The Covid-19 pandemic has had a lasting and disproportionate impact on diagnosis rates for various conditions, including depression, asthma, and osteoporosis. The study by King's College London, published in the British Medical Journal, reveals a concerning trend: almost a third fewer diagnoses of depression than expected compared to pre-pandemic trends. This is just one of the many health disparities highlighted by the research.
The pandemic's unprecedented impact on healthcare systems worldwide has led to abrupt decreases in diagnosis rates for a wide range of diseases. Of the 19 major conditions analyzed, depression diagnoses were 27.7% lower than expected, while asthma, chronic obstructive pulmonary disease (COPD), and osteoporosis diagnoses were also significantly lower than pre-pandemic levels. The study also found that dementia diagnoses recovered to pre-pandemic levels for certain groups but remained lower than expected for others.
The study's co-author, Professor Sam Norton, noted the striking and puzzling nature of the depression diagnosis deficits. After an initial decrease during the early pandemic, diagnosis rates partially recovered by late 2021 but have since declined sharply, particularly among younger adults aged 20 to 39 and individuals of white or mixed ethnicity. This pattern contradicts other indicators of mental health need, such as increased disability benefit claims for mental health conditions.
The research team suggests several factors influencing diagnosis rates. Increasing pressures on the NHS may be causing delays in formal diagnoses, and more people might be accessing mental health support without receiving a formal diagnosis of depression. The national drive to expand access to psychological therapies has led to a nearly two-thirds increase in referrals to NHS Talking Therapies services between 2013 and 2024, with self-referrals accounting for almost 70% of all referrals.
The team also proposes that pandemic-related disruptions could be behind the fall in diagnoses for asthma, COPD, and osteoporosis. Backlogs in diagnostic testing during the pandemic are likely a key factor, and the NHS has identified this as a priority area for improvement. Interestingly, chronic kidney disease (CKD) diagnoses have increased by 34.8% compared to expected levels, possibly due to increased testing and awareness following guideline changes and new treatments.
The research team utilized the OpenSAFELY platform, a secure and anonymized NHS data platform, to analyze disease trends for 29 million people between April 2016 and November 2024. Dr. Mark Russell, the lead author, emphasized the platform's potential to transform disease monitoring and earlier identification of inequities, all while keeping patient data secure within the NHS system.
