新冠疫情期间的持续性抑郁症状：一项针对美国成年人的全国性、具有人口代表性的纵向研究。
Persistent depressive symptoms during COVID-19: a national, population-representative, longitudinal study of U.S. adults.
作者信息
Ettman Catherine K, Cohen Gregory H, Abdalla Salma M, Sampson Laura, Trinquart Ludovic, Castrucci Brian C, Bork Rachel H, Clark Melissa A, Wilson Ira, Vivier Patrick M, Galea Sandro
机构信息
Boston University School of Public Health, Boston, MA, USA.
Brown University School of Public Health, Providence, RI, USA.
出版信息
Lancet Reg Health Am. 2022 Jan;5:100091. doi: 10.1016/j.lana.2021.100091. Epub 2021 Oct 4.
BACKGROUND
The COVID-19 pandemic and its consequences have been associated with an increase in poor population mental health. We assessed how depressive symptoms changed among U.S. adults over the course of the COVID-19 pandemic and identified the key risk factors for these symptoms.
METHODS
Longitudinal panel study of a nationally representative group of U.S. adults ages 18 years and older surveyed in March-April 2020 (Time 1; N=1441) and March-April 2021 (Time 2; N=1161) in the COVID-19 and Life Stressors Impact on Mental Health and Well-being study (CLIMB). The Patient Health Questionnaire-9 (PHQ-9) was used to define elevated depressive symptoms (cut-off ≥10) and depressive symptoms score (0-27).
FINDINGS
The prevalence of elevated depressive symptoms persisted from 27.8% in 2020 (95% CI: 24.9, 30.9) to 32.8% in 2021 (95% CI: 29.1, 36.8). Over time, the central drivers of depressive symptoms were low household income, not being married, and experiencing multiple stressors during the COVID-19 pandemic. The odds ratio of elevated depressive symptoms for low income relative to high income persons increased from 2.3 (95% CI: 1.2, 4.2) in 2020 to 7.0 (95% CI: 3.7, 13.3) in 2021. Fewer people reported experiencing 4 or more COVID-19 stressors in 2021 than in 2020 (47.5% in 2020 vs 37.1% in 2021), but the odds ratio of elevated depressive symptoms associated with 4 or more stressors relative to 1 stressor or less increased from 1.9 (95% CI: 1.2, 3.1) in 2020 to 5.4 (95% CI: 3.2, 9.2) in 2021.
INTERPRETATION
The burden of depressive symptoms in the U.S. adult population increased over the course of the COVID-19 pandemic. Mental health gaps grew between populations with different assets and stressor experiences during the COVID-19 pandemic.
FUNDING
CLIMB Time 1 was sponsored by the Rockefeller Foundation-Boston University 3-D Commission. CLIMB Time 2 was sponsored by the de Beaumont Foundation.
背景
2019冠状病毒病疫情及其后果与贫困人口心理健康状况恶化有关。我们评估了美国成年人在2019冠状病毒病疫情期间抑郁症状的变化情况，并确定了这些症状的关键风险因素。
方法
对年龄在18岁及以上具有全国代表性的美国成年人进行纵向面板研究，这些成年人在2019冠状病毒病与生活压力源对心理健康和幸福感的影响研究（CLIMB）中于2020年3月至4月（时间1；N = 1441）和2021年3月至4月（时间2；N = 1161）接受了调查。使用患者健康问卷-9（PHQ-9）来定义抑郁症状加重（临界值≥10）和抑郁症状评分（0 - 27）。
研究结果
抑郁症状加重的患病率从2020年的27.8%（95%置信区间：24.9，30.9）持续至2021年的32.8%（95%置信区间：29.1，36.8）。随着时间推移，抑郁症状的主要驱动因素是家庭收入低、未婚以及在2019冠状病毒病疫情期间经历多种压力源。低收入者相对于高收入者抑郁症状加重的优势比从2020年的2.3（95%置信区间：1.2，4.2）增至2021年的7.0（95%置信区间：3.7，13.3）。2021年报告经历4种或更多2019冠状病毒病压力源的人数少于2020年（2020年为47.5%，2021年为37.1%），但与4种或更多压力源相关的抑郁症状加重相对于1种或更少压力源的优势比从2020年的1.9（95%置信区间：1.2，3.1）增至2021年的5.4（95%置信区间：3.2，9.2）。
解读
在2019冠状病毒病疫情期间，美国成年人群体中抑郁症状的负担有所增加。在2019冠状病毒病疫情期间，不同资产和压力源经历人群之间的心理健康差距加大。
资金来源
CLIMB时间1由洛克菲勒基金会 - 波士顿大学三维委员会赞助。CLIMB时间2由德博蒙特基金会赞助。
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