Changes in depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population

Aims. To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain; and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown. Methods. Data from a longitudinal adult population-based cohort from the provinces of Madrid and Barcelona were analysed (n = 1103). Structured face-to-face home-based interviews (pre-pandemic) and telephone interviews were performed. Both depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). A variety of validated instruments and sociodemographic variables including age, sex, educational level, occupational status, home quietness, screen time, resilience, loneliness, social support, physical activity, disability, economic situation and COVID-19-related information were also considered. Population prevalence estimates and multivariable logistic regressions were computed. Results. Overall, prevalence rates of depression and suicidal ideation did not change significantly from before to after the COVID-19 outbreak. However, the rates of depression among individuals aged 50+ years showed a significant decrease compared to before the pandemic (from 8.48 to 6.41%; p = 0.01). Younger individuals (odds ratio (OR) = 0.97 per year older; 95% confidence interval (CI) = 0.95–0.99) and those feeling loneliness (OR = 1.96; 95% CI = 1.42–2.70) during the lockdown were at an increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.46; 95% CI = 0.32–0.66) and suicidal ideation (OR = 0.33; 95% CI = 0.16–0.68), whereas individuals perceiving social support were at a lower risk of developing suicidal thoughts (OR = 0.35; 95% CI = 0.18–0.69). Conclusions. Continuous reinforcement of mental health preventive and intervening measures during and in the aftermath of the crisis is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health. E. L.’s work is supported by the Sara Borrell postdoctoral programme (CD18/00099) from the Instituto de Salud Carlos III (Spain) and co-funded by European Union (ERDF/ESF, ‘Investing in your future’). The authors sincerely appreciate the generous contribution of all the participants, which made this work possible. This work was funded by the Instituto de Salud Carlos III (J. L. A. M., grant numbers PI16/00218 and PI19/00150), (J. M. H., grantnumber PI16/01073 and PI19/00088), (M. M., grant number PI19/00235), (B. O., gran number PI19/00103), the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), and by the European Union’s Horizon 2020 under Grant Agreement No 101016127