Estimated number of underdiagnosed anxiety and depressive disorders based on prelockdown data and percentage of reduction compared with expected, by lockdown and postlockdown period
| Lockdown period | Postlockdown period (by trimesters) | Postlockdown period (overall) | ||||||||
| March–June 2020 | July–September 2020 | October–December 2020 | January–March 2021 | July 2020–March 2021 | ||||||
| Estimated number of underdiagnoses, n (95% PI) | Reduction in cases*, % (95% PI) | Estimated number of underdiagnoses, n (95% PI) | Reduction in cases, % (95% PI) | Estimated number of underdiagnoses, n (95% PI) | Reduction in cases, % (95% PI) | Estimated number of underdiagnoses, n (95% PI) | Reduction in cases, % (95% PI) | Estimated number of underdiagnoses, n (95% PI) | Reduction in cases, % (95% PI) | |
| Anxiety disorders | ||||||||||
| Overall | −586 (−2690 to 1783) | −2.5 (−12.5 to 6.9) | 2987 (1604 to 4469) | 19.3 (11.4 to 26.3) | 2552 (1141 to 4102) | 16.2 (8.0 to 23.7) | 2148 (485 to 3976) | 12.4 (3.1 to 20.8) | 7688 (3230 to 12547) | 15.8 (7.3 to 23.5) |
| Sex | ||||||||||
| Women | 212 (−1413 to 1983) | 1.4 (−10.8 to 12.0) | 1890 (816 to 3058) | 19.9 (9.7 to 28.6) | 1414 (312 to 2637) | 14.4 (3.6 to 23.9) | 1380 (110 to 2762) | 12.8 (1.2 to 22.7) | 4684 (1238 to 8457) | 15.5 (4.6 to 24.9) |
| Men | −771 (−1727 to 233) | −8.7 (−21.7 to 2.4) | 1146 (487 to 1858) | 19.0 (9.1 to 27.5) | 1156 (500 to 1853) | 19.4 (9.4 to 27.9) | 807 (69 to 1599) | 12.3 (1.2 to 21.8) | 3108 (1056 to 5310) | 16.8 (6.4 to 25.6) |
| Sex: women | ||||||||||
| Age group (years) | ||||||||||
| 18–34 | 895 (405 to 1420) | 19.7 (10.0 to 28.0) | 855 (510 to 1231) | 26.5 (17.7 to 34.2) | 479 (148 to 839) | 15.6 (5.4 to 24.5) | 390 (2 to 804) | 11.5 (0.1 to 21.1) | 1723 (660 to 2874) | 17.8 (7.7 to 26.5) |
| 35–64 | −497 (−1354 to 451) | −6.3 (−19.2 to 5.1) | 874 (336 to 1463) | 18.2 (7.9 to 27.1) | 816 (240 to 1466) | 15.6 (5.2 to 25.0) | 872 (203 to 1612) | 15.0 (3.9 to 24.5) | 2563 (779 to 4541) | 16.2 (5.5 to 25.4) |
| >65 | −186 (−464 to 112) | −8.2 (−23.5 to 4.4) | 161 (−30 to 364) | 10.9 (−2.3 to 21.7) | 119 (−76 to 332) | 7.7 (−5.7 to 18.9) | 118 (−95 to 346) | 7.5 (−7.0 to 19.3) | 398 (−201 to 1042) | 8.7 (−5.0 to 19.9) |
| Sex: men | ||||||||||
| Age group (years) | ||||||||||
| 18–34 | 337 (−10 to 698) | 11.3 (−0.4 to 20.9) | 552 (304 to 823) | 25.2 (15.7 to 33.4) | 506 (266 to 758) | 25.1 (15.0 to 33.5) | 350 (77 to 641) | 15.9 (4.0 to 25.7) | 1408 (647 to 2222) | 22.0 (11.5 to 30.8) |
| 35–64 | −783 (−1229 to −310) | −15.8 (−27.3 to −5.7) | 476 (183 to 791) | 15.1 (6.4 to 22.8) | 535 (232 to 855) | 16.5 (7.9 to 23.9) | 322 (−17 to 689) | 8.9 (−0.5 to 17.2) | 1332 (398 to 2335) | 13.3 (4.4 to 21.2) |
| >65 | −325 (−488 to −155) | −33.1 (−59.6 to −13.5) | 118 (0 to 244) | 17.1 (0.0 to 29.9) | 115 (2 to 240) | 16.9 (0.4 to 29.7) | 135 (9 to 269) | 18.6 (1.5 to 31.3) | 368 (11 to 753) | 17.5 (0.6 to 30.3) |
| MEDEA Deprivation Index | ||||||||||
| First, least deprived | −53 (−405 to 345) | −1.7 (−14.5 to 9.7) | 272 (43 to 533) | 13.9 (2.5 to 24.0) | 217 (−25 to 492) | 10.3 (−1.3 to 20.6) | 287 (5 to 611) | 12.2 (0.2 to 22.9) | 776 (23 to 1636) | 12.1 (0.4 to 22.5) |
| Second | −107 (−501 to 324) | −3.1 (−16.1 to 8.2) | 454 (194 to 738) | 20.9 (10.1 to 30.0) | 433 (153 to 727) | 17.9 (7.2 to 26.8) | 277 (−38 to 614) | 10.6 (−1.7 to 20.9) | 1165 (309 to 2079) | 16.2 (4.9 to 25.6) |
| Third | −191 (−619 to 260) | −5.4 (−19.8 to 6.5) | 484 (198 to 785) | 20.4 (9.5 to 29.4) | 347 (67 to 646) | 15.2 (3.3 to 25.0) | 417 (84 to 780) | 15.7 (3.6 to 25.8) | 1248 (349 to 2211) | 17.0 (5.4 to 26.7) |
| Fourth | −144 (−478 to 193) | −3.9 (−14.4 to 4.8) | 506 (282 to 741) | 20.9 (12.8 to 27.9) | 452 (211 to 692) | 18.1 (9.3 to 25.2) | 371 (113 to 644) | 14.0 (4.7 to 22.0) | 1330 (606 to 2077) | 17.5 (8.8 to 24.9) |
| Fifth, most deprived | −81 (−444 to 287) | −2.3 (−14.1 to 7.4) | 533 (287 to 790) | 22.5 (13.5 to 30.1) | 511 (269 to 760) | 21.3 (12.5 to 28.8) | 361 (81 to 653) | 13.7 (3.4 to 22.3) | 1405 (637 to 2203) | 19.0 (9.6 to 26.9) |
| Rural | −88 (−405 to 256) | −2.5 (−12.5 to 6.6) | 426 (197 to 676) | 17.2 (8.8 to 24.8) | 351 (126 to 590) | 14.6 (5.8 to 22.3) | 234 (−18 to 500) | 8.9 (−0.8 to 17.3) | 1011 (305 to 1766) | 13.5 (4.5 to 21.4) |
| Depressive disorders | ||||||||||
| Overall | 2419 (1856 to 3002) | 45.6 (39.2 to 51.0) | 821 (446 to 1209) | 23.8 (14.5 to 31.5) | 832 (445 to 1247) | 22.8 (13.6 to 30.7) | 804 (361 to 1281) | 19.8 (10.0 to 28.3) | 2458 (1252 to 3737) | 22.0 (12.6 to 30.1) |
| Sex | ||||||||||
| Women | 1596 (1078 to 2165) | 47.1 (37.6 to 54.7) | 596 (239 to 986) | 27.7 (13.3 to 38.7) | 559 (182 to 968) | 23.8 (9.2 to 35.0) | 632 (206 to 1102) | 24.1 (9.4 to 35.6) | 1788 (627 to 3056) | 25.1 (10.5 to 36.4) |
| Men | 830 (442 to 1261) | 43.2 (28.9 to 53.6) | 227 (−41 to 526) | 17.6 (−4.0 to 33.0) | 293 (18 to 600) | 22.2 (1.7 to 36.9) | 205 (−99 to 554) | 14.0 (−8.6 to 30.6) | 723 (−122 to 1680) | 17.8 (−3.8 to 33.4) |
| Sex: women | ||||||||||
| Age group (years) | ||||||||||
| 18–34 | 332 (211 to 475) | 61.5 (50.4 to 69.5) | 115 (29 to 208) | 34.1 (11.6 to 48.4) | 93 (0 to 199) | 23.2 (0.0 to 39.3) | 121 (14 to 249) | 26.9 (4.1 to 43.1) | 329 (43 to 656) | 27.7 (4.8 to 43.3) |
| 35–64 | 715 (499 to 942) | 45.1 (36.4 to 52.0) | 280 (136 to 437) | 28.2 (16.0 to 38.0) | 271 (119 to 436) | 24.4 (12.4 to 34.2) | 325 (148 to 516) | 25.4 (13.4 to 35.1) | 877 (403 to 1389) | 25.9 (13.9 to 35.7) |
| >65 | 549 (368 to 748) | 43.5 (34.1 to 51.2) | 201 (74 to 341) | 24.4 (10.6 to 35.3) | 195 (63 to 333) | 23.2 (8.9 to 34.0) | 186 (44 to 337) | 20.7 (5.8 to 32.2) | 582 (181 to 1011) | 22.7 (8.4 to 33.8) |
| Sex: men | ||||||||||
| Age group (years) | ||||||||||
| 18–34 | 176 (85 to 286) | 55.2 (37.3 to 66.7) | 58 (−7 to 136) | 25.1 (−4.2 to 44.2) | 60 (−7 to 140) | 25.5 (−4.2 to 44.6) | 44 (−34 to 138) | 15.7 (−17.0 to 37.1) | 161 (−48 to 414) | 21.7 (−9.0 to 41.6) |
| 35–64 | 409 (244 to 583) | 43.1 (31.1 to 51.9) | 122 (12 to 243) | 19.8 (2.4 to 33.0) | 164 (42 to 292) | 24.0 (7.5 to 36.0) | 72 (−58 to 212) | 9.9 (−9.8 to 24.6) | 357 (−4 to 747) | 17.7 (−0.2 to 31.0) |
| >65 | 245 (113 to 392) | 37.6 (21.7 to 49.1) | 47 (−46 to 147) | 10.6 (−13.0 to 26.9) | 69 (−17 to 168) | 17.1 (−5.4 to 33.5) | 89 (−7 to 204) | 19.4 (−1.9 to 35.5) | 205 (−70 to 519) | 15.7 (−6.8 to 32.0) |
| MEDEA Deprivation Index | ||||||||||
| First, least deprived | 315 (174 to 481) | 42.0 (28.6 to 52.5) | 134 (39 to 246) | 27.8 (10.1 to 41.4) | 148 (43 to 266) | 27.8 (10.0 to 40.9) | 103 (−15 to 242) | 17.9 (−3.3 to 33.8) | 385 (67 to 754) | 24.2 (5.3 to 38.4) |
| Second | 391 (241 to 556) | 49.2 (37.4 to 57.9) | 157 (55 to 273) | 30.3 (13.2 to 43.0) | 153 (46 to 275) | 26.7 (9.9 to 39.5) | 175 (49 to 321) | 27.2 (9.4 to 40.6) | 486 (150 to 869) | 27.9 (10.7 to 41.0) |
| Third | 309 (166 to 465) | 42.9 (28.8 to 53.1) | 101 (7 to 206) | 21.8 (1.9 to 36.3) | 60 (−34 to 166) | 13.0 (−9.3 to 29.3) | 77 (−38 to 202) | 14.1 (−8.8 to 30.1) | 237 (−65 to 574) | 16.2 (−5.6 to 31.8) |
| Fourth | 376 (231 to 539) | 49.9 (38.0 to 58.8) | 107 (8 to 220) | 22.2 (2.1 to 37) | 113 (9 to 231) | 21.3 (2.1 to 35.6) | 118 (4 to 255) | 20.1 (0.8 to 35.3) | 338 (21 to 706) | 21.1 (1.6 to 35.9) |
| Fifth, most deprived | 375 (204 to 575) | 52.9 (37.9 to 63.3) | 113 (0 to 247) | 24.5 (0.0 to 41.5) | 137 (9 to 286) | 26.0 (2.3 to 42.4) | 118 (−21 to 284) | 21 (−5.0 to 39.1) | 367 (−12 to 817) | 23.8 (−1.0 to 41.0) |
| Rural | 347 (197 to 515) | 39.7 (27.2 to 49.4) | 94 (−14 to 212) | 15.4 (−2.8 to 29.2) | 125 (17 to 244) | 20.6 (3.4 to 33.6) | 76 (−44 to 215) | 11.7 (−8.3 to 27.2) | 296 (−41 to 671) | 15.8 (−2.7 to 29.9) |
The estimated number of underdiagnoses was calculated by subtracting the observed diagnoses from the expected number of diagnoses (95% PI) estimated by negative binomial models.
Reduction in diagnoses (95% PI) was calculated by dividing the number of underdiagnoses by the expected diagnoses and was estimated by study period (lockdown and postlockdown, overall and divided by trimesters).
*Negative values indicate an increase in diagnoses. The MEDEA Deprivation Index is calculated at the census tract level in the urban areas of Catalonia and categorised in quintiles of deprivation.
MEDEA, Mortalidad en áreas pequeñas Españolas y Desigualdades Socioeconómicas y Ambientales; PI, prediction interval.