The pandemic has taken a devastating toll on the physical health of millions of people. But the mental-health effects could prove even more enduring. A new study published in The Lancet, a medical journal, attempts to quantify the impact of covid-19 on mental health and wellbeing around the world. The authors estimate that cases of depression rose by 53m globally as a consequence of the pandemic, 28% above pre-pandemic levels; cases of anxiety increased by 76m, a 26% rise.
To arrive at these figures, the authors assembled survey data from 48 papers that reported on the prevalence of depressive and anxiety disorders during the pandemic in more than a dozen mostly rich countries, and compared them with corresponding pre-pandemic data. The authors developed a “covid-19 impact index” based on two measures associated with increases in the prevalence of depressive and anxiety disorders: reductions in mobility and the daily covid-19 infection rate. The authors then used this index to estimate the change in prevalence of depressive and anxiety disorders across 204 countries and territories.
They found that the pandemic has affected women’s mental health more than men’s. Of the additional 53m cases of depression and 76m cases of anxiety estimated for 2020, roughly two-thirds were in women. Household responsibilities taken on during lockdown may be partly to blame. A British survey conducted in April and May 2020 found that women were spending roughly 50% more time on housework and nearly twice as much time on childcare as men. Women who spent more time on such unpaid care work tended to report higher levels of psychological distress.
In poor countries, the pandemic caused other problems for women. UNESCO, a UN agency, estimates that 11m girls who dropped out of school during the pandemic may never return to the classroom, increasing the risk that they are subjected to child marriage and other abuses.
Troubled regions seemed to suffer most. According to the authors’ estimates, cases of depression increased by 37% in North Africa and the Middle East, more than any other region. In the case of anxiety, South Asia saw the biggest increase, with an estimated jump of 35%. Citizens of South-East Asia, East Asia and Oceania proved most resilient. Although many countries in that part of the world have imposed some of the strictest border controls, they also enjoyed some of the lowest excess death rates.
There are some limitations to the study. Most of the data came from rich countries, which means estimates for poorer parts of the world may be imprecise. Furthermore, the data underlying the researchers’ model was in most cases based on self-reported symptoms rather than medical diagnoses. Meanwhile, other mental illnesses, such as eating disorders, which may have also been affected by the pandemic, were not included. Nonetheless the study’s findings show another way in which the true toll of the pandemic is far bigger than was initially realised. ■