Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014-2021

Abstract

Purpose: The COVID-19 pandemic increased the burden of mental disorders worldwide. Peru has been one of the countries most affected by COVID-19, however, studies evaluating the medium and long-term consequences of the pandemic on Peruvians' mental health are recent and represent a new field of study in proliferation. We aimed to estimate the impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru.

Methods: Our study is an analysis of secondary data. We carried out a time series cross-sectional analysis based on the National Demographic and Health Survey of Peru, collected using a complex sampling design. The Patient Health Questionnaire-9 was used to measure mild (5-9 points), moderate (10-14 points), and severe (15 points or more) depressive symptoms. The participants were men and women aged 15 years and older, living in urban and rural areas of all regions of Peru. The main statistical analysis used segmented regression with Newey-West standard errors, taking into account that each year of the evaluation was divided into four measures (quarter measure).

Results: We included 259,516 participants. An average quarterly increase of 0.17% (95% CI 0.03-0.32%) in the prevalence of moderate depressive symptoms was identified after the onset of the COVID-19 pandemic (approximately an increase of 1583 new cases of moderate depressive symptoms by each quarter). The percentage of cases treated for mild depressive symptoms increased quarterly by an average of 0.46% (95% CI 0.20-0.71%) after the onset of the COVID-19 pandemic (approximately an increase of 1242 new cases treated for mild depressive symptoms by each quarter).

Conclusion: In Peru, increases in the prevalence of moderate depressive symptoms and the proportion of cases treated with mild depressive symptoms were found after the COVID-19 pandemic. Therefore, this study is a precedent for future research assessing the prevalence of depressive symptoms and the proportion of cases receiving treatment during the pandemic and post-pandemic years.

Keywords: Depressive symptoms; Epidemiology; Prevalence; Public health; Treatments.

Fig. 1

Interrupted time series analysis (quarterly) for depressive symptoms according to level of intensity (adjusted model). Blue color (first dotted line) are mild depressive symptoms. Purple color (second dotted line) are moderate depressive symptoms. Red color (third dotted line) are severe depressive symptoms. Adjusted model by sex, wealth index, and age. In all the analyses, the weighted proportion by complex sampling was used. The first measurement on the dotted line corresponds to June 2020

Fig. 2

Interrupted time series analysis (quarterly) for proportion of depressive case treated according to level of intensity (adjusted model). Blue color (first dotted line) are mild depressive symptoms. Purple color (second dotted line) are moderate depressive symptoms. Red color (third dotted line) are severe depressive symptoms. Adjusted model by sex, wealth index, and age. In all the analyses, the weighted proportion by complex sampling was used. The first measurement on the dotted line corresponds to June 2020