Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Room 798, Baltimore, MD, USA.
Department of Neuropsychology, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, MD, USA.
Ann Behav Med. 2021 Mar 16;55(2):93-102. doi: 10.1093/abm/kaaa126.
Cross-sectional studies have found that the coronavirus disease 2019 (COVID-19) pandemic has negatively affected population-level mental health. Longitudinal studies are necessary to examine trajectories of change in mental health over time and identify sociodemographic groups at risk for persistent distress.
To examine the trajectories of mental distress between March 10 and August 4, 2020, a key period during the COVID-19 pandemic.
Participants included 6,901 adults from the nationally representative Understanding America Study, surveyed at baseline between March 10 and 31, 2020, with nine follow-up assessments between April 1 and August 4, 2020. Mixed-effects logistic regression was used to examine the association between date and self-reported mental distress (measured with the four-item Patient Health Questionnaire) among U.S. adults overall and among sociodemographic subgroups defined by sex, age, race/ethnicity, household structure, federal poverty line, and census region.
Compared to March 11, the odds of mental distress among U.S. adults overall were 1.84 (95% confidence interval [CI] = 1.65-2.07) times higher on April 1 and 1.92 (95% CI = 1.62-2.28) times higher on May 1; by August 1, the odds of mental distress had returned to levels comparable to March 11 (odds ratio [OR] = 0.80, 95% CI = 0.66-0.96). Females experienced a sharper increase in mental distress between March and May compared to males (females: OR = 2.29, 95% CI = 1.85-2.82; males: OR = 1.53, 95% CI = 1.15-2.02).
These findings highlight the trajectory of mental health symptoms during an unprecedented pandemic, including the identification of populations at risk for sustained mental distress.
横断面研究发现，2019 年冠状病毒病（COVID-19）大流行对人群心理健康产生了负面影响。需要进行纵向研究来检查随着时间的推移心理健康变化的轨迹，并确定持续困扰的高危人群。
研究 2020 年 3 月 10 日至 8 月 4 日期间 COVID-19 大流行期间的精神困扰轨迹。
参与者包括来自具有全国代表性的“理解美国研究”的 6901 名成年人，他们于 2020 年 3 月 10 日至 31 日进行了基线调查，并于 2020 年 4 月 1 日至 8 月 4 日进行了九次随访评估。采用混合效应逻辑回归分析了美国成年人总体以及按性别、年龄、种族/族裔、家庭结构、联邦贫困线和人口普查区域定义的社会人口学亚组中，日期与自我报告的精神困扰（使用四项患者健康问卷测量）之间的关联。
与 3 月 11 日相比，美国成年人总体的精神困扰几率在 4 月 1 日时高出 1.84 倍（95%置信区间[CI] = 1.65-2.07），在 5 月 1 日时高出 1.92 倍（95% CI = 1.62-2.28）；到 8 月 1 日，精神困扰的几率已恢复到与 3 月 11 日相当的水平（比值比[OR] = 0.80，95% CI = 0.66-0.96）。与男性相比，女性在 3 月至 5 月期间精神困扰的增加更为明显（女性：OR = 2.29，95% CI = 1.85-2.82；男性：OR = 1.53，95% CI = 1.15-2.02）。
这些发现突出了在前所未有的大流行期间心理健康症状的变化轨迹，包括确定了持续困扰的高危人群。
