School of Psychology, Ulster University, Derry, Northern Ireland.
Department of Psychology, University of Sheffield, Sheffield, UK.
Psychol Med. 2023 Jan;53(2):429-437. doi: 10.1017/S0033291721001665. Epub 2021 Apr 20.
The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population.
The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, = 2025), Wave 2 (April 2020, = 1406) and Wave 3 (July 2020, = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics.
Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories.
A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.
本研究认为，心理健康障碍的人群流行率估计，或随着时间的推移均值分数的变化，可能无法充分反映人群中对 COVID-19 大流行的心理健康反应的异质性。
COVID-19 心理研究联盟（C19PRC）研究是一项针对英国成年人的纵向、全国代表性、在线调查。本研究分析了其前三个数据收集波次的数据：第 1 波（2020 年 3 月，=2025）、第 2 波（2020 年 4 月，=1406）和第 3 波（2020 年 7 月，=1166）。焦虑-抑郁使用患者健康问卷焦虑和抑郁量表（PHQ-9 和 GAD-7 的综合测量）测量，COVID-19 相关创伤后应激障碍（PTSD）使用国际创伤问卷测量。在这三个波次中，对心理健康结果的变化进行建模。潜在类别增长分析用于识别焦虑-抑郁和 COVID-19 PTSD 变化轨迹不同的个体亚组。潜在类别成员资格回归到基线特征。
焦虑-抑郁的总体流行率保持稳定，而 COVID-19 PTSD 在第 2 波和第 3 波之间减少。发现了心理健康反应的异质性，并假设了反映（i）稳定性、（ii）改善和（iii）心理健康恶化的类别。心理因素最有可能将改善、恶化和高稳定类与低稳定心理健康轨迹区分开来。
一种低稳定特征，表现为几乎没有心理困扰（“有弹性”类），是焦虑-抑郁和 COVID-19 PTSD 最常见的轨迹。在前进的过程中，对那些焦虑-抑郁水平升高的约 30%的个体，监测这些轨迹是必要的。
