Changes in Mental Health Needs during COVID-19 in the Republic of Georgia: A Longitudinal Follow-up Study

Nino Makhashvili1, *, Ketevan Pilauri2, Amy Mulick3, Jana Darejan Javakhishvili4, Lela Sturua5, Daniela C. Fuhr6, Bayard Roberts6
1 Mental Health Resource Centre, Ilia State University, Q. Cholokashvili Av. 3/5. E 122. Tbilisi, Georgia
2 Ilia State University, Q. Cholokashvili Av. 3/5. E 122. Tbilisi, Georgia
3 Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
4 Institute of Addictions, Ilia State University, Q. Cholokashvili Av. 3/5. E 122. Tbilisi, Georgia
5 National Center for Disease Control and Public Health of Georgia, 99, Kakhety highway, P. Shotadze Tbilisi Medical Academy; 51/2 Ketevan Dedofali Ave, Tbilisi, Georgia
6 Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, UK

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© 2022 Makhashvili et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Mental Health Resource Centre, Ilia State University, Q. Cholokashvili Av. 3/5. E 122. Tbilisi, Georgia; E-mail:



To examine changes in COVID-19 stressors and symptoms of mental disorders in the Republic of Georgia.


A longitudinal design was used. Following on from our study of May-June 2020, this follow-up study in January-March 2021 was conducted at: (i)an individual level with the same respondents involved in the May-June 2020 study (repeat responders/cohort); and (ii) at a population-wide level, using non-probabilistic sampling. Questionnaire sections covered: (i)demographic, socio-economic characteristics; (ii)level of burden caused by COVID-19-related stressors/concern; and (iii)symptoms of anxiety(GAD-7), depression(PHQ-9), PTSD(ITQ), adjustment disorder(ADNM8). Descriptive and multivariable regression analyses were conducted.


Among population-level survey respondents(N=1195), the probability of reporting mental ill health symptoms increased in 2021 compared to 2020 for PTSD(OR1.82), depression(OR1.40), adjustment disorder(OR 1.80), and marginally for anxiety(OR1.17). For the individual repeat respondents(N=455), the probability increased for depression(OR1.88) and adjustment disorder(OR2.56). The perceived burden of pandemic concern worsened in 2021 compared to 2020 for almost all stressors, particularly around access to health care, infecting others, and conflict in the home. PTSD was associated with an increased concern score from 2020 to 2021.


Our study highlights the need to strengthen response strategies to address the elevated mental health needs related to COVID-19 in Georgia. It recommends increasing accessibility of early interventions and the need to modernise mental health services to strengthen access to care. It also calls for monitoring patterns of mental health disorders for better understanding and responses to mental health needs in Georgia.

Keywords: Mental health, Republic of Georgia, COVID-19 concern, Stressors, Symptoms, Mental disorders.