Increased generalized anxiety, depression and distress during the COVID-19 pandemic: a cross-sectional study in Germany

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Abstract

Background

Since the first cases of the novel coronavirus disease SARS-CoV-2 were reported in December 2019 in China, the virus has spread in most countries. The aim of the present study was to assess initial data on the mental health burden of the German public during the COVID-19 pandemic.

Methods

A cross-sectional study was conducted in Germany and collected complete datasets from 15 704 German residents aged 18 years and over. Besides demographics, generalized anxiety (GAD-7), depression (PHQ-2) and psychological distress (DT) were assessed. Furthermore, COVID-19-related fear, trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 were covered.

Results

Significantly increased symptoms were highly prevalent in all dimensions: generalized anxiety (44.9%), depression (14.3%), psychological distress (65.2%) and COVID-19-related fear (59%). Females and younger people reported higher mental burden. Trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 are negatively associated with mental health burden. However, the subjective level of information regarding COVID-19 is positively associated with increased COVID-19-related fear.

Conclusions

The provision of appropriate psychological interventions for those in need and the provision of transparency and comprehensible information are crucial during the current pandemic.

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Most cited references 29

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A Novel Coronavirus from Patients with Pneumonia in China, 2019

Na Zhu, Dingyu Zhang, Wenling Wang … (2020)

Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)

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A brief measure for assessing generalized anxiety disorder: the GAD-7.

Robert L Spitzer, Kurt Kroenke, Janet B W Williams … (2006)

Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.

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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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Author and article information

Journal

Journal ID (nlm-ta): J Public Health (Oxf)

Journal ID (iso-abbrev): J Public Health (Oxf)

Journal ID (publisher-id): pubmed

Title: Journal of Public Health (Oxford, England)

Publisher: Oxford University Press

ISSN (Print): 1741-3842

ISSN (Electronic): 1741-3850

Publication date (Electronic): 13 July 2020

Electronic Location Identifier: fdaa106

Affiliations

[1] University of Duisburg-Essen , Clinic for Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, 45147 Essen, Germany

Author notes

Address correspondence to Martin Teufel, E-mail: martin.teufel@ 123456uni-due.de

Article

Publisher ID: fdaa106

DOI: 10.1093/pubmed/fdaa106

PMC ID: 7454766

PubMed ID: 32657323

SO-VID: 019814ce-eb36-49ad-a1aa-7d7ffdeb6f14

License:

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

History

Date received : 15 June 2020

Date revision received : 15 June 2020

Date accepted : 16 June 2020

Page count

Pages: 7

Funding

Funded by: Essen University Medicine Foundation;

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article-lifecycle PAP

ScienceOpen disciplines: Public health

Keywords: covid-19,covid-19-related fear,depression,generalized anxiety,mental health

Data availability:

ScienceOpen disciplines: Public health

Keywords: covid-19, covid-19-related fear, depression, generalized anxiety, mental health

Increased generalized anxiety, depression and distress during the COVID-19 pandemic: a cross-sectional study in Germany

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Abstract

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Novel Coronavirus Disease COVID-19

Most cited references 29

A Novel Coronavirus from Patients with Pneumonia in China, 2019

A brief measure for assessing generalized anxiety disorder: the GAD-7.

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

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