Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 2213 McElderry Street, 2nd Floor, 624 N. Broadway, Baltimore, MD 21205, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA.
J Affect Disord. 2021 Nov 1;294:949-956. doi: 10.1016/j.jad.2021.07.095. Epub 2021 Jul 30.
During the COVID-19 pandemic, many Americans have experienced mental distress, which may be partially characterized by a rise in mental illnesses. However, COVID-19 specific psychological distress may also be separate from diagnosable conditions, a distinction that has not been well established in the context of the pandemic.
Data came from an online survey of US adults collected in March 2020. We used factor analysis to assess the relationship between COVID-19 related mental distress and depressive symptoms. Using four questions on psychological distress modified for COVID-19 and eight depressive symptoms, we conducted an exploratory factor analysis (EFA) to identify the factor structure and then estimated a confirmatory factor analysis (CFA).
The EFA model indicated a two-factor solution, where the COVID-19 distress items loaded onto the first factor and depression items loaded onto the second. Only two items cross-loaded between factors: feeling fearful and being bothered by things that do not usually bother the participant. The CFA indicated that this factor structure fit the data adequately (RMSEA=0.106, SRMR=0.046, CFI=0.915, TLI=0.890).
It is possible that there are additional important symptoms of COVID-19 distress that were not included. Depression symptoms were measured via the CES-D-10, which while validated is not equivalent to a clinician diagnosis.
As COVID-19 related mental distress appears to be distinct from, though related to, depression, public health responses must consider what aspects of depression treatment may apply to this phenomenon. For COVID-related distress, it may be more appropriate to treat symptomatically and with supportive psychotherapy.
在 COVID-19 大流行期间，许多美国人经历了精神困扰，这可能部分表现为精神疾病的增加。然而，COVID-19 特有的心理困扰也可能与可诊断的疾病不同，这种区别在大流行背景下尚未得到很好的确定。
数据来自于 2020 年 3 月对美国成年人进行的一项在线调查。我们使用因子分析来评估 COVID-19 相关精神困扰与抑郁症状之间的关系。使用四个针对 COVID-19 修改的心理困扰问题和八个抑郁症状，我们进行了探索性因子分析（EFA）以确定因子结构，然后估计了验证性因子分析（CFA）。
EFA 模型表明存在两因素解决方案，其中 COVID-19 困扰项目加载到第一个因素上，而抑郁项目加载到第二个因素上。只有两个项目在因素之间交叉加载：感到恐惧和被通常不会困扰参与者的事情困扰。CFA 表明该因子结构适用于数据（RMSEA=0.106，SRMR=0.046，CFI=0.915，TLI=0.890）。
可能有其他未包括的重要 COVID-19 困扰症状。抑郁症状通过 CES-D-10 进行测量，尽管经过验证，但与临床医生诊断并不等同。
由于 COVID-19 相关精神困扰似乎与抑郁不同，但又相关，公共卫生应对措施必须考虑到哪些抑郁治疗方面可能适用于这种现象。对于 COVID 相关的困扰，可能更适合进行对症治疗和支持性心理治疗。
