Table 2. Changes in mental health in the NAKO study during the COVID-19 pandemic (2020) compared to the previous period (2014–2019).
| PHQ-9 (scores) | GAD-7 (scores) | |||||
| b | [95% CI] | p | b | [95% CI] | p | |
| Wave | ||||||
| Baseline survey | Reference category | Reference category | ||||
| COVID-19 survey | 0.03 | [0.00; 0.06] | 0.033 | 0.06 | [0.03; 0.08] | <0.001 |
| Occupational and financial changes during the pandemic | ||||||
| Change in employment situation | ||||||
| Working – no pandemic-related change | Reference category | Reference category | ||||
| Working – change of job | 0.29 | [−0.00; 0.57] | 0.051 | 0.38 | [0.12; 0.63] | 0.004 |
| Working – increased working hours | 0.78 | [0.71; 0.85] | <0.001 | 0.71 | [0.65; 0.77] | <0.001 |
| Working – reduced working hours with short-time allowance | −0.17 | [−0.24; −0.10] | <0.001 | −0.20 | [−0.26; −0.13] | <0.001 |
| Working – reduced working hours without short-time allowance | 0.09 | [0.03; 0.15] | 0.002 | 0.13 | [0.08; 0.18] | <0.001 |
| Unemployed prior to Corona | 0.61 | [0.51; 0.71] | <0.001 | 0.52 | [0.43; 0.61] | <0.001 |
| Unemployed due to Corona | 1.16 | [0.91; 1.41] | <0.001 | 0.66 | [0.44; 0.88] | <0.001 |
| Inactive person (pension, retirement, study) | −0.13 | [−0.18; −0.07] | <0.001 | −0.12 | [−0.17; −0.08] | <0.001 |
| Job Insecurity | ||||||
| High (reference category: ”low or not employed” | 0.77 | [0.72; 0.82] | <0.001 | 0.69 | [0.65; 0.74] | <0.001 |
| Working from home | ||||||
| Yes, always or on some days (reference category: “No“) | 0.41 | [0.36; 0.45] | <0.001 | 0.28 | [0.25; 0.32] | <0.001 |
| Change in financial situation | ||||||
| No change | Reference category | Reference category | ||||
| Improvement | −0.15 | [−0.25; −0.05] | 0.004 | −0.15 | [−0.24; −0.06] | 0.001 |
| Deterioration | 0.81 | [0.76; 0.86] | <0.001 | 0.75 | [0.71; 0.80] | <0.001 |
| Covariates | ||||||
| Age | ||||||
| 19–29 years | Reference category | Reference category | ||||
| 30–39 years | 0.12 | [0.01; 0.23] | 0.026 | 0.06 | [−0.03; 0.16] | 0.198 |
| 40–49 years | 0.22 | [0.06; 0.38] | 0.008 | 0.17 | [0.03; 0.31] | 0.018 |
| 50–59 years | 0.14 | [−0.04; 0.32] | 0.128 | 0.15 | [−0.01; 0.30] | 0.070 |
| 60–69 years | −0.23 | [−0.43; −0.03] | 0.023 | −0.11 | [−0.28; 0.07] | 0.238 |
| 70–79 years | −0.47 | [−0.68; −0.25] | <0.001 | −0.33 | [−0.52; −0.14] | 0.001 |
| Type of household | ||||||
| One-person household | Reference category | Reference category | ||||
| Multiple-person household without children (<14 years) | −0.18 | [−0.24;−0.13] | <0.001 | 0.07 | [0.02; 0.12] | 0.005 |
| Multiple-person household with children (< 14 years) | −0.13 | [−0.21;−0.05] | 0.001 | 0.22 | [0.15; 0.29] | <0.001 |
| High-risk contact with an infected person | ||||||
| Yes (reference category: “No“) | 0.24 | [0.14; 0.34] | <0.001 | 0.24 | [0.14; 0.34] | <0.001 |
| Tested positive for SARS-CoV-2 virus | ||||||
| Yes (reference category: “No“) | −0.03 | [−0.35; 0.30] | 0.865 | −0.03 | [−0.35; 0.30] | 0.865 |
| General health | ||||||
| Poor (reference category: “Good”) | 2.26 | [2.20; 2.31] | <0.001 | 2.26 | [2.20; 2.31] | <0.001 |
| Model information | ||||||
| R2 (intrapersonal) | 0.072 | 0.062 | ||||
| R2 (interpersonal) | 0.201 | 0.148 | ||||
| R2 (total) | 0.156 | 0.117 | ||||
| Individuals (n) | 161 787 | 161 787 | ||||
| Observations (n) | 323 574 | 323 574 | ||||
Mental health measured using PHQ-9 (depressive symptoms) and GAD-7 (anxiety disorder). The analyses are based on a linear fixed-effects model with jointly adjusted regression coefficient b.
Positive vales indicate deterioration of mental health (increase in symptom value), while negative values indicate improvement. The total R-squared value indicates the weighted mean of the explained variance between and within persons.
b, adjusted regression coefficient; GAD-7, Generalized Anxiety Disorder Scale-7; CI, confidence interval;
NAKO, German National Cohort Study; p, p-value; PHQ-9, Patient Health Questionnaire