- Background: Most estimates for the prevalence of depression and anxiety predate COVID-19, which has had a detrimental effect on mental health worldwide. While some literature has been published recently on the rise in prevalence of mental health disorders in the United States and the European Union, little is known about the impact of the pandemic on the prevalence and economic burden of mental disorders in Asia. Herein we characterize the prevalence of depression and anxiety and estimate the per capita indirect economic burden of depression and anxiety among adults living in Singapore.
Methods: We quantify the prevalence and total per capita indirect costs of depression and anxiety among adults via a cross-sectional online survey administered to a national web panel in Singapore. Participants were asked about their current symptom burden of depression and anxiety (through the PHQ-4), healthcare utilization, days missed from work, and reduced productivity due to their symptoms. These values were then monetized, annualized, and multiplied by the prevalence to generate total costs.
Results: 2,348 households filled out the screener, accounting for approximately 5,275 adults when accounting for all adults living in each household. Out of the 5,275 adults, 1,145 adults were found to have either likely anxiety or depression (20.0%), of which 51.2% had no prior lifetime diagnosis of depression or anxiety. Respondents who screened positive for depression and/or anxiety and were full-time or part-time employees (79%) missed 18.4 days on average per year due to their mental health symptoms (absenteeism) and exhibited reduced productivity at work for approximately 103.8 days on average per year (presenteeism), translating to approximately S$35,300 in per capita economic losses annually.
Conclusion: Policy makers require timely information on prevalence and economic burden of diseases to prioritize prevention and treatment efforts. This study highlights not only the massive economic impact of depression and anxiety due to missed time at work and lost productivity in a single country in Asia but also how depression and anxiety are largely undiagnosed. Better identification of adults with symptoms of depression and anxiety and more dedicated resources to control active depression and anxiety has the potential to generate health improvements and productivity gains.