The Impact of COVID-19 Lockdown on Adults with Major Depressive Disorder from Catalonia: A Decentralized Longitudinal Study

Int J Environ Res Public Health. 2023 Mar 15;20(6):5161. doi: 10.3390/ijerph20065161.


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.

Keywords: SARS-CoV-2; Spain; anxiety; decentralized study; depression; lockdown; quarantine; remote measurement technology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety
  • COVID-19* / epidemiology
  • Communicable Disease Control
  • Depression
  • Depressive Disorder, Major* / epidemiology
  • Humans
  • Longitudinal Studies
  • SARS-CoV-2
  • Spain / epidemiology

Grants and funding

The RADAR-CNS project received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 115902. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation program and EFPIA ( accessed on 8 February 2023). This communication reflects the views of the RADAR-CNS consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funding body has been involved in the design of the study, the collection or analysis of data, or the interpretation of data. MTPM (7Z22/009) is partially released of clinical activity through a personal research grant of IDIAP Jordi Gol and Institut Català de la Salut (ICS).