BackgroundThe present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of adults with a history of major depressive disorder (MDD).MethodsThis analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Individuals included had a diagnosis of DSM-5 major depressive disorder (MDD), at least two episodes of major depression (MDE), one of them in the previous two years. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8) and anxiety with the Generalized Anxiety Disorder-7 (GAD-7). A total of 121 participants recruited from Catalonia were registered from November 1, 2019, to October 16, 2020. Levels of depression were explored across the phases (pre-lockdown, lockdown, four post-lockdown phases) of the restrictions imposed by the Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases.ResultsA small but statistically significant rise in the depressive severity was found during the lockdown and phase 0 (early post-lockdown), as compared with the pre-lockdown phase in this sample with a history of MDD. Those with low pre-lockdown depression experienced an increase in depression levels during the “new normality”. We observed a significant decrease in the depression levels during the “new normality” in those with high pre-lockdown depression, compared to the pre-lockdown period.ConclusionThese findings suggest that COVID-19 restrictions impacted on the depression of individuals diagnosed with MDD, depending on their pre-lockdown depression severity. Furthermore, these subjects worsened when the restrictions were harder, during the lockdown and the early post-lockdown.

The present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of 121 adults with a history of major depressive disorder (MDD) from Catalonia recruited from 1 November 2019, to 16 October 2020. This analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8), and anxiety was evaluated with the Generalized Anxiety Disorder-7 (GAD-7). Depression’s levels were explored across the phases (pre-lockdown, lockdown, and four post-lockdown phases) according to the restrictions of Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. A significant rise in depression severity was found during the lockdown and phase 0 (early post-lockdown), compared with the pre-lockdown. Those with low pre-lockdown depression experienced an increase in depression severity during the “new normality”, while those with high pre-lockdown depression decreased compared with the pre-lockdown. These findings suggest that COVID-19 restrictions affected the depression level depending on their pre-lockdown depression severity. Individuals with low levels of depression are more reactive to external stimuli than those with more severe depression, so the lockdown may have worse detrimental effects on them.