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新冠疫情相关的感知压力和社会支持对广泛性焦虑症和重度抑郁症的影响:疫情前精神障碍的调节作用

The impact of COVID-related perceived stress and social support on generalized anxiety and major depressive disorders: moderating effects of pre-pandemic mental disorders.

作者信息

Monistrol-Mula Anna, Felez-Nobrega Mireia, Domènech-Abella Joan, Mortier Philippe, Cristóbal-Narváez Paula, Vilagut Gemma, Olaya Beatriz, Ferrer Montse, Gabarrell-Pascuet Aina, Alonso Jordi, Haro Josep Maria

机构信息

Research, Teaching and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.

Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.

出版信息

Ann Gen Psychiatry. 2022 Feb 14;21(1):7. doi: 10.1186/s12991-022-00385-3.

Abstract

BACKGROUND

We assessed the moderating effect of pre-pandemic mental disorders on the association of COVID-related perceived stress and social support with mental health.

METHODS

A nationally representative sample of 3500 Spanish adults was interviewed in June 2020 (mean age 49.25 years, ± 15.64; 51.50% females). Mental health included Generalized Anxiety Disorders (GAD; GAD-7, cut-off point of ≥ 10), Major Depressive Disorders (MDD; PHQ-8, cut-off point of ≥ 10) and the comorbid form (those screening positive for GAD and MDD). COVID-related stress was assessed using an adapted version of the Peri Life Events Scale, and social support using the Oslo Social Support Scale. Logistic regression models were used to assess if COVID-related stress and social support were related to mental health outcomes and interactions were conducted to examine whether these relationships differed according to the presence of pre-pandemic mental disorders.

RESULTS

Higher COVID-related stress was associated with a higher risk of lower mental health. The association between COVID-related stress with GAD and MDD was significantly moderated by pre-pandemic mental disorders, except for comorbid GAD + MDD. Higher levels of social support were linked to better mental health. Only the association between social support and GAD was significantly moderated by pre-pandemic mental disorders. That is, for those without pre-pandemic mental disorders, higher levels of social support decreased the odds of GAD, while minor decreases were observed in those with pre-pandemic mental disorders.

CONCLUSIONS

The impact of COVID-related stress and social support on specific indicators of mental health may vary depending on the existence of a previous mental disorder.

摘要

背景

我们评估了疫情前精神障碍对新冠相关感知压力和社会支持与心理健康之间关联的调节作用。

方法

2020年6月对3500名西班牙成年人进行了全国代表性抽样访谈(平均年龄49.25岁,±15.64;51.50%为女性)。心理健康包括广泛性焦虑障碍(GAD;GAD - 7,临界值≥10)、重度抑郁症(MDD;PHQ - 8,临界值≥10)以及共病形式(GAD和MDD筛查均呈阳性者)。使用改编版的《围产期生活事件量表》评估新冠相关压力,使用《奥斯陆社会支持量表》评估社会支持。采用逻辑回归模型评估新冠相关压力和社会支持是否与心理健康结果相关,并进行交互分析以检验这些关系是否因疫情前精神障碍的存在而有所不同。

结果

较高的新冠相关压力与较低心理健康风险较高相关。除了共病的GAD + MDD外,疫情前精神障碍对新冠相关压力与GAD和MDD之间的关联有显著调节作用。较高水平的社会支持与更好的心理健康相关。只有社会支持与GAD之间的关联受到疫情前精神障碍的显著调节。也就是说,对于那些没有疫情前精神障碍的人,较高水平的社会支持降低了患GAD的几率,而对于有疫情前精神障碍的人,这种几率有轻微下降。

结论

新冠相关压力和社会支持对心理健康特定指标的影响可能因先前是否存在精神障碍而有所不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/669f/8845272/df9a5e8f0b21/12991_2022_385_Fig1_HTML.jpg

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