Adult Mental Health During the COVID-19 Pandemic: Diagnostic and Service Trends in a Saudi Tertiary Center

Background: The COVID-19 pandemic imposed unprecedented social and psychological stress on communities worldwide. Restrictions, fear of infection, and social isolation contributed to a surge in mental-health problems among adults. In Saudi Arabia and across the Gulf region, few studies have systematically evaluated adult psychiatric presentations before and during the pandemic using real clinical data. Objectives: To examine trends in adult psychiatric diagnoses and service utilization before and during the COVID-19 pandemic in a tertiary care center in Saudi Arabia, and to compare the findings with regional and international studies. Methods: A retrospective cross-sectional review was conducted of adults aged ≥ 18 years who attended psychiatric services at Johns Hopkins Aramco Healthcare (JHAH), Dhahran, from January 2019 to December 2021. Diagnostic frequencies, demographic data, and visit trends were compared between the pre-pandemic and pandemic periods. Statistical analyses included chi-square tests and percentage change in diagnostic categories. Results: A total of 3,037 adult patients were analyzed (mean age = 33.9 ± 9.4 years; 61% female). Compared to 2019, there was a significant increase in the diagnosis of anxiety disorders (↑ 27%) and depressive disorders (↑ 19%) during 2020–2021 (p < 0.01). Conversely, adjustment and stress-related disorders, psychotic disorders and substance use disorders declined slightly possibly because people in these categories were less likely to seek help during the strict lock down period which was followed by community restrictions eased. These trends parallel findings from Saudi and GCC studies but were less pronounced than those reported in Europe and North America, where the rise in depressive disorders exceeded 30%. Conclusion: The COVID-19 pandemic significantly altered adult psychiatric profiles in Saudi Arabia, with a notable increase in anxiety and depressive disorders. Similar trends have been documented in regional and international research, emphasizing the need for sustained mental-health services and preventive strategies during future crises.