Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
Epidemiol Psychiatr Sci. 2021 Jun 2;30:e49. doi: 10.1017/S2045796021000408.
To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain; and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown.
Data from a longitudinal adult population-based cohort from the provinces of Madrid and Barcelona were analysed (n = 1103). Structured face-to-face home-based interviews (pre-pandemic) and telephone interviews were performed. Both depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). A variety of validated instruments and sociodemographic variables including age, sex, educational level, occupational status, home quietness, screen time, resilience, loneliness, social support, physical activity, disability, economic situation and COVID-19-related information were also considered. Population prevalence estimates and multivariable logistic regressions were computed.
Overall, prevalence rates of depression and suicidal ideation did not change significantly from before to after the COVID-19 outbreak. However, the rates of depression among individuals aged 50+ years showed a significant decrease compared to before the pandemic (from 8.48 to 6.41%; p = 0.01). Younger individuals (odds ratio (OR) = 0.97 per year older; 95% confidence interval (CI) = 0.95-0.99) and those feeling loneliness (OR = 1.96; 95% CI = 1.42-2.70) during the lockdown were at an increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.46; 95% CI = 0.32-0.66) and suicidal ideation (OR = 0.33; 95% CI = 0.16-0.68), whereas individuals perceiving social support were at a lower risk of developing suicidal thoughts (OR = 0.35; 95% CI = 0.18-0.69).
Continuous reinforcement of mental health preventive and intervening measures during and in the aftermath of the crisis is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.
评估西班牙第一波 COVID-19 大流行期间严格封锁措施后抑郁和自杀意念的流行率是否发生变化；并评估在封锁期间哪些因素与抑郁发作或自杀意念的发生有关。
分析了马德里和巴塞罗那省的一项基于成年人的纵向人群队列研究的数据（n=1103）。进行了结构化的面对面家庭入户访谈（大流行前）和电话访谈。通过改编复合国际诊断访谈（CIDI 3.0）评估抑郁和自杀意念。还考虑了各种经过验证的工具以及社会人口统计学变量，包括年龄、性别、教育水平、职业状况、家庭安静程度、屏幕时间、韧性、孤独感、社会支持、身体活动、残疾、经济状况和与 COVID-19 相关的信息。计算了人群患病率估计值和多变量逻辑回归。
总体而言，与大流行前相比，COVID-19 爆发后抑郁和自杀意念的患病率没有显著变化。然而，50 岁以上人群的抑郁率与大流行前相比显著下降（从 8.48%降至 6.41%；p=0.01）。在封锁期间，年龄较大的个体（每增加 1 岁，比值比（OR）=0.97；95%置信区间（CI）=0.95-0.99）和感到孤独的个体（OR=1.96；95%CI=1.42-2.70）患抑郁的风险增加。在封锁期间，韧性对抑郁的风险具有保护作用（OR=0.46；95%CI=0.32-0.66）和自杀意念（OR=0.33；95%CI=0.16-0.68），而感到社会支持的个体自杀念头的风险较低（OR=0.35；95%CI=0.18-0.69）。
在危机期间和危机之后持续加强心理健康预防和干预措施对于全球都非常重要，特别是对于正在经历最大痛苦的弱势群体。未来的研究应努力评估 COVID-19 危机对心理健康的长期影响。
