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. 2025 Jan 3;20(1):e0313689.
doi: 10.1371/journal.pone.0313689. eCollection 2025.

Mental health in Germany before, during and after the COVID-19 pandemic

Affiliations

Mental health in Germany before, during and after the COVID-19 pandemic

Alexander Patzina et al. PLoS One. .

Abstract

Based on nationally representative panel data (N person-years = 40,020; N persons = 18,704; Panel Labour Market and Social Security; PASS) from 2018 to 2022, we investigate how mental health changed during and after the COVID-19 pandemic. We employ time-distributed fixed effects regressions to show that mental health (Mental Health Component Summary Score of the SF-12) decreased from the first COVID-19 wave in 2020 onward, leading to the most pronounced mental health decreases during the Delta wave, which began in August 2021. In the summer of 2022, mental health had not returned to baseline levels. An analysis of the subdomains of the mental health measure indicates that long-term negative mental health changes are mainly driven by declines in psychological well-being and calmness. Furthermore, our results indicate no clear patterns of heterogeneity between age groups, sex, income, education, migrant status, childcare responsibilities or pre-COVID-19 health status. Thus, the COVID-19 pandemic appears to have had a uniform effect on mental health in the German adult population and did not lead to a widening of health inequalities in the long run.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Mean development of mental health (on a scale from 1 to 5) before and during the COVID-19 pandemic.
Note: PASS data.
Fig 2
Fig 2. Mean development of mental health index components (on a scale from 1 to 5) before and during the COVID-19 pandemic.
Note: PASS data.
Fig 3
Fig 3. Heterogeneity in intra-individual changes of the mental health index during the pandemic.
Note: Figure shows point estimates of the employed time variable based on individual fixed effects regressions. Control variables: Interview month indicator variables, interview mode, and age (linear).
Fig 4
Fig 4. Intra-individual changes of the mental health components during the pandemic.
Note: Figure shows point estimates of the employed time variable based on individual fixed effects regressions. Control variables: Interview month, interview mode, and age (linear).

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