Spain has experienced one of the deepest recessions among European countries affected by the economic crisis. We investigated the effects of the recession on the frequency of mental disorders in Primary Care (PC).
A group of PC physicians selected into the study a random sample of patients attending primary care centres. These patients were administered the PRIME-MD for the assessment of mental disorders, in 2006 and again in 2010, before and during the financial crisis. Multivariate logistic regression models were used to assess the relationship of unemployment, mortgage payment difficulties, and eviction on risks of mental health disorders.
Compared with the pre-crisis period of 2006, the 2010 survey revealed substantial increases in the proportion of patients with mood, anxiety, somatoform, and alcohol-related disorders (p< 0.0001), but not in eating disorders (p = 0.172). Major depression (19.4% increase) and dysthymia (10.8), showed the greatest rise, followed generalized anxiety disorder (8.4) and panic attack disorder (7.3). Both alcohol dependence and alcohol abuse rose significantly, by 4.6% and 2.4% (OR = 11.6 and 4.5, p< 0.001), respectively. After correcting for the risks of unemployment, we observed a significant rise in attendance with depression associated with mortgage repayment difficulties (OR =2.12, p< 0.001) and evictions (OR = 2.95, p< 0.001).
Recession has significantly increased the frequency of mental health disorders, particularly among families experiencing unemployment and mortgage payment difficulties. Expanding mental health services in primary care settings to at-risk groups may help cope with rising mental health disorders in areas affected by recession.