Mental health of Covid-19 risk groups during the first Covid-19 lockdown in Germany: a cross-sectional study

Background: The ongoing Covid-19 pandemic not only threats physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We, therefore, assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression. Methods Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for an increased risk of severe illness from Covid-19 and various aspects of mental health during the first Covid-19 lockdown in Germany. Standardized and validated self-report measures (e.g. PHQ-9, GAD-7) were used using Mann-Whitney U-tests as well as regression and mediation analyses. Results The results clearly show that the mental health burden is higher among persons at increased risk of severe illness from Covid-19 compared to persons at low risk of severe illness from Covid-19. Moreover, our findings indicate that individuals at increased risk of severe illness are more worried about their health during the pandemic and may therefore respond with social withdrawal to protect themselves and, consequently, experience higher levels of loneliness, which in turn has an impact on depressive symptoms. Conclusions Individuals at increased risk of severe illness have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.