Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 4:33:e9.
doi: 10.1017/S2045796024000088.

Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study

Yi Chai  1   2 , Kenneth K C Man  1   3   4 , Hao Luo  2   5   6 , Carmen Olga Torre  1   7   8 , Yun Kwok Wing  9 , Joseph F Hayes  10   11 , David P J Osborn  10   11 , Wing Chung Chang  12   13 , Xiaoyu Lin  14 , Can Yin  14 , Esther W Chan  1   4   15 , Ivan C H Lam  1 , Stephen Fortin  16 , David M Kern  17 , Dong Yun Lee  18 , Rae Woong Park  18 , Jae-Won Jang  19 , Jing Li  14 , Sarah Seager  14 , Wallis C Y Lau  1   3   4 , Ian C K Wong  1   3
Affiliations

Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study

Yi Chai et al. Epidemiol Psychiatr Sci. .

Abstract

Aims: Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic.

Methods: By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions.

Results: A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021.

Conclusions: Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.

Keywords: COVID-19; OHDSI; OMOP; SARS-CoV-2; mental health; psychiatric disorder.

PubMed Disclaimer

Conflict of interest statement

K. Man reports grants from the CW Maplethorpe Fellowship, National Institute of Health Research, UK, Hong Kong Research Grant Council and the European Commission Horizon 2020 Framework, personal fees from IQVIA and grants from Amgen and GlaxoSmithKline, outside the submitted work; H. Luo reports grants from Research Grants Council of Hong Kong, outside the submitted work; J. Hayes reports grants from UKRI, NIHR UCLH Biomedical Research Centre, and Wellcome Trust and Consultancy Fees from Wellcome Trust and juli Health, outside the submitted work; E. Chan reports grants from Research Grants Council of Hong Kong, Research Fund Secretariat of the Food and Health Bureau of Hong Kong, National Natural Science Fund of China, Wellcome Trust, Bayer, Bristol-Myers Squibb, Pfizer, Janssen, Amgen, Takeda and Narcotics Division of the Security Bureau of Hong Kong; honorarium from Hospital Authority; outside the submitted work; S. Fortin is an employee of Johnson and Johnson and owns stock in Johnson and Johnson; D. Kern is an employee of Janssen R&D, a subsidiary of Johnson and Johnson, and owns stock in Johnson and Johnson; W. Lau reports receiving grants from AIR@InnoHK administered by the Innovation and Technology Commission of Hong Kong outside the submitted work; I. Wong reports grants from Amgen, Bristol-Myers Squibb, Pfizer, Janssen, Bayer, GSK and Novartis, the Hong Kong RGC, and the Hong Kong Health and Medical Research Fund in Hong Kong, National Institute for Health Research in England, European Commission, National Health and Medical Research Council in Australia, consulting fees from IQVIA, payment for expert testimony and is an independent non-executive director of Jacobson Medical in Hong Kong, outside of the submitted work; no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1.
Figure 1.
Monthly number of incident cases of seven mental health diagnoses in 2020 and 2021 and historical averages for that month from 2017 to 2019. Vertical dashed lines represent February and April 2020. The vertical solid line represents January 2021.
Figure 2.
Figure 2.
Monthly incidence of seven mental health diagnoses in 2020 and 2021 and historical averages for that month from 2017 to 2019. Vertical dashed lines represent February and April 2020. The vertical solid line represents January 2021.
Figure 3.
Figure 3.
(a) Estimates of the immediate change (i.e., level change) in monthly number of incident cases of seven mental health diagnoses. (b) Estimates of the gradual change (i.e., slope change) in monthly number of incident cases of seven mental health diagnoses.
Figure 4.
Figure 4.
(a) Estimates of the immediate change (i.e., level change) in monthly incidence of seven mental health diagnoses. (b) Estimates of the gradual change (i.e., slope change) in monthly incidence of seven mental health diagnoses.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ahmed N, Barnett P, Greenburgh A, Pemovska T, Stefanidou T, Lyons N, Ikhtabi S, Talwar S, Francis ER, Harris SM, Shah P, Machin K, Jeffreys S, Mitchell L, Lynch C, Foye U, Schlief M, Appleton R, Saunders KRK, Baldwin H, Allan SM, Sheridan-Rains L, Kharboutly O, Kular A, Goldblatt P, Stewart R, Kirkbride JB, Lloyd-Evans B and Johnson S (2023) Mental health in Europe during the COVID-19 pandemic: A systematic review. The Lancet Psychiatry 10(7), 537–556. - PMC - PubMed
    1. Aknin LB, De Neve JE, Dunn EW, Fancourt DE, Goldberg E, Helliwell JF, Jones SP, Karam E, Layard R, Lyubomirsky S, Rzepa A, Saxena S, Thornton EM, VanderWeele TJ, Whillans AV, Zaki J, Karadag O and Ben Amor Y (2022) Mental health during the first year of the COVID-19 pandemic: A review and recommendations for moving forward. Perspectives on Psychological Science 17(4), 915–936. - PMC - PubMed
    1. Anderson KN, Radhakrishnan L, Lane RI, Sheppard M, DeVies J, Azondekon R, Smith AR, Bitsko RH, Hartnett KP, Lopes-Cardozo B, Leeb RT, van Santen KL, Carey K, Crossen S, Dias TP, Wotiz S, Adjemian J, Rodgers L, Njai R and Thomas C (2022) Changes and inequities in adult mental health–related emergency department visits during the COVID-19 pandemic in the US. JAMA Psychiatry 79(5), 475–485. - PMC - PubMed
    1. Bhaskaran K, Gasparrini A, Hajat S, Smeeth L and Armstrong B (2013) Time series regression studies in environmental epidemiology. International Journal of Epidemiology 42(4), 1187–1195. - PMC - PubMed
    1. Bohlken J, Kostev K, Riedel-Heller S, Hoffmann W and Michalowsky B (2021) Effect of the COVID-19 pandemic on stress, anxiety, and depressive disorders in German primary care: A cross-sectional study. Journal of Psychiatric Research 143, 43–49. - PMC - PubMed