Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Sweden.
Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Sweden.
Scand J Public Health. 2021 Nov;49(7):741-749. doi: 10.1177/14034948211015814. Epub 2021 May 26.
The COVID-19 pandemic has had a profound effect on societies and citizens worldwide, raising concerns about potential mental health impacts. We aimed to describe trajectories of depression, anxiety and stress symptoms during the COVID-19 outbreak compared to before the outbreak, and to determine if trajectories were modified by pre-pandemic loneliness, poor sleep quality and mental health problems.
We conducted a cohort study with 1836 Swedish university students entering the study before 13 March 2020, the onset of the pandemic, with follow-ups within three (FU1) and six months (FU2) of the outbreak. Generalized Estimating Equations were used to estimate mean differences in symptom levels over time-periods, and to estimate potential effect modifications.
We found small differences in mean levels of the depression, anxiety and stress scale (DASS-21) over time. Compared to before the pandemic, depression increased by 0.25 points of 21 (95% CI: 0.04 to 0.45) at FU1 and decreased by 0.75/21 (95% CI:-0.97 to -0.53) at FU2. Anxiety decreased from baseline to FU1 by 0.09/21 (95% CI: -0.24 to 0.07) and by 0.77/21 (95% CI: -0.93 to -0.61) to FU2. Stress decreased from baseline to FU1 by 0.30/21 (95% CI: -0.52 to -0.09) and by 1.32/21 (95% CI: -1.55 to -1.09) to FU2. Students with pre-pandemic loneliness, poor sleep quality or pre-pandemic mental health problems did not have worse trajectories of mean mental health symptoms.
Symptom levels were relatively stable during the first three months of the pandemic, while there was a slight decrease during the summer months, probably due to seasonality effects.
新冠疫情对全球社会和民众产生了深远影响，引发了对潜在心理健康影响的担忧。本研究旨在描述新冠疫情爆发期间与疫情前相比，抑郁、焦虑和压力症状的变化轨迹，并确定轨迹是否因疫情前的孤独感、睡眠质量差和心理健康问题而改变。
我们进行了一项队列研究，纳入了 1836 名于 2020 年 3 月 13 日（疫情爆发）前进入研究的瑞典大学生，在疫情爆发后 3 个月（FU1）和 6 个月（FU2）进行随访。采用广义估计方程来估计不同时间段内症状水平的均值差异，并估计潜在的效应修饰作用。
我们发现，在不同时间点，抑郁、焦虑和压力量表（DASS-21）的平均水平差异较小。与疫情前相比，FU1 时抑郁症状增加了 0.25 分（95%CI：0.04 至 0.45），FU2 时抑郁症状减少了 0.75/21 分（95%CI：-0.97 至 -0.53）。从基线到 FU1，焦虑症状减少了 0.09/21 分（95%CI：-0.24 至 0.07），到 FU2 时焦虑症状减少了 0.77/21 分（95%CI：-0.93 至 -0.61）。从基线到 FU1，压力症状减少了 0.30/21 分（95%CI：-0.52 至 -0.09），到 FU2 时压力症状减少了 1.32/21 分（95%CI：-1.55 至 -1.09）。在疫情前有孤独感、睡眠质量差或有心理健康问题的学生，其心理健康症状的平均变化轨迹并没有更差。
在疫情的前三个月，症状水平相对稳定，而在夏季几个月，症状水平略有下降，这可能是季节性因素的影响。
