Mental Health Burden of the COVID-19 Outbreak in Germany: Predictors of Mental Health Impairment

J Prim Care Community Health. Jan-Dec 2020;11:2150132720953682. doi: 10.1177/2150132720953682.


Introduction: COVID-19 is causing an enormous psychological burden for most people. This study aims to assess individual changes in mental health and health status before and after the COVID-19 outbreak, and to explore potential predictors of change.

Methods: A cross-sectional study in Germany (n = 15 037) were conducted. Demographics, depression and anxiety symptoms (PHQ-2, GAD-2), distress (DT), and health status (EQ-5D-3L) were assessed. Additionally, all instruments used were adapted to measure the participants' mental health and health status before the COVID-19 outbreak. COVID-19-related fear, trust in governmental actions to face COVID-19, and the subjective level of information about COVID-19 were examined.

Results: Overall, the participants showed a significant increase in depression and anxiety symptoms, and distress, while health status deteriorated since the COVID-19 outbreak. Impairment in mental health was predicted by COVID-19-related fear. Pre-existing mental illness predicted an increase in depression symptoms and a deterioration in health status. Trust in governmental actions and the subjective level of information predicted less increase in psychological burden.

Conclusions: Our data revealed that there have been changes in mental health and health status at an individual level since the outbreak of COVID-19. In order to maintain mental health, the observed predictors should be addressed.

Keywords: COVID-19; anxiety; changes in mental health; depression; mental health; predictors of change.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / psychology*
  • Cross-Sectional Studies
  • Disease Outbreaks*
  • Fear / psychology
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / psychology*
  • Risk Factors
  • Young Adult

Supplementary concepts

  • COVID-19