Department of Psychology, Maynooth University, Co. Kildare, Ireland.
Institute of Population Health Sciences, University of Liverpool, Liverpool, United Kingdom.
J Affect Disord. 2021 May 1;286:296-300. doi: 10.1016/j.jad.2021.02.054. Epub 2021 Feb 26.
The impact of the coronavirus disease 2019 (COVID-19) on the mental health of the US population is unclear. This study drew on two nationally representative samples to compare the prevalence rate of anxiety in the U.S. before and during the 2020 COVID-19 pandemic.
The Generalized Anxiety Disorder-2 (GAD-2) screening tool was used to detect the proportion of US adults screening positive for high levels of anxiety symptoms. Anxiety symptoms was assessed in 2019 using the National Health Interview Survey (NHIS; N = 30,915) and during the pandemic using biweekly surveys collected as part of the Understanding America Study (UAS; N=8,022 Obs.=121,768) between March and December 2020.
The proportion of participants with high levels of anxiety symptoms increased significantly from 8.1% (95% CI[7.7, 8.5]) in 2019 to 21.4% (95% CI[19.9, 22.9]) at the beginning of April, 2020. The prevalence then declined to 11.4% (95% CI[10.3, 12.5]) in May and remained 3% above 2019 levels until December 2020. This pattern of increasing anxiety between 2019 and April 2020 followed by a rapid decrease in anxiety was identified across all demographic characteristics examined.
The NHIS and UAS samples differ in their sampling and mode of administration which may bias comparisons between samples.
Anxiety symptoms increased markedly during the onset of the COVID-19 pandemic and reduced quickly as stay-at-home orders were lifted. These findings highlight the importance of providing mental health supports during future lockdowns and suggest that resilience in mental health may have been a key population-level response to the demands of the pandemic.
2019 年冠状病毒病（COVID-19）对美国人口心理健康的影响尚不清楚。本研究利用两个具有全国代表性的样本，比较了美国在 2020 年 COVID-19 大流行之前和期间焦虑症的患病率。
使用广泛性焦虑症 2 项（GAD-2）筛查工具来检测美国成年人出现高水平焦虑症状的比例。在 2019 年使用国家健康访谈调查（NHIS；N=30915）评估焦虑症状，在 2020 年大流行期间使用作为理解美国研究（UAS）的一部分每两周收集一次的调查评估（N=8022 次观察=121768 次），调查时间为 2020 年 3 月至 12 月。
从 2019 年的 8.1%（95%CI[7.7,8.5]）到 2020 年 4 月初的 21.4%（95%CI[19.9,22.9]），有高水平焦虑症状的参与者比例显著增加。随后，在 5 月降至 11.4%（95%CI[10.3,12.5]），直到 2020 年 12 月仍比 2019 年高出 3%。在所有检查的人口统计学特征中，都观察到了 2019 年到 2020 年 4 月之间焦虑增加，然后焦虑迅速减少的这种模式。
NHIS 和 UAS 样本在抽样和管理模式上存在差异，这可能会影响样本之间的比较。
在 COVID-19 大流行开始时，焦虑症状明显增加，随着居家令的解除，焦虑症状迅速减少。这些发现强调了在未来封锁期间提供心理健康支持的重要性，并表明心理健康的弹性可能是应对大流行需求的关键人群反应。
