Yoshioka Takashi, Okubo Ryo, Tabuchi Takahiro, Odani Satomi, Shinozaki Tomohiro, Tsugawa Yusuke
Center for Innovative Research for Communities and Clinical Excellence (CiRCLE), Fukushima Medical University, Fukushima, Japan.
Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan.
medRxiv. 2021 Mar 1:2021.02.27.21252458. doi: 10.1101/2021.02.27.21252458.
The coronavirus disease 2019 (COVID-19) pandemic may have a negative impact on mental health of the population, leading to higher suicide rates, in many countries. However, little is known about risk factors associated with worsened mental health during the COVID-19 pandemic.
To investigate the factors associated with serious psychological distress (SPD) during the COVID-19 pandemic in Japan.
A cross-sectional study using a large-scale internet survey conducted between August 25 and September 30, 2020, in Japan.
Demographics (age, gender, marital status, family composition, and caregiving burden), socio-economic status (income level, employment type, educational attainment), the experience of domestic violence (DV), the state of emergency, fear of COVID-19, and stigma related to COVID-19.
Prevalence of SPD, defined as Kessler 6 scale score ≥13.
Among 25,482 individuals included in this study, 2,556 (10%) met the criteria of SPD. Overall, women (adjusted odds ratio [aOR] 1.59; 95%CI, 1.17-2.16; P=0.003), ages 15-29 (aOR compared with ages 45-59, 2.35; 95%CI, 1.64-3.38; P<0.001), low income (aOR compared with intermediate income, 1.70; 95%CI, 1.16-2.49; P=0.007), providing caregiving to family members (aOR, 5.48; 95%CI, 3.51-8.56; P<0.001), experiencing DV (aOR, 5.72; 95%CI, 3.81-8.59; P<0.001), and fear of COVID-19 (aOR, 1.96; 95%CI, 1.55-2.48; P<0.001) were associated with a higher rate of SPD. Among women aged 15-29 years, who experienced the highest rate of SPD, caregiving, DV, fear of COVID-19, and COVID-19-related stigma were associated with a higher rate of SPD; whereas economic situation (income level and employment type) and social isolation (marital status) were not associated with the prevalence of SPD.
Economic situation, caregiving burden, DV, and fear of COVID-19 were independently associated with SPD during the COVID-19 pandemic. Among young women-who have a higher risk of suicide during the COVID-19 pandemic in Japan-similar factors, except economic situation, were associated with a higher rate of SPD. Targeted interventions based on age and gender may be more effective in mitigating the negative impact of the COVID-19 pandemic on the population's mental health.
2019年冠状病毒病（COVID-19）大流行可能会对许多国家民众的心理健康产生负面影响，导致自杀率上升。然而，对于COVID-19大流行期间心理健康恶化的相关风险因素，人们知之甚少。
调查日本COVID-19大流行期间与严重心理困扰（SPD）相关的因素。
设计、设置和参与者：一项横断面研究，采用2020年8月25日至9月30日在日本进行的大规模互联网调查。
人口统计学特征（年龄、性别、婚姻状况、家庭构成和照料负担）、社会经济地位（收入水平、就业类型、教育程度）、家庭暴力经历、紧急状态、对COVID-19的恐惧以及与COVID-19相关的污名。
SPD的患病率，定义为凯斯勒6项量表评分≥13。
在本研究纳入的25482名个体中，2556名（10%）符合SPD标准。总体而言，女性（调整优势比[aOR]为1.59；95%置信区间[CI]为1.17 - 2.16；P = 0.003）、15 - 29岁人群（与45 - 59岁人群相比，aOR为2.35；95%CI为1.64 - 3.38；P < 0.001）、低收入人群（与中等收入人群相比，aOR为1.70；95%CI为1.16 - 2.49；P = 0.007）、为家庭成员提供照料者（aOR为5.48；95%CI为3.51 - 8.56；P < 0.001）、经历过家庭暴力者（aOR为5.72；95%CI为3.81 - 8.59；P < 0.001）以及对COVID-19的恐惧（aOR为1.96；95%CI为1.55 - 2.48；P < 0.001）与SPD发生率较高相关。在SPD发生率最高的15 - 29岁女性中，照料、家庭暴力、对COVID-19的恐惧以及与COVID-19相关的污名与SPD发生率较高相关；而经济状况（收入水平和就业类型）和社会隔离（婚姻状况）与SPD患病率无关。
在COVID-19大流行期间，经济状况、照料负担、家庭暴力和对COVID-19的恐惧与SPD独立相关。在日本COVID-19大流行期间自杀风险较高的年轻女性中，除经济状况外，类似因素与SPD发生率较高相关。基于年龄和性别的针对性干预可能在减轻COVID-19大流行对民众心理健康的负面影响方面更有效。
