Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis

Abstract

Introduction The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. Method We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. Results A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7–48.1, I 2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9–39.4, I 2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity, high publication bias confirmed by Egger's test, and varying prevalence rates across sub-groups. Conclusion South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.

How Has the COVID-19 Pandemic Changed BMI Status and Physical Activity – Its Associations with Mental Health Conditions, Suicidality: An Exploratory Study

“…That is, the pooled prevalence rates for depression and anxiety were reported to be 48.2% (34.8 – 61.8%) and 52.3% (41 – 63.6%), respectively. 44 Although the present study rates seemed lower than the pooled rates, many people were still suffering from mental health problems.…”

“…Considering the COVID-19-related psychiatric epidemiological studies of South Asian countries (including Bangladesh), a recent systematic review pooled the prevalence rates of depression and anxiety and found them to be 34.1% (28.9–39.4%) and 41.3% (34.7 – 48.1%) respectively. 44 The same study also observed that Bangladeshi people were the most psychologically vulnerable within this subcontinent. That is, the pooled prevalence rates for depression and anxiety were reported to be 48.2% (34.8 – 61.8%) and 52.3% (41 – 63.6%), respectively.…”

Prevalence and risk factors of mental disorders during the COVID-19 pandemic in Bangladesh: a systematic review

“…Applying some of the mandatory restrictions, including social distancing at the earlier period of the pandemic inception, people started grabbing and worrying about their lives and personal safety, fear of getting infected, lost a beloved one, absence of appropriate treatment etc., which in uenced the risk of depression, anxiety and stress (17,45). Thus, participants belonging to general people, students etc.…”

“…generally increase psychological suffering, including post-traumatic stress disorder (PTSD), insomnia, phobia, fear, anxiety, depression etc. (15)(16)(17).…”

Perceived stress and generalized anxiety in the Indian population due to lockdown during the COVID-19 pandemic: a cross-sectional study

“… The authors have obviated meta-analysis of anxiety in the general population (Santabárbara et al (2020 1 )) and in specific populations like health workers (Santabárbara et al (2021 2 )) during COVID-19 outbreak that should be included in the introduction and discussion sections. In addition, a recent meta-analysis reported prevalence of anxiety in South Asia and also should be discussed (Hossain et al (2021 3 )). Data analysis: Please, replace ANOVA by t-test.…”