Department of Behavioural Science and Health, University College London, London, UK.
Department of Behavioural Science and Health, University College London, London, UK
J Epidemiol Community Health. 2021 Sep;75(9):817-823. doi: 10.1136/jech-2020-215598. Epub 2021 Jan 22.
There is evidence that the COVID-19 pandemic is having adverse effects on mental health. It is vital to understand what is causing this: worries over potential adversities due to the pandemic, or the toll of experiencing adverse events.
We used panel data from 41 909 UK adults in the COVID-19 Social Study assessed weekly from 1 April 2020 to 12 May 2020 to study the association between adversities and anxiety and depressive symptoms. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. Anxiety and depression were measured using the 7-item Generalised Anxiety Disorder Assessment and the 9-item Patient Health Questionnaire. We used fixed-effect regression models to account for time-invariant confounders.
Cumulative number of worries and experience of adversities were both related to higher levels of anxiety and depression. A number of worries were associated more with anxiety than depression, but number of experiences were equally related to anxiety and depression. There were clear associations between specific worries and poorer mental health. There was weak evidence that individuals of lower socio-economic position were more negatively affected psychologically by the adverse experiences.
Measures over the first few weeks of lockdown in the UK appear to have been insufficient at reassuring people given that we see clear associations with mental health and cumulative worries. Interventions are required that seek to prevent adverse events (eg, redundancies) and reassure individuals and support adaptive coping strategies.
有证据表明，COVID-19 大流行对心理健康产生了不利影响。了解造成这种情况的原因至关重要：是对大流行带来潜在不利影响的担忧，还是经历不利事件的影响。
我们使用了来自英国 COVID-19 社会研究的 41909 名成年人的面板数据，该研究从 2020 年 4 月 1 日至 2020 年 5 月 12 日每周进行评估，以研究逆境与焦虑和抑郁症状之间的关联。我们研究了逆境的六个类别，包括与 COVID-19 相关的疾病、经济困难、失去有薪工作、获取药物困难、获取食物困难和人身安全威胁等担忧和经历。焦虑和抑郁使用 7 项广泛性焦虑症评估量表和 9 项患者健康问卷进行测量。我们使用固定效应回归模型来解释时间不变的混杂因素。
累积的担忧数量和经历的逆境都与更高水平的焦虑和抑郁有关。一些担忧与焦虑的关系比抑郁更密切，但经历的数量与焦虑和抑郁的关系同样密切。具体的担忧与较差的心理健康之间存在明确的关联。有一些证据表明，社会经济地位较低的个体受到逆境的心理影响更大。
鉴于我们发现与心理健康和累积担忧之间存在明显关联，英国封锁的头几周的措施似乎在安抚人们方面做得还不够。需要采取干预措施，以防止不利事件（例如裁员）的发生，并向个人提供支持和帮助他们采取适应性应对策略。
