The impact of the COVID-19 pandemic on mental health symptoms in new patients presenting to outpatient psychiatry.

OBJECTIVE

To compare self-reported anxiety, depression, insomnia, functional impairment, and substance use among distinct cohorts of new adult psychiatric outpatients before and after the onset of the COVID-19 pandemic.

METHODS

Outpatient intake visit data, collected pre-pandemic (May 1, 2019-February 28, 2020) and early in the pandemic (May 1, 2020-February 26, 2021), included the Generalised Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Work and Social Adjustment Scale (WSAS), and the World Health Organisation Alcohol, Smoking, and Substance Involvement Screening Test. Substance use treatment-seeking patients also completed the Brief Addiction Monitor. Analysis of variance models, adjusted for sex and race, examined between-cohort differences.

RESULTS

Among 4,197 patients (pre-pandemic: 2,434; early pandemic: 1,763), anxiety and insomnia (GAD-7, ISI) symptoms were greater after pandemic onset. Depression (PHQ-9) and functioning (WSAS) were not different. Rates of cannabis, cocaine, and inhalant use were higher post-pandemic. Among substance use treatment seekers, drug and marijuana use was higher, with women reporting more binge drinking days.

CONCLUSIONS

New psychiatric outpatients who presented after the pandemic reported greater anxiety and insomnia symptoms and different substance use patterns vs. a pre-pandemic cohort, underscoring the need for targeted interventions during public health crises.