The following article is a part of conference coverage from the American Psychiatric Association Annual Meeting 2021, held virtually from May 1 to 3, 2021. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the APA 2021.


A recent sample of adults in the United States during the COVID-19 pandemic showed that the prevalence of major depressive disorder (MDD) was high among individuals with no prior history of depression, according to study results presented at the American Psychiatric Association annual meeting held virtually from May 1 to 3, 2021. The study researchers also associated current MDD with changes in sleep quality, marijuana use, and physical activity.

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According to researchers, the COVID-19 pandemic has had a significant impact on the social, economic, and health wellbeing of individuals in the US and across the globe. The purpose of this study was to examine and describe the prevalence of MDD during COVID-19 among US residents with and without a history of depressive disorders and the associations of current MDD with changes in negative and positive health behaviors.

The study investigators conducted a national online survey, to which 1838 adults responded from March to April 2020. Participants reported prior diagnoses of depressive disorders and completed the Patient Health Questionnaire (PHQ-9) to measure MDD. Changes in health behaviors and sociodemographics were also collected, and the relationship between changes in health behaviors and current MDD (with no prior depression diagnosis) were evaluated using multinomial, multivariable regression models.

Among the 1838 adults, 14.2% reported current MDD with no history of depressive disorder, 9.0% reported both current MDD and a depressive disorder history, and 8.5% reported a history of depressive disorder with no current MDD. The risk for current MDD (with no depressive disorder history) was significantly higher among women compared with men (relative risk reduction [RRR] 2.09; 95% CI, 1.45-3.02) and among individuals with limited mobility compared with those with no limitations (RRR 2.00; 95% CI, 1.19-3.27). Compared with those aged 18-34, current risk was significantly lower among individuals aged 50-64 (OR 0.53; 95% CI, 0.33-0.87) and 65+ (RRR 0.23; 95% CI, 0.09-0.58).

After controlling for sociodemographics, current MDD risk (without history) was significantly higher among individuals reporting increased marijuana use (RRR 2.41; 95% CI, 1.40-4.15) compared with those with no recent use. Current MDD risk was significantly lower among individuals reporting the same (RRR 0.23; 95% CI, 0.15-0.35) or more physical activity (RRR 0.41; 95% CI, 0.29-0.57), compared with those reporting less physical activity, and also lower among those reporting the same (RRR 0.26; 95% CI, 0.19-0.36) or better sleep quality (RRR 0.20; 95% CI, 0.12-0.35) compared with those experiencing worse sleep quality.

The study investigators concluded, “The prevalence of MDD was high among those with no prior history of depressive disorders in a sample of US adults. Changes in physical activity, marijuana use, and sleep quality were associated with current MDD during the pandemic. Further research is needed to determine how to facilitate healthy behaviors during the pandemic and mitigate the negative impacts of COVID-19 on mental health while in isolation.”

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Lavingia R, Knell G, Jetelina K. Association between changes in health behaviors and major depressive disorder during the COVID-19 pandemic. Presented at: APA annual meeting May 1-3, 2021. Abstract/Poster 4500.