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Prevalence and Correlates of Probable Depression and Anxiety Among Homeless Individuals During the COVID-19 Pandemic
Veronika Kowalski1, André Hajek2, Victoria Van Rüth1
1Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany.
Objective:
Homeless individuals are vulnerable, and a high burden of mental health problems is suspected. We aim to identify the prevalence and key predictors of probable depression and anxiety among homeless individuals in Germany during the Coronavirus disease-2019 (COVID-19) pandemic.
Study Design:
Nationwide multicentre cross-sectional study including clinical, laboratory, and questionnaire-based data on the health of homeless individuals in Germany.
Methods:
Data were used from the National Survey on the psychiatric and somatic health of homeless individuals during the COVID-19 pandemic. Probable depression and anxiety were determined using the Patient Health Questionnaire 9 and the General Anxiety Disorder 2 questionnaire. Logistic regression analysis was used to identify key predictors of probable depression and anxiety.
Results:
A high prevalence of probable depression (26.8% [95% CI: 23.2-30.3]) and anxiety (27.2% [95% CI: 23.7-30.7]) was found. Logistic regressions showed both probable depression and anxiety associated with being female (depression: OR 1.80 [95% CI: 1.06-3.03]; anxiety: OR: 1.69 [95% CI: 1.03-2.76]), daily use of any illegal substances (depression: OR 3.20 [95% CI: 1.87-5.49]; anxiety: OR 2.04 [95% CI: 1.21-3.45]), and fear of contracting COVID-19 (little fear, depression: OR: 1.81 [95% CI 1.01-3.23], some fear, anxiety: OR: 2.52 [95% CI: 1.31-4.83]). Probable depression was associated with longer durations of homelessness (OR: 1.004, [95% CI: 1.001-1.007].
Conclusions:
Probable depression and anxiety are highly prevalent in homeless individuals throughout. Key predictors may help to identify individuals in need and design targeted interventions.
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