What data show the deterioration of the mental health of the French?

The data pile up and overlap: the mental health of French women and men has deteriorated with the health crisis. A year and a half after the first containment, we have not seen a return to pre-pandemic levels.

The last Weekly epidemiological bulletin (BEH), published on November 23 by the Public Health France (SPF) agency, is devoted to the anxious and depressive states of working people who remain at high levels throughout 2020. The authors of this focus fear that mental health weakened French become a “Public health problem”.

But how to measure the mental health of the French when the disorders are of variable nature and intensity and any deterioration in it does not necessarily lead to a consultation or to the prescription of care or medication? Numerous studies, on populations and with different methods, attempt to shed light on the extent of this public health issue. “Each analysis method has its limits, it is important to compile and cross-reference the maximum number of indicators”, notes Maria Melchior, epidemiologist at Inserm (National Institute for Health and Medical Research) and specialist in mental health. We have chosen five different ones, the conclusions of which converge: the mental health of the French has deteriorated since the Covid-19 has turned our lives upside down.

• Studies of the perception of mental health in the general population

THE’Coviprev study initiated by the health agency Public Health France precisely aims to follow the evolution of behavior and mental health of the French during the Covid-19 epidemic. It works by self-administered questionnaires sent regularly since March 2020 to different samples of 2,000 people over 18 in mainland France.

If the sample size is medium, the level of detail allows respondents to describe their health in a fairly fine way, explains Dr.^r Melchior. “This involves, for example, answering precisely questions on the quality of sleep, appetite, the level of motivation to perform daily tasks. “ Researchers can then assess the anxiety and depressive disorders of certain respondents.

16% of respondents show signs of depression

The latest published results, covering September and October 2021, are in line with the data already collected in previous months: 16% of people questioned show signs of a depressive state, which corresponds to a ” high level “, indicates SPF, six points higher than the non-epidemic level. They are also 26% to show signs of an anxious state, a rate higher of 12 points than the level except epidemic. During the period observed, 70% of respondents said they had experienced sleep problems in the past eight days, 20 points above the non-epidemic level, and 10% said they had suicidal thoughts during the year , which is also a high level.

• Spotlight on specific populations

Based on the Coviprev survey, analyzes specific to certain population groups are carried out. So the last BEH focuses on employed people (in activity, partial unemployment or on sick leave) throughout the year 2020. These represent between 52% and 55% of the Coviprev samples, in other words between 1,030 and 1 100 men and women over 18 years old. The goal is to refine the picture of the mental health of the French by sub-groups, even if the sample is therefore quite small.

It appears that women are more affected by anxiety throughout the period (which overlaps with other analyzes relating to the widening of gender inequalities during the pandemic). The prevalence of anxiety states is also higher among those under the age of 50, employees, people with less than a baccalaureate diploma, living in cramped housing, perceiving their financial situation as ” just “ Where ” hard “ or having already had a follow-up for psychological disorders before the first confinement.

Occupations are also more affected: workers in the financial activities, arts and entertainment and education sectors are more affected by anxiety states than, for example, those in the health and action sectors. social.

• Studies following the same group of people over a long period

Unlike the Coviprev surveys, theEpicov study (Epidemiology and living conditions linked to Covid-19), led by Inserm and the Directorate of Research, Studies, Evaluation and Statistics (Dress) since spring 2020, keeps the same sample of 135,000 people over the age of 15 over the entire period. The researchers concluded that in May 2020, at the end of the first national confinement, 13.5% of people aged 15 years or over living in France had a depressive syndrome, almost one in seven people. The prevalence of depressive syndromes is up 2.5 points compared to 2019, the study finds. It is particularly strong among 15-24 year olds and among women.

Since the Epicov study is continuing on the same population cohort, new analyzes will be published and will make it possible to follow the evolution of the mental health of this very large sample in 2021 and 2022. “The limitation of this large-scale study is that the 135,000 people contacted at the start of the survey do not respond to every request. We lose some along the way, especially the most vulnerable, which can skew some results. This is characteristic of cohort studies where people are followed over time ”, notes epidemiologist Maria Melchior, herself a member of the Epicov research team.

• The consumption of antidepressants

The last published figures in the spring of 2021 by Medicare indicate a sharp increase in prescriptions for antidepressants, antipsychotics, anxiolytics and hypnotics since the start of the pandemic, which even accelerated in 2021. “Since the start of the first confinement, between March 2020 and April 2021, there has been an increase of 1.9 million deliveries of antidepressants, 440,000 deliveries of antipsychotics, 3.4 million deliveries of anxiolytics and 1.4 million deliveries of hypnotics compared to expected, detailed the organization in May. The dispensing of drugs for alcohol dependence was broadly stable in 2020, but has increased markedly since the start of 2021 (an increase of 18,300 dispensations between January and April 2021). “

• Hospital data

In emergency services, the indirect effects of the Covid-19 pandemic have resulted in an increase in passages for suicidal gestures and ideas among adolescents. The last monthly mental health update published by SPF, which is based in particular on the figures of emergency visits (recorded by the Oscour network), once again attests to this in November 2021.

The last bulletin reports a “Increase in crossings for suicidal gesture, suicidal ideation and mood disorders among 11-17 year olds and to a lesser extent among 18-24 year olds”, which is not unusual at the start of the school year, but it is specified that “The levels observed, in particular among 11-17 year olds, are however clearly higher than those of previous years”.

According to the SOS-Médecins network, “We observe an increase in acts for anxiety in all age groups, with levels slightly higher than those of previous years among 11-14 year olds and 18-24 year olds”.

These figures corroborate other worrying data on the mental health of young people. Researchers at the University of Bordeaux have thus started to specifically study the prevalence of depression in college students since spring 2020: their first results show that symptoms of depression and high stress are higher there than in the general population.

Faced with this gloomy picture, the health authorities insist on the need to learn and talk about it with others in the event of signs of depression (sadness, loss of interest, energy) or anxiety (tension, irritability).