Depressive symptoms were observed prior to and during the pandemic using monthly data from beginning of April 2019 until mid-June 2022 (see Figure 1 ). There were four short data gaps (the largest between January and mid-March 2021). The indicator was measured with the established ultra-brief screening instrument “Patient Health Questionnaire-2” (PHQ-2) (86 (link)), which has been found to perform well as a screening tool for depressive disorders in the German general population (92 (link)). The PHQ-2 captures the frequencies of two core symptoms of depressive disorders, asking, “Over the last 2 weeks, how often have you been bothered by the following problems?”: (1) “little interest and pleasure in doing things” (2) “feeling down, depressed or hopeless” (possible responses: 0 = “not at all,” 1 = “several days,” 2 = “more than half the days,” 3 = “nearly every day”). The total score of the PHQ-2 ranges from 0 to 6 (“no symptoms” to “severe symptoms”). According to scoring recommendations (92 (link)), scores ≥ 3 represent a positive screen for possible depressive disorder and indicate a potential need for further diagnostic assessment. In our analytical sample, the internal consistency of the PHQ-2 is α = 0.73 [standardized alpha coefficient as recommended for two items (93 (link)), unstandardized α = 0.72], slightly higher than in a comparable German sample (45 (link)). Two measures are reported in the current study: (1) the mean depressive symptom score, which tracks changes in the mean severity of symptoms in the population (73 (link)); (2) the proportion of the adult population screening positive for possible depressive disorder.
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