Prevalence of anxiety, depression in U.S. adults elevated in first year of pandemic

Prevalence of clinically significant anxiety and depression among adults in the United States increased during the first year of the COVID-19 pandemic compared with prior years, according to a study published in JAMA Network Open.

“Concerns about adverse mental health effects of COVID-19 have been raised since the beginning of the pandemic,” Ronald C. Kessler, PhD, of the department of health care policy at Harvard Medical School, and colleagues wrote. “Many empirical papers subsequently investigated the association of the pandemic with mental health, and most concluded that the pandemic cause dramatic increases in anxiety and depression.”

Kessler and colleagues examined survey data for clinically significant diagnoses of anxiety and depression among adults during the first year of the pandemic.

The study obtained information from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), a state-based monthly telephone survey in which 1,429,354 adults responded (1,093,663 from 2017 to 2019; 335,691 from March to December 2020). The primary outcome was estimated 30-day prevalence of anxiety and depression based on a single BRFSS item calibrated to a score of six or higher on the four-item Patient Health Questionnaire.

Results showed that median within-state response rates were 45.9% to 49.4% in during the 2017 to 2019 survey period, and 47.9% in 2020. Estimated 30-day prevalence of clinically significant anxiety and depression was 0.4 (95% CI, 0 to 0.7) percentage points higher in March to December 2020 (12.4%) than March to December 2017 to 2019 (12.1%). This estimated increase was limited, however, to students (2.4 [95% CI, 0.8 to 3.9] percentage points) and the employed (0.9 [95% CI, 0.5 to 1.4] percentage points).

“Although it is impossible to predict future trends with accuracy there are some promising signs in the expansion of tele-mental health care and increased use of scalable interventions to address increasing demand for treatment of emotional problems,” Kessler and colleagues wrote.