It is internationally well documented that the COVID-19 pandemic has led to an unprecedented impact on the mental health of broad sections of the world’s population. This includes people with pre-existing mental health problems as well as those who were not previously affected before the corona crisis.
A new study published this month in The Lancet sought to quantify the global prevalence and burden of depression and anxiety disorders, and found significant increases worldwide. The study was a systematic review of published data that reported the prevalence of depression and anxiety before the pandemic, and compared this using 48 articles published during the first 12 months of the 2020 pandemic.
The study, conducted by investigators from the Queensland Center for Mental Health Research and the University of Queensland in Australia, presented data from 204 countries and territories. If the pandemic did not occur, model estimates suggest that there would have been 193 million cases of major depressive disorder (2,471 cases per 100,000 population) globally by 2020.
However, the results of the study show that there were 246 million cases (3,153 per 100,000), an increase of 28 percent, an increase of 53 million cases. Similarly, the number of anxiety cases increased by 76 million, 26 percent above expectations if there had not been a pandemic. More than 35 million of the additional cases were in women, compared to close to 18 million in men.
The study also showed that younger people were more affected by severe depression and anxiety disorders by 2020 than older age groups. The additional incidence of both disorders peaked among those aged 20-24 years, which resulted in 1,118 additional cases of major depressive disorder per year. 100,000 and 1,331 additional cases of anxiety disorders per. 100,000. This was found to decrease with increasing age.
Further, the study showed that some regions of the world fared worse than others, especially those experiencing military conflict such as North Africa and the Middle East. The latter recorded the largest increase in depression at 37 percent. South Asia experienced the largest increase in anxiety at 35%.
The increased prevalence was associated with increasing COVID-19 infection rates as well as declining human mobility. The authors cited, among other things, “the combined effects of the spread of the virus, shutdowns, orders to stay at home, reduced public transportation, school and business closures, and reduced social interactions.” It was further estimated that countries that were more negatively affected by the pandemic during 2020 were those with the largest increase in these disorders.
The study’s lead author, Dr Damian Santomauro, said in a press release “Our findings highlight an urgent need to strengthen mental health systems to address the growing burden of major depressive disorder and anxiety disorders worldwide.”
The authors noted that mental illness is among the leading causes of the global health-related burden, with the two most disabling conditions, depression and anxiety disorders, both of which are among the 25 leading causes of burden worldwide in 2019. This was the case internationally. , and across gender boundaries, a trend that had persisted since 1990.
Dr. Santomauro stated: “Even before the pandemic, mental health systems in most countries have historically been under-resources and disorganized in their services. It will be challenging to meet the growing demand for mental health services due to COVID-19, but failing to act should not be an option. “
The implications of this were highlighted by a study earlier this year which showed that people suffering from the mood-related conditions were twice as likely to suffer severe negative consequences of COVID infection, including serious illness, hospitalization and death.
Published in July in JAMA Psychiatry, a journal of the American Medical Association, was a review and meta-analysis of 21 published studies involving more than 91 million people worldwide.
In an interview with the Australian Broadcasting Corporations’ (ABC) Health Report, senior author Dr. Roger McIntyre, “…. we have all been aware of the risk given if you have cardiovascular disease and obesity, and what we have learned is that the risk with these well-known pre-existing conditions …… “Having a depression or bipolar disorder is in many cases a doubling of the risk, if not more than a doubling of the risk. So it is an extraordinary risk.”
Although the relationship between mood disorders and the risk of COVID-19 is still unclear, the authors say that patients may exhibit immune dysfunction that may lead to deficiencies in the management of viral infections. In addition, people with mood disorders may be at greater risk for cardiovascular disease and obesity, which are known to increase the dangers of COVID.
In addition, there are social factors that exacerbate adverse outcomes for those with mood disorders. These patients are increasingly poor and have limited timely access to preventive health care.
The study authors note that “many individuals with mood disorders live in community facilities, such as psychiatric wards, homeless shelters, community housing and prisons, where the risk of COVID-19 transmission is increased due to inability to effectively distance themselves from social and / or quarantined. “
Professor Iain Hickie of the Brain Mind Institute at the University of Sydney added: “One of the flaws of depression is thinking of it as just a psychological reaction. It is a physiological disorder. The body is disturbed, in the immune system, in the neuroendocrine or cortisol or “stress response system, in the sympathetic nervous system and in its metabolic system. So depression is much, much more than just in your head, it’s in your body, and your body is disturbed and has trouble coping with things like infection, with viral diseases.”
Young people are particularly vulnerable. Professor Hickie explained that mood disorders start in young people, with most before the age of 25.
The results of the report are supported by a similar survey design in May 2021 in the journal Psychiatric research. In over 600,000 COVID19 patients, researchers from the University of Jordan found that a prior diagnosis of mental disorders increased the risk of COVID19 mortality and the severity of the disease. Higher mortality occurred in patients with disorders such as schizophrenia.
This is exacerbated by the fear of contracting the virus, becoming seriously ill, the impact of lockdown and decreased social interaction. A previous study in December 2020 of over 90,000 people from eight countries in Journal of Affective Disorders revealed significant increases in rates for; anxiety (6 to 51%), depression (15 to 48%), post-traumatic stress disorder (7 to 54%), mental disorders (34 to 38%) and stress (8% to 82%).
The situation of those with mental illness is not the result of the pandemic. The coronavirus has instead exacerbated what was an already existing crisis. This is due to the reduction in mental health care budgets in virtually all countries, including the closure of nursing homes, the reduction of staff and beds in hospitals and the increased cost of private mental health care.
The World Health Organization’s report on Mental Health Atlas 2017 found in a survey among 169 countries that mental health spending on average was less than 2 percent of health budgets. Mental health development assistance has never been more than 1 percent of global health development assistance.
These research findings suggest that the crisis triggered by COVID will see a drastic increase in morbidity and mortality for those suffering from mental illness globally, not only during the pandemic, but for many years to come.
In addition to the strain of cuts in mental health services, governments’ criminal response to the pandemic has greatly exacerbated the pressures workers face. While rescuing the banks and forcing the working class to pay, capitalist governments have lifted lockdowns and other significant security measures, allowing the virus to circulate and millions to die, to ensure corporate profit-making and capitalist exploitation can continue.