Anxiety and depression levels in Malta : a year into COVID-19 pandemic

Background: Covid-19 pandemic resulted in a number of lifestyle changes and restrictive measures. The aim was to assess for the impact of Covid-19 on anxiety- depression levels and associated behavioural attitudes among the adult population of Malta.Methods: An anonymous survey using Google Forms was disseminated on social media (1st to 26th of February), targeting the adult residents of Malta. The survey’s questions assessed for sociodemographic characteristics, changes in physical activity levels, and body weight. The Generalised Anxiety Disorder assessment tool was used to evaluate the level of anxiety and the Patient Health Questionnaire-9 assessment tool was used to evaluate the level of depression among the participants during the pandemic. Quantitative and qualitative analyses were performed.Results: A total of 1,034 participants responded. Mild anxiety levels (41.20% CI95%:38.24 - 44.23) and minimal depression levels (54.23% CI95%:51.17-57.25) were generally reported. On stratification by employment status, students reported severe anxiety levels (p = <0.01). Indeed, a participant reported, ‘‘COVID-19 made me very anxious. . .not knowing if I will be finishing my degree’’. Covid-19 also impacted on behavioural attitudes, ‘‘I am eating more, I put on weight. . .resulting in feeling a bit depressed and have nothing to look forward to’’. Indeed, a proportional increase in body weight was reported among those with mild to severe anxiety levels (p = <0.01). An inverse trend with an increase in anxiety and depression scores and decrease physical activity levels was observed (p =