Depressive symptoms among adults in 2018–2019 and during the 2020 COVID-19 pandemic in Italy

BACKGROUND: Restrictions due to Coronavirus disease 2019 (COVID-19) has produced a large number of effects on mental health, which are expected to endure over time. In this study, we assessed depressive symptom levels before the COVID-19 pandemic, from January 2018 to December 2019, and during the pandemic in Italy in 2020. METHODS: We used the Patient Health Questionnaire-2 (PHQ-2), which is a screening instrument devised to detect probable depression and which has been annually administered in the framework of the Italian Behavioural Risk Factor Surveillance System since 2008. Depressive symptoms were assessed in a sample of 41,362 18–64-year-old adults surveyed in 2018–2019 and in a sample of 14,612 adults surveyed in 2020. RESULTS: The prevalence of depressive symptoms increased from 6.1% (95% CI 5.8%–6.4%) in 2018–2019 to 7.1% (95% CI 5.6%–8.6%) in March–April 2020. It then declined in May–June to 4.4% (95% CI 3.2%–5.5%) but in July–August it once again increased to 8.2% (95% CI 6.0%–10.4%) and, finally, gradually returned above the pre-lockdown level by November–December 2020 (5.9%; 95% CI 4.7%–7.1%). Compared to before the health crisis, during the pandemic, women and individuals with financial difficulties were found to have a significantly higher risk of depressive symptoms while younger, individuals with a higher education and those living in South Italy became increasingly vulnerable. CONCLUSIONS: While the average response to the pandemic was one of resilience over time, women and younger individuals were found to be particularly prone to the risk of depressive symptoms, as a result of the pandemic. In future investigations, the risk of individuals living in the South of Italy should also be taken into consideration.