The impact of COVID-19 lockdown on a cohort of adults with recurrent major depressive disorder from Catalonia: a decentralized longitudinal study using remote measurement technology

Background The present study analyzes the effects of each containment phase of the first COVID-19 wave on depression levels in a cohort of adults with a history of major depressive disorder (MDD). Methods This analysis is part of the Remote Assessment of Disease and Relapse-MDD (RADAR-MDD) study. Individuals included had a diagnosis of DSM-5 major depressive disorder (MDD), at least two episodes of major depression (MDE), one of them in the previous two years. Depression was evaluated with the Patient Health Questionnaire-8 (PHQ-8) and anxiety with the Generalized Anxiety Disorder-7 (GAD-7). A total of 121 participants recruited from Catalonia were registered from November 1, 2019, to October 16, 2020. Levels of depression were explored across the phases (pre-lockdown, lockdown, four post-lockdown phases) of the restrictions imposed by the Spanish/Catalan governments. Then, a mixed model was fitted to estimate how depression varied over the phases. Results A small but statistically significant rise in the depressive severity was found during the lockdown and phase 0 (early post-lockdown), as compared with the pre-lockdown phase in this sample with a history of MDD. Those with low pre-lockdown depression experienced an increase in depression levels during the “new normality”. We observed a significant decrease in the depression levels during the “new normality” in those with high pre-lockdown depression, compared to the pre-lockdown period. Conclusion These findings suggest that COVID-19 restrictions impacted on the depression of individuals diagnosed with MDD, depending on their pre-lockdown depression severity. Furthermore, these subjects worsened when the restrictions were harder, during the lockdown and the early post-lockdown.