Top

Social Psychiatry and Psychiatric Epidemiology

Published in:

Open Access 28-05-2022 | Mood Disorders | Original Paper

Mental health and COVID-19 in a general population cohort in Spain (COVICAT study)

Authors: X. Goldberg, G. Castaño-Vinyals, A. Espinosa, A. Carreras, L. Liutsko, E. Sicuri, M. Foraster, C. O’Callaghan-Gordo, P. Dadvand, G. Moncunill, C. Dobaño, B. Cortés, V. Pleguezuelos, K. Straif, J. Garcia-Aymerich, R. de Cid, E. Cardis, M. Kogevinas

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 12/2022

Abstract

Purpose

Mental health conditions may affect outcome of COVID-19 disease, while exposure to stressors during the pandemic may impact mental health. The purpose of this study was to examine these factors in relation to ocurrence of depression and anxiety after the first outbreak in Spain.

Methods

We contacted 9515 participants from a population-based cohort study in Catalonia between May and October 2020. We drew blood samples to establish infection to the virus. Pre-pandemic mental health conditions were confirmed through Electronic Health Registries. We used the Hospital Anxiety and Depression Scale to assess severe depression and anxiety post-pandemic. Exposure to proximal, financial and wider environment stressors during the lockdown were collected. We calculated Relative Risks (RR), adjusting for individual- and contextual covariates.

Results

Pre-pandemic mental health disorders were not associated with SARS-CoV-2 infection , but were associated with severity of COVID-19 disease. People with pre-existing mental health disorders showed higher prevalence of severe depression (25.4%) and anxiety (37.8%) than those without prior mental disorders (4.9% and 10.1%). Living alone was a strong predictor of severe depression among mental health patients (RR = 1.6, 95% CI 1.2–2.2). Among those without prior mental health disorders, post-lockdown depression and anxiety were associated with household interpersonal conflicts (RR = 2.6, 95% CI 2.1–3.1; RR = 2.1, 95% CI 1.9–2.4) and financial instability (RR = 2.2, 95% CI 1.8–2.9; 1.9, 95% CI 1.6–2.2).

Conclusions

The COVID-19 pandemic and the lockdown were associated with increased post-lockdown depression and anxiety. Patients with pre-existing mental health conditions are a vulnerable group for severe COVID-19 disease.

Available only for authorised users

Holmes EA, O’Connor RC, Perry VH et al (2020) Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry 7:547–560. https://doi.org/10.1016/S2215-0366(20)30168-1CrossRefPubMedPubMedCentral

Simon N, Saxe G, Marmar CR (2020) Mental health disorders related to COVID-19 – related deaths. JAMA 324:1493–1494. https://doi.org/10.1001/jama.2020.19632CrossRefPubMed

Kessler RC, Bromet EJ (2013) The epidemiology of depression across cultures. Annu Rev Public Health 34:119. https://doi.org/10.1146/ANNUREV-PUBLHEALTH-031912-114409CrossRefPubMedPubMedCentral

Bandelow B, Michaelis S (2015) Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci 17:327. https://doi.org/10.31887/DCNS.2015.17.3/BBANDELOWCrossRefPubMedPubMedCentral

Allen J, Balfour R, Bell R, Marmot M (2014) Social determinants of mental health. Int Rev Psychiatry 26:392–407. https://doi.org/10.3109/09540261.2014.928270CrossRefPubMed

Chandola T, Kumari M, Booker CL, Benzeval MJ (2020) The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK. Psychol Med 7:1–10. https://doi.org/10.1017/S0033291720005048CrossRef

Kuehner C (2017) Why is depression more common among women than among men? Lancet Psychiatry 4:146–158CrossRefPubMed

Fitzpatrick KM, Harris C, Drawve G (2020) Living in the midst of fear: depressive symptomatology among US adults during the COVID-19 pandemic. Depress Anxiety. https://doi.org/10.1002/da.23080CrossRefPubMedPubMedCentral

Liu L, Ni S-Y, Yan W et al (2021) Mental and neurological disorders and risk of COVID-19 susceptibility, illness severity and mortality: a systematic review, meta-analysis and call for action. EClinicalMedicine 40:101111. https://doi.org/10.1016/J.ECLINM.2021.101111CrossRefPubMedPubMedCentral

10.

Yao H, Chen JH, Xu YF (2020) Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry 7:e21. https://doi.org/10.1016/S2215-0366(20)30090-0CrossRefPubMedPubMedCentral

11.

Otte C, Gold SM, Penninx BW et al (2016) Major depressive disorder. Nat Rev Dis Prim 2:44

12.

Craske MG, Stein MB, Eley TC et al (2017) Anxiety disorders. Nat Rev Dis Prim 3:1–18. https://doi.org/10.1038/nrdp.2017.24CrossRef

13.

Moni MA, Lin P-I, Quinn JMW, Eapen V (2021) COVID-19 patient transcriptomic and genomic profiling reveals comorbidity interactions with psychiatric disorders. Transl Psychiatry 11:160. https://doi.org/10.1038/s41398-020-01151-3CrossRefPubMedPubMedCentral

14.

Xia J, Chen S, Li Y et al (2022) Immune response is key to genetic mechanisms of SARS-CoV-2 infection with psychiatric disorders based on differential gene expression pattern analysis. Front Immunol. https://doi.org/10.3389/FIMMU.2022.798538/FULLCrossRefPubMedPubMedCentral

15.

Fancourt D, Steptoe A, Bu F (2021) Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study. Lancet Psychiatry 8:141–149. https://doi.org/10.1016/S2215-0366(20)30482-XCrossRefPubMed

16.

Ministerio de Trabajo y Economía Social (2020) Evolución del paro registrado, Madrid

17.

Ministerio de Igualdad (2020) Boletín Estadístico Mensual, Madrid

18.

Obón-Santacana M, Vilardell M, Carreras A et al (2018) GCAT|Genomes for life: a prospective cohort study of the genomes of Catalonia. BMJ Open. https://doi.org/10.1136/bmjopen-2017-018324CrossRefPubMedPubMedCentral

19.

Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.xCrossRefPubMed

20.

Carmen Terol-Cantero M, Cabrera-Perona V, Martín-Aragón M (2015) Revisión de estudios de la Escala de Ansiedad y Depresión Hospitalaria (HAD) en muestras españolas. An Psicol. https://doi.org/10.6018/analesps.31.2.172701CrossRef

21.

Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the hospital anxiety and depression scale: an updated literature review. J Psychosom Res 52:69–77. https://doi.org/10.1016/S0022-3999(01)00296-3CrossRefPubMed

22.

Bronfenbrenner U, Ceci SJ (1994) Nature-nurture reconceptualized in developmental perspective: a bioecological model. Psychol Rev 101:568–586CrossRefPubMed

23.

Karachaliou M, Moncunill G, Espinosa A et al (2021) Infection induced SARS-CoV-2 seroprevalence and heterogeneity of antibody responses in a general population cohort study in Catalonia Spain. Sci Rep 11:21571. https://doi.org/10.1038/S41598-021-00807-4CrossRefPubMedPubMedCentral

24.

Dobaño C, Vidal M, Santano R et al (2021) Highly sensitive and specific multiplex antibody assays to quantify immunoglobulins M, A, and G against SARS-CoV-2 antigens. J Clin Microbiol. https://doi.org/10.1128/JCM.01731-20CrossRefPubMedPubMedCentral

25.

Dal Grande E, Chittleborough CR, Campostrini S et al (2015) Health estimates using survey raked-weighting techniques in an Australian population health surveillance system. Am J Epidemiol 182:544–556. https://doi.org/10.1093/aje/kwv080CrossRef

26.

Gobbi S, Płomecka M, Ashraf Z et al (2020) Worsening of preexisting psychiatric conditions during the COVID-19 pandemic. Front Psychiatry 11:581426. https://doi.org/10.3389/fpsyt.2020.581426CrossRefPubMedPubMedCentral

27.

Favreau M, Hillert A, Osen B et al (2021) Psychological consequences and differential impact of the COVID-19 pandemic in patients with mental disorders. Psychiatry Res. https://doi.org/10.1016/j.psychres.2021.114045CrossRefPubMedPubMedCentral

28.

Hao F, Tan W, Jiang L et al (2020) Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behav Immun 87:100–106. https://doi.org/10.1016/j.bbi.2020.04.069CrossRefPubMedPubMedCentral

29.

Cacioppo JT, Cacioppo S (2018) The growing problem of loneliness. Lancet (London, England) 391:426. https://doi.org/10.1016/S0140-6736(18)30142-9CrossRef

30.

Burrai J, Roma P, Barchielli B et al (2020) Psychological and emotional impact of patients living in psychiatric treatment communities during Covid-19 lockdown in Italy. J Clin Med 9:3787. https://doi.org/10.3390/JCM9113787CrossRefPubMedCentral

31.

Mills EHA, Møller AL, Gnesin F et al (2020) National all-cause mortality during the COVID-19 pandemic: a Danish registry-based study. Eur J Epidemiol 35:1. https://doi.org/10.1007/S10654-020-00680-XCrossRef

32.

Sheridan Rains L, Johnson S, Barnett P et al (2021) Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses. Soc Psychiatry Psychiatr Epidemiol 56:13–24. https://doi.org/10.1007/S00127-020-01924-7CrossRefPubMed

33.

Taquet M, Luciano S, Geddes JR, Harrison PJ (2020) Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. Lancet Psychiatry 0366:1–11. https://doi.org/10.1016/S2215-0366(20)30462-4CrossRef

34.

Lee SW, Yang JM, Moon SY et al (2020) Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study. Lancet Psychiatry 7:1025–1031. https://doi.org/10.1016/S2215-0366(20)30421-1CrossRefPubMedPubMedCentral

35.

Park HY, Song I-A, Lee SH et al (2021) Prevalence of mental illness among COVID-19 survivors in South Korea: nationwide cohort. BJPsych open. https://doi.org/10.1192/BJO.2021.1001CrossRefPubMed

36.

Taquet M, Dercon Q, Luciano S et al (2021) Incidence, co-occurrence, and evolution of long-COVID features: a 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLoS Med. https://doi.org/10.1371/JOURNAL.PMED.1003773CrossRefPubMedPubMedCentral

37.

Sass MR, Juul TS, Skov R et al (2022) SARS-CoV-2 seroprevalence among patients with severe mental illness: a cross-sectional study. PLoS One 17:e0264325. https://doi.org/10.1371/JOURNAL.PONE.0264325CrossRefPubMedPubMedCentral

38.

Niemi KME, Karjalainen J, Liao RG et al (2021) Mapping the human genetic architecture of COVID-19. Nature 600:472–477. https://doi.org/10.1038/s41586-021-03767-xCrossRef

39.

Degenhardt F, Ellinghaus D, Juzenas S et al (2022) Detailed stratified GWAS analysis for severe COVID-19 in four European populations. medRxiv. https://doi.org/10.1101/2021.07.21.21260624CrossRef

40.

Garcia-Moreno C, Jansen HA, Ellsberg M et al (2006) Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 368:1260–1269. https://doi.org/10.1016/S0140-6736(06)69523-8CrossRefPubMed

41.

Coll CVN, Ewerling F, García-Moreno C et al (2020) Intimate partner violence in 46 low-income and middle-income countries: an appraisal of the most vulnerable groups of women using national health surveys. BMJ Glob Heal 5:e002208. https://doi.org/10.1136/bmjgh-2019-002208CrossRef

42.

Wright L, Steptoe A, Fancourt D (2021) Does thinking make it so? Differential associations between adversity worries and experiences and mental health during the COVID-19 pandemic. J Epidemiol Community Health 75:817–823. https://doi.org/10.1136/jech-2020-215598CrossRefPubMed

43.

Bratman GN, Anderson CB, Berman MG et al (2019) Nature and mental health: an ecosystem service perspective. Sci Adv. https://doi.org/10.1126/sciadv.aax0903CrossRefPubMedPubMedCentral

44.

Orban E, McDonald K, Sutcliffe R et al (2016) Residential road traffic noise and high depressive symptoms after five years of follow-up: results from the heinz nixdorf recall study. Environ Health Perspect. https://doi.org/10.1289/ehp.1409400CrossRefPubMed

45.

Park J, Chung S, Lee J et al (2017) Noise sensitivity, rather than noise level, predicts the non-auditory effects of noise in community samples: a population-based survey. BMC Public Health. https://doi.org/10.1186/s12889-017-4244-5CrossRefPubMedPubMedCentral

46.

Ministerio de Sanidad Consumo y Bienestar Social (2017) Informe monográfico de Salud Mental, Madrid

47.

Cénat JM, Noorishad PG, Kokou-Kpolou CK et al (2021) Prevalence and correlates of depression during the COVID-19 pandemic and the major role of stigmatization in low- and middle-income countries: a multinational cross-sectional study. Psychiatry Res. https://doi.org/10.1016/j.psychres.2021.113714CrossRefPubMedPubMedCentral

48.

Czeisler M, Lane RI, Wiley JF et al (2021) Follow-up survey of US adult reports of mental health, substance use, and suicidal ideation during the COVID-19 pandemic, september 2020. JAMA Netw open. https://doi.org/10.1001/JAMANETWORKOPEN.2020.37665CrossRefPubMedPubMedCentral

49.

Gagné T, Schoon I, McMunn A, Sacker A (2021) Mental distress among young adults in Great Britain: long-term trends and early changes during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/S00127-021-02194-7CrossRefPubMedPubMedCentral

50.

Santomauro DF, Mantilla Herrera AM, Shadid J et al (2021) Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet (London, England) 398:1700–1712. https://doi.org/10.1016/S0140-6736(21)02143-7CrossRef

51.

Equipo COVID-19 (2020) Informe n^o 42. Situación de COVID-19 en España, Madrid

Title: Mental health and COVID-19 in a general population cohort in Spain (COVICAT study)
Authors: X. Goldberg
G. Castaño-Vinyals
A. Espinosa
A. Carreras
L. Liutsko
E. Sicuri
M. Foraster
C. O’Callaghan-Gordo
P. Dadvand
G. Moncunill
C. Dobaño
B. Cortés
V. Pleguezuelos
K. Straif
J. Garcia-Aymerich
R. de Cid
E. Cardis
M. Kogevinas
Publication date: 28-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Mood Disorders
SARS-CoV-2
Affective Disorder
COVID-19
Anxiety
Published in: Social Psychiatry and Psychiatric Epidemiology / Issue 12/2022
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI: https://doi.org/10.1007/s00127-022-02303-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Mental health and COVID-19 in a general population cohort in Spain (COVICAT study)

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2022

Investigating a psychological model of mental conditions and coping during the COVID-19 pandemic driven by participatory methods

Impact of the 2018 Japan Floods on benzodiazepine use: a longitudinal analysis based on the National Database of Health Insurance Claims

The network of psychosocial health in middle-aged and older adults during the first COVID-19 lockdown

Prevalence of mental disorders in the elderly population 5 years after the Lushan earthquake in Ya’an, China

Trajectories of common mental disorders symptoms before and during the COVID-19 pandemic: findings from the ELSA-Brasil COVID-19 Mental Health Cohort

Violent experiences and neighbourhoods during adolescence: understanding and mitigating the association with mental health at the transition to adulthood in a longitudinal cohort study