BackgroundAffective disorders are a debilitating and very prevalent problem throughout the world. Often these are associated with the onset of comorbidities or a consequence of chronic diseases. Anxiety and depression are associated with poor social and personal relationships, compromised health. We aimed to synthesize evidence from studies measuring the impact of a health literacy (HL) intervention on the improvement of affective disorders.MethodsFor this systematic review and meta-analysis, we searched PubMed/MEDLINE, Embase, Web of Science, Ibecs, Cuiden, Scielo, Science Direct and Dialnet for exclusively randomized controlled trial studies (RCTs) published between 1 Jan 2011, and 31 May 2022. The search terms employed were “health literacy,” “health knowledge,” “anxiety,” “anxiety disorder,” “depression,” “depressive disorder,” and “adult.” The risk of bias assessment was performed using the Cochrane Collaboration Revised Risk of Bias tool (RoB2). We conducted random-effects meta-analyses and explored heterogeneity using meta-regression and a stratified survey.ResultsOf 2,863 citations found through the initial screening, 350 records were screened by the title and abstract for their themes and relevance. Finally, nine studies complied with the inclusion criteria for the meta-analysis. 66.66% of studies (n = 6) were rated as having a low risk of bias and 33.33% (n = 3) were judged to raise some concerns. The health literacy interventions were associated with −1.378 reduction in depression and anxiety questionnaires scores [95% CI (−1.850, −0.906)]. Low mood disorder scores are associated with better mental health and wellbeing.ConclusionOur findings demonstrate that an HL intervention in relation to the symptoms associated with affective disorders improves the emotional state of patients in PHC, with a moderately positive effect in reducing depression and anxiety.

Background: The restrictions introduced to stop the spread of the COVID-19 virus have also had a direct impact on people with chronic diseases and especially on diseases to which lifestyles are relevant in their control and management, such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD), etc. The lockdown measures implemented hindered patients’ ability to lead a healthy lifestyle (balanced diet, physical activity, etc.), which plays a crucial role in the proper management and control of chronic diseases. Method: An observational real world data pre-post study of 668,974 people was undertaken. The patients studied were over 16 years of age, had been receiving care from the Aragon Health Service (Northeastern Spain), been diagnosed with one or more chronic diseases and had not contracted COVID-19. Sociodemographic, comorbidity, pharmacological and health resource use variables were collected during the six months prior to the onset of the lockdown and during the six and 12 months following the end of the lockdown. The comparisons by sex were carried out using a Student T-test or chi squared test to analyse differences. Results: Dyslipidaemia (42.1%) followed by hypertension (35.1%) and anxiety and depression (34.6%) were the most prevalent chronic diseases among the study popualtion. 79.2% patients had between zero and four illness comorbidities. There was a decrease in new diagnoses of other chronic comorbidities in this population as well as a decrease in drugs prescribed and the use of health services. Although women received a higher number of diagnoses of chronic diseases, the number of drugs dispensed was lower, but the use of health services was higher. These figures were maintained throughout the pandemic. Conclusion: Our results suggest that there was a decrease in new diagnoses of comorbidities and in the mortality rate from causes unrelated to COVID-19 due to the closure of health centres during the pandemic. This trend was exacerbated in women.