Management School, Lancaster University, Lancaster, UK
Oxford Department of International Development, University of Oxford, Oxford, UK.
BMJ Open. 2021 Apr 15;11(4):e049653. doi: 10.1136/bmjopen-2021-049653.
To provide evidence on the effect of the COVID-19 pandemic on the mental health of young people who grew up in poverty in low/middle-income countries (LMICs).
A phone survey administered between August and October 2020 to participants of a population-based longitudinal cohort study established in 2002 comprising two cohorts born in 1994-1995 and 2001-2002 in Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam. We use logistic regressions to examine associations between mental health and pandemic-related stressors, structural factors (gender, age), and lifelong protective/risk factors (parent and peer relationship, wealth, long-term health problems, past emotional problems, subjective well-being) measured at younger ages.
A geographically diverse, poverty-focused sample, also reaching those without mobile phones or internet access.
10 496 individuals were approached; 9730 participated. Overall, 8988 individuals were included in this study; 4610 (51%) men and 4378 (49%) women. Non-inclusion was due to non-location or missing data.
Symptoms consistent with at least mild anxiety or depression were measured by Generalized Anxiety Disorder-7 (≥5) or Patient Health Questionnaire-8 (≥5).
Rates of symptoms of at least mild anxiety (depression) were highest in Peru at 41% (32%) (95% CI 38.63% to 43.12%; (29.49-33.74)), and lowest in Vietnam at 9% (9%) (95% CI 8.16% to 10.58%; (8.33-10.77)), mirroring COVID-19 mortality rates. Women were most affected in all countries except Ethiopia. Pandemic-related stressors such as health risks/expenses, economic adversity, food insecurity, and educational or employment disruption were risk factors for anxiety and depression, though showed varying levels of importance across countries. Prior parent/peer relationships were protective factors, while long-term health or emotional problems were risk factors.
Pandemic-related health, economic and social stress present significant risks to the mental health of young people in LMICs where mental health support is limited, but urgently needed to prevent long-term consequences.
为在中低收入国家（LMICs）长大的贫困青年的新冠疫情对心理健康的影响提供证据。
2020 年 8 月至 10 月期间，对 2002 年建立的一项基于人群的纵向队列研究的参与者进行了电话调查，该研究包括 1994-1995 年和 2001-2002 年在埃塞俄比亚、印度（安得拉邦和特伦甘纳邦）、秘鲁和越南出生的两个队列。我们使用逻辑回归来研究心理健康与与大流行相关的压力源、结构因素（性别、年龄）以及在年轻时测量的终身保护/风险因素（父母和同伴关系、财富、长期健康问题、过去的情绪问题、主观幸福感）之间的关联。
一个地理位置多样化、以贫困为重点的样本，也覆盖了那些没有手机或互联网接入的人群。
共联系了 10496 人，其中 9730 人参与。总体而言，共有 8988 人纳入本研究，其中 4610 人（51%）为男性，4378 人（49%）为女性。未纳入的原因是位置不详或数据缺失。
使用广义焦虑障碍 7 项量表（≥5）或患者健康问卷 8 项量表（≥5）测量至少轻度焦虑或抑郁的症状。
至少轻度焦虑（抑郁）症状的发生率在秘鲁最高，为 41%（32%）（95%置信区间 38.63%至 43.12%；（29.49-33.74）），在越南最低，为 9%（9%）（95%置信区间 8.16%至 10.58%；（8.33-10.77）），与新冠病毒死亡率相吻合。除埃塞俄比亚外，所有国家的女性受影响最大。与大流行相关的压力源，如健康风险/费用、经济逆境、粮食不安全以及教育或就业中断，是焦虑和抑郁的危险因素，但在各国的重要程度不同。先前的父母/同伴关系是保护因素，而长期健康或情绪问题是危险因素。
在心理健康支持有限的中低收入国家，与大流行相关的健康、经济和社会压力对年轻人的心理健康构成了重大风险，但迫切需要采取措施预防长期后果。
