Mental health and loneliness in the German general population during the COVID-19 pandemic compared to a representative pre-pandemic assessment

Abstract During the pandemic, the extent of subsequent mental health strains is an important issue. A representative face-to-face survey was conducted to assess mental health consequences in the general population and to identify mental health risk factors. In a representative German sample (N = 2,503), we assessed depression and anxiety symptoms by the PHQ-4 and loneliness by a validated item. An earlier survey (2018) which used the same methods and had comparable response rates served as comparison. Scores of depression and anxiety symptoms increased from an average of 0.89 (SD = 1.21) and 0.77 (SD = 1.17) in 2018 to 1.14 (SD = 1.23) and 1.05 (SD = 1.31) in 2020. Loneliness did not increase (M = 1.35, SD = 0.68 in 2018; M = 1.38, SD = 0.78 in 2020), affecting about one in four participants to some degree. Younger participants and women were most likely to report depression, anxiety, and loneliness. As in the previous survey, social inequality factors contributed to distress and loneliness. The small overall increase of distress was consistent with recent German panel studies. In future studies and mental health interventions female sex, younger age, and socioeconomic disparities need to be considered as vulnerability factors for distress