Prevalence of anxiety in the COVID-19 pandemic: An updated meta-analysis of community-based studies

https://doi.org/10.1016/j.pnpbp.2020.110207Get rights and content

Highlights

  • Anxiety in the general population has increased 3-fold during the COVID-19 outbreak.

  • Anxiety appears to be highest at the initial phase and the peak of the epidemic.

  • Several risk factors have been identified.

  • Preventive and therapeutic strategies should be implemented.

Abstract

Background

The unprecedented worldwide crisis caused by the rapid spread of COVID-19 and the restrictive public health measures enforced by some countries to slow down its transmission have severely threatened the physical and mental wellbeing of communities globally.

Methods

We conducted a systematic review and meta-analysis to determine the prevalence of anxiety in the general population during the COVID-19 pandemic. Two researchers independently searched for cross-sectional community-based studies published between December 1, 2019 and August 23, 2020, using PubMed, WoS, Embase, and other sources (e.g., grey literature, manual search).

Results

Of 3049 records retrieved, 43 studies were included. These studies yielded an estimated overall prevalence of anxiety of 25%, which varied significantly across the different tools used to measure anxiety. Consistently reported risk factors for the development of anxiety included initial or peak phase of the outbreak, female sex, younger age, marriage, social isolation, unemployment and student status, financial hardship, low educational level, insufficient knowledge of COVID-19, epidemiological or clinical risk of disease and some lifestyle and personality variables.

Conclusions

As the overall global prevalence of anxiety disorders is estimated to be 7.3% normally, our results suggest that rates of anxiety in the general population could be more than 3 times higher during the COVID-19 pandemic. These findings suggest a substantial impact on mental health that should be targeted by individual and population-level strategies.

Keywords

Anxiety
COVID-19
Prevalence
Community-based studies
Meta-analysis

Abbreviations

COVID-19
coronavirus infectious disease 2019
SARS-CoV-1
severe acute respiratory syndrome coronavirus 1
MERS-CoV
Middle East respiratory syndrome coronavirus
GAD
Generalized Anxiety Disorder scale
DASS
Depression Anxiety and Stress Scale
SAS
Zung Self-rating Anxiety Scale
STAI
State-Trait Anxiety Inventory
BAI
Beck Anxiety Inventory
HADS
Anxiety and Depression Scale
BSI-53
Brief Symptom Inventory-53

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