COVID-19 on Depression and Anxiety: Analyzing Age and Sex Differences Among Patients Before and During the Pandemic

The COVID-19 pandemic raised concerns about increased mental health morbidity, yet limited evidence exists on how demand for mental health care manifested in primary care settings during this period. This study evaluated cases of anxiety and depression with conclusive ICD-10 diagnoses recorded in medical records, examining associations with age group, sex, and the pre- versus pandemic context. The sample consisted of 8,365 individuals (6,038 females, 2,316 males; mean age 45.5±16.1 years) who sought spontaneous medical care at Basic Health Units (BHUs) between the pre-pandemic period (2019; n=2,600) and the pandemic period (2020-2022; n=5,755). Contrary to expectations, no significant increase was observed in the proportion of consultations for anxiety (P=0.7) and depression (P=0.4) during the COVID-19 pandemic compared to the pre-pandemic period. However, significant shifts within subgroups were identified: elderly individuals (≥65 years; n=1,382) showed 82% higher odds of depression compared to younger adults, while males had 12% higher odds of anxiety compared to females. These findings reveal that while the pandemic did not lead to a proportional increase in formal mental health diagnoses at primary care level, it was associated with significant demographic shifts particularly higher depression risk among the elderly and elevated anxiety risk among males.