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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

Alexander Patzina  1   2 , Matthias Collischon  2 , Rasmus Hoffmann  1 , Maksym Obrizan  3
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).
See this image and copyright information in PMC

References

    1. Blendermann M, Ebalu TI, Obisie-Orlu IC, Fried EI, Hallion LS. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol Med. 2023; 1–24. doi: 10.1017/S0033291723002295 - DOI - PMC - PubMed
    1. Cénat JM, Blais-Rochette C, Kokou-Kpolou CK, Noorishad PG, Mukunzi JN, McIntee SE, et al.. Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. 2021; 295:113599. doi: 10.1016/j.psychres.2020.113599 - DOI - PMC - PubMed
    1. Cénat JM, Farahi SMMM, Dalexis RD, Darius WP, Bekarkhanechi FM, Poisson H, et al.. The global evolution of mental health problems during the COVID-19 pandemic: a systematic review and meta-analysis of longitudinal studies. J Affect Disord. 2022; 315:70–95. doi: 10.1016/j.jad.2022.07.011 - DOI - PMC - PubMed
    1. Sun Y, Wu Y, Fan S, Dal Santo T, Li L, Jiang X, et al.. Comparison of mental health symptoms before and during the COVID-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ. 2023; 380. - PMC - PubMed
    1. Etikan I, Musa SA, Alkassim RS. Comparison of convenience sampling and purposive sampling. Am J Theor Appl Stat. 2016; 5(1):1–4.