Increased generalized anxiety, depression and distress during the COVID-19 pandemic: a cross-sectional study in Germany.
Open accessAbstract
BACKGROUND: Since the first cases of the novel coronavirus disease SARS-CoV-2 were reported in December 2019 in China, the virus has spread in most countries. The aim of the present study was to assess initial data on the mental health burden of the German public during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted in Germany and collected complete datasets from 15 704 German residents aged 18 years and over. Besides demographics, generalized anxiety (GAD-7), depression (PHQ-2) and psychological distress (DT) were assessed. Furthermore, COVID-19-related fear, trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 were covered. RESULTS: Significantly increased symptoms were highly prevalent in all dimensions: generalized anxiety (44.9%), depression (14.3%), psychological distress (65.2%) and COVID-19-related fear (59%). Females and younger people reported higher mental burden. Trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 are negatively associated with mental health burden. However, the subjective level of information regarding COVID-19 is positively associated with increased COVID-19-related fear. CONCLUSIONS: The provision of appropriate psychological interventions for those in need and the provision of transparency and comprehensible information are crucial during the current pandemic.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The previously described reduced wellbeing and quality of life in the general population during the pandemic did presumably apply also to the participants in this study.
“The previously described reduced wellbeing and quality of life in the general population during the pandemic did presumably apply also to the participants in this study.”
From Acceptance and commitment therapy in a psychiatric day hospital—A longitudinal naturalistic effectiveness trial (2023) · cites this paper as [26]
The paper’s ‘Main finding of this study’ reports high levels of anxiety, depression and psychological distress in a German sample during the pandemic, supporting the claim of reduced mental wellbeing. Its ‘Measures’ section does not include quality of life, and the paper cannot establish whether the citing study’s participants experienced the same effects. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe average mental wellbeing and subjective quality of life decreased significantly in Germany during the COVID pandemic.
“This is remarkable, considering that in the same time, due to the COVID pandemic and associated restrictions, the average mental wellbeing as well as subjective quality of life decreased significantly in Germany (26–28).”
From Acceptance and commitment therapy in a psychiatric day hospital—A longitudinal naturalistic effectiveness trial (2023) · cites this paper as [26]
The Main finding section reports higher prevalence of depression symptoms and psychological distress than in comparison German samples, supporting a decline in mental health during the pandemic. The Measures section assesses anxiety, depression and distress, but not subjective quality of life; the paper also does not establish a significant decrease in average wellbeing or attribute it specifically to restrictions. Page numbers were not available in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
A novel coronavirus from patients with pneumonia in China, 2019
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001017 · Cited by 28,244 · see citing works
The psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30460-8 · Cited by 16,378 · see citing works
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.3976 · Cited by 8,015 · see citing works
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30168-1 · Cited by 5,715 · see citing works
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008) · Medical Care · doi:10.1097/mlr.0b013e318160d093 · Cited by 4,527 · see citing works
Huang, Y., & Zhao, N. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112954 · Cited by 3,736 · see citing works
COVID-19 and mental health: A review of the existing literature
Rajkumar, R. P. (2020) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2020.102066 · Cited by 3,574 · see citing works
The adequacy of response rates to online and paper surveys: what can be done?
Nulty, D. D. (2008) · Assessment & Evaluation in Higher Education · doi:10.1080/02602930701293231 · Cited by 2,581 · see citing works
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K., et al. (2020) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2020.04.028 · Cited by 2,571 · see citing works
Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19)
Sanders, J. M., Monogue, M. L., Jodlowski, T. Z., & Cutrell, J. B. (2020) · JAMA · doi:10.1001/jama.2020.6019 · Cited by 2,357 · see citing works
Online mental health services in China during the COVID-19 outbreak
Liu, S., Yang, L., Zhang, C., Xiang, Y.-T., Liu, Z., Hu, S., & Zhang, B. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30077-8 · Cited by 1,992 · see citing works
Kang, L., Ma, S., Chen, M., Yang, J., Wang, Y., Li, R., Yao, L., Bai, H., Cai, Z., Xiang Yang, B., et al. (2020) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2020.03.028 · Cited by 1,516 · see citing works
Detecting and monitoring depression with a two-item questionnaire (PHQ-2)
Löwe, B., Kroenke, K., & Gräfe, K. (2005) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2004.09.006 · Cited by 1,473 · see citing works
Garfin, D. R., Silver, R. C., & Holman, E. A. (2020) · Health Psychology · doi:10.1037/hea0000875 · Cited by 1,270 · see citing works
The pandemic of social media panic travels faster than the COVID-19 outbreak
Depoux, A., Martin, S., Karafillakis, E., Preet, R., Wilder-Smith, A., & Larson, H. (2020) · Journal of Travel Medicine · doi:10.1093/jtm/taaa031 · Cited by 1,068 · see citing works
COVID-19, ACE2, and the cardiovascular consequences
South, A. M., Diz, D. I., & Chappell, M. C. (2020) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00217.2020 · Cited by 779 · see citing works
Emami, A., Javanmardi, F., Pirbonyeh, N., & Akbari, A. (2020) · Archives of Academic Emergency Medicine · doi:10.22037/aaem.v8i1.600 · Cited by 767 · see citing works
Hinz, A., Klein, A. M., Brähler, E., Glaesmer, H., Luck, T., Riedel-Heller, S. G., Wirkner, K., & Hilbert, A. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.12.012 · Cited by 443 · see citing works
Covid‐19 and diabetes mellitus: unveiling the interaction of two pandemics
Maddaloni, E., & Buzzetti, R. (2020) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.3321 · Cited by 309 · see citing works
Media Messages and Perception of Risk for Ebola Virus Infection, United States
Sell, T. K., Boddie, C., McGinty, E. E., Pollack, K. M., Smith, K. C., Burke, T. A., & Rutkow, L. (2016) · Emerging infectious diseases · doi:10.3201/eid2301.160589 · Cited by 73 · see citing works
Teufel, M., Schweda, A., Dörrie, N., Musche, V., Hetkamp, M., Weismüller, B., Lenzen, H., Stettner, M., Dinse, H., Bäuerle, A., et al. (2020) · Journal of Public Health · doi:10.1093/pubmed/fdaa060 · Cited by 67 · see citing works
Self-citationBäuerle, A., Graf, J., Jansen, C., Dörrie, N., Junne, F., Teufel, M., & Skoda, E. (2020) · Journal of Public Health · doi:10.1093/pubmed/fdaa058 · Cited by 65 · see citing works
Self-citationPsychological support in times of COVID-19: the Essen community-based CoPE concept
Bäuerle, A., Skoda, E., Dörrie, N., Böttcher, J., & Teufel, M. (2020) · Journal of Public Health · doi:10.1093/pubmed/fdaa053 · Cited by 59 · see citing works
Self-citationHinz, A., Mitchell, A. J., Dégi, C. L., & Mehnert, A. (2018) · Quality of Life Research · doi:10.1007/s11136-018-2014-1 · Cited by 33 · see citing works
Spangenberg, L., Brähler, E., & Glaesmer, H. (2012) · Zeitschrift für Psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2012.58.1.3 · Cited by 29 · see citing works
Psychoneuroimmunologie: Ein Update
Schubert, C., & Schüßler, G. (2009) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2009.55.1.3 · Cited by 13 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kunzler, A. M., Röthke, N., Günthner, L., Stoffers-Winterling, J., Tüscher, O., Coenen, M., Rehfuess, E., Schwarzer, G., Binder, H., Schmucker, C., et al. (2021) · Globalization and Health · doi:10.1186/s12992-021-00670-y · Cited by 262 · see citing works
Mariani, R., Renzi, A., Di Trani, M., Trabucchi, G., Danskin, K., & Tambelli, R. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.587724 · Cited by 199 · see citing works
Duplaga, M., & Grysztar, M. (2021) · Healthcare · doi:10.3390/healthcare9010043 · Cited by 106 · see citing works
“Similar results were reported by other authors [10,92].”
BackgroundMethodResultInfluentialCOVID-19-Related Fear and Health-Related Safety Behavior in Oncological Patients
Musche, V., Bäuerle, A., Steinbach, J., Schweda, A., Hetkamp, M., Weismüller, B., Kohler, H., Beckmann, M., Herrmann, K., Tewes, M., et al. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01984 · Cited by 99 · see citing works
Self-citationBruhns, A., Lüdtke, T., Moritz, S., & Bücker, L. (2021) · JMIR mHealth and uHealth · doi:10.2196/26498 · Cited by 68 · see citing works
Preuss, H., Capito, K., van Eickels, R. L., Zemp, M., & Kolar, D. R. (2021) · Internet Interventions · doi:10.1016/j.invent.2021.100388 · Cited by 64 · see citing works
Keller, F. M., Derksen, C., Kötting, L., Dahmen, A., & Lippke, S. (2023) · Applied Psychology: Health and Well-Being · doi:10.1111/aphw.12352 · Cited by 56 · see citing works
Rentrop, V., Damerau, M., Schweda, A., Steinbach, J., Schüren, L. C., Niedergethmann, M., Skoda, E.-M., Teufel, M., & Bäuerle, A. (2022) · JMIR Formative Research · doi:10.2196/31229 · Cited by 42 · see citing works
Kunzler, A. M., Stoffers-Winterling, J., Stoll, M., Mancini, A. L., Lehmann, S., Blessin, M., Gilan, D., Helmreich, I., Hufert, F., & Lieb, K. (2021) · PLOS ONE · doi:10.1371/journal.pone.0244748 · Cited by 41 · see citing works
Ripoll, J., Contreras-Martos, S., Esteva, M., Soler, A., & Serrano-Ripoll, M. J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10143191 · Cited by 25 · see citing works
Daimer, S., Mihatsch, L. L., Neufeld, S. A., Murray, G. K., & Knolle, F. (2022) · eLife · doi:10.7554/elife.75893 · Cited by 21 · see citing works
Rutschmann, R., Romanczuk-Seiferth, N., & Richter, C. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1052874 · Cited by 10 · see citing works
Kocol, D., Bäuerle, A., Schadendorf, T., Geiger, S., Krakowczyk, J. B., Skoda, E.-M., & Teufel, M. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1296433 · Cited by 7 · see citing works
Self-citationMakević, A., Ilić, S., Pantović-Stefanović, M., Murić, N., Djordjević, N., & Jurišić, V. (2022) · International Journal of Disaster Risk Reduction · doi:10.1016/j.ijdrr.2022.103086 · Cited by 7 · see citing works
Volkert, J., Taubner, S., Berning, A., Kling, L., Wießner, H., Georg, A. K., & Holl, J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.720104 · Cited by 6 · see citing works
- Authors
- Bäuerle, A., Teufel, M., Musche, V., Weismüller, B., Kohler, H., Hetkamp, M., Dörrie, N., Schweda, A., & Skoda, E.-M.
- Affiliations
- Essen University Hospital (DE)
- University of Duisburg-Essen, Clinic for Psychosomatic Medicine and Psychotherapy, LVR University Hospital Essen, 45147 Essen, Germany
- Corresponding author
- Teufel, Martin
- Venue
- Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-07-13
- Volume
- 42
- Issue
- 4
- Pages
- 672-678
- ISSN
- 0943-1853 (ISSN-L)
- 1741-3842
- 1741-3850
- PMC
- PMC7454766
- OpenAlex
- W3041048391
- Cited by
- 597
- References
- 27
- Citations by year
- 2026: 13 · 2025: 36 · 2024: 58 · 2023: 105 · 2022: 171 · 2021: 190 · 2020: 24
- FWCI
- 48.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Essen University Medicine Foundation
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID-19 pandemic, mental health burden, generalized anxiety disorder, depression, psychological distress, public trust in government, COVID-19 information, sex differences, age differences, German population
- MeSH terms
- COVID-19, SARS-CoV-2, Adult, Aged, Anxiety, Cross-Sectional Studies, Depression, Fear, Female, Germany, Humans, Male, Middle Aged, Stress, Psychological, Prevalence, Access to Information, Trust, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review