-significant among all sex and age subgroups.

“These findings suggest that the decrease in the mental well-being of the general population observed since the beginning of the COVID-19 pandemic is related to factors other than the infection itself (eg, decreased physical activity and social disruption),” Jacob and colleagues wrote. “Finally, further research is warranted to corroborate or invalidate these reassuring preliminary data in other regions of the world and in other settings.”