Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Duke-NUS Medical School, Singapore, Singapore.
PLoS One. 2020 Dec 28;15(12):e0244630. doi: 10.1371/journal.pone.0244630. eCollection 2020.
The Coronavirus Disease 2019 (COVID-19) outbreak has escalated the burden of psychological distress. We aimed to evaluate factors associated with psychological distress among the predominantly general population during the COVID-19 pandemic.
We searched PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO, and World Health Organization COVID-19 databases (Dec 2019-15 July 2020). We included cross-sectional studies that reported factors associated with psychological distress during the COVID-19 pandemic. Primary outcomes were self-reported symptoms of anxiety and depression. Random-effects models were used to pool odds ratios (OR) and 95% confidence intervals (CI). The protocol was registered in PROSPERO (#CRD42020186735).
We included 68 studies comprising 288,830 participants from 19 countries. The prevalence of anxiety and depression was 33% (95% CI: 28%-39%) and 30% (26%-36%). Women versus men (OR: 1.48 [95% CI: 1.29-1.71; I2 = 90.8%]), younger versus older (< versus ≥35 years) adults (1.20 [1.13-1.26]; I2 = 91.7%), living in rural versus urban areas (1.13 [1.00-1.29]; I2 = 82.9%), lower versus higher socioeconomic status (e.g. lower versus higher income: 1.45 [1.24-1.69; I2 = 82.3%]) were associated with higher anxiety odds. These factors (except for residential area) were also associated with higher depression odds. Furthermore, higher COVID-19 infection risk (suspected/confirmed cases, living in hard-hit areas, having pre-existing physical or mental conditions) and longer media exposure were associated with higher odds of anxiety and depression.
One in three adults in the predominantly general population have COVID-19 related psychological distress. Concerted efforts are urgently needed for interventions in high-risk populations to reduce urban-rural, socioeconomic and gender disparities in COVID-19 related psychological distress.
2019 年冠状病毒病（COVID-19）疫情加剧了心理困扰的负担。我们旨在评估 COVID-19 大流行期间主要为普通人群中与心理困扰相关的因素。
我们检索了 PubMed、EMBASE、Scopus、Cochrane 图书馆、PsycINFO 和世界卫生组织 COVID-19 数据库（2019 年 12 月至 2020 年 7 月 15 日）。我们纳入了报告 COVID-19 大流行期间与心理困扰相关因素的横断面研究。主要结局是自我报告的焦虑和抑郁症状。使用随机效应模型汇总比值比（OR）和 95%置信区间（CI）。该方案已在 PROSPERO（#CRD42020186735）中注册。
我们纳入了来自 19 个国家的 68 项研究，共包含 288830 名参与者。焦虑和抑郁的患病率分别为 33%（95%CI：28%-39%）和 30%（26%-36%）。与男性相比，女性（OR：1.48 [95%CI：1.29-1.71；I2 = 90.8%]）、年轻成人（<35 岁）与较年长成人（1.20 [1.13-1.26]；I2 = 91.7%）、居住在农村地区与城市地区（1.13 [1.00-1.29]；I2 = 82.9%）、社会经济地位较低者（例如收入较低者：1.45 [1.24-1.69；I2 = 82.3%]）与较高的焦虑几率相关。这些因素（除了居住地区）也与较高的抑郁几率相关。此外，较高的 COVID-19 感染风险（疑似/确诊病例、居住在受影响严重地区、有既往身体或精神疾病）和较长的媒体暴露时间与焦虑和抑郁的几率增加相关。
在主要为普通人群的成年人中，有三分之一的人存在与 COVID-19 相关的心理困扰。迫切需要在高危人群中开展干预措施，以减少 COVID-19 相关心理困扰方面的城乡、社会经济和性别差距。
