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老年人在欧洲 COVID-19 疫情第一波期间的抑郁恶化。

Depression deterioration of older adults during the first wave of the COVID-19 outbreak in Europe.

机构信息

Department of Statistical Sciences, University of Padua, Via Cesare Battisti 241/243, 35121, Padova, Italy.

Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, Via Sarfatti 25, 20136, Milan, Italy.

出版信息

Soc Sci Med. 2022 Apr;299:114828. doi: 10.1016/j.socscimed.2022.114828. Epub 2022 Feb 16.

Abstract

RATIONALE

Determining who is particularly vulnerable to mental health deterioration during the COVID-19 pandemic is essential when designing and targeting interventions to mitigate the adverse psychological impacts of the outbreak. Older people have appeared to be less exposed to mental health deterioration compared with younger individuals, but most exposed to the risk of severe illness and death from the virus, as well as less equipped to use technologies for coping with lockdown measures.

OBJECTIVE

Amongst the old population, we aim at determining how depressive symptoms have changed during the first wave of the COVID-19 pandemic and identifying individual risk factors associated with changes in reporting depression. We are particularly interested in exploring the role of pre-existing mental health problems and evaluating gender differences.

METHOD

Data come from the Survey of Health, Ageing and Retirement in Europe, in particular from the first COVID-19 survey administered in summer 2020. Logistic models are estimated and Average Marginal Effects computed to take the degree of individual unobserved heterogeneity into account comparing point estimates across samples. Multiple Imputation (implemented through Multivariate Imputation by Chained Equations) is used to replace missing data. Statistical power of the effect sizes is estimated by a simulation approach.

RESULTS

Pre-existing mental health problems, a diagnosis of affective/emotional disorders, a recent diagnosis of a major illness, and (only for men) job loss during the first wave of the outbreak are the most important risk factors. Statistical differences between genders emerge, with women experiencing higher levels of depression and greater worsening of mental health than men.

CONCLUSIONS

To identify people at greater risk of depression deterioration during an outbreak it is very important to consider their pre-existing mental and general health, distinguishing severity level. On population level, it is also crucial to evaluate depression disorders separately by gender.

摘要

背景

在设计和针对干预措施以减轻疫情对心理健康的负面影响时,确定谁在 COVID-19 大流行期间特别容易出现心理健康恶化至关重要。与年轻人相比,老年人似乎较少受到心理健康恶化的影响,但他们面临着因病毒而患上重病和死亡的风险,并且不太具备使用技术来应对封锁措施的能力。

目的

在老年人群中,我们旨在确定在 COVID-19 大流行的第一波期间抑郁症状如何变化,并确定与报告抑郁变化相关的个体风险因素。我们特别感兴趣的是探索先前存在的心理健康问题的作用,并评估性别差异。

方法

数据来自欧洲健康、老龄化和退休调查,特别是 2020 年夏季进行的第一次 COVID-19 调查。估计了逻辑模型,并计算了平均边际效应,以考虑个体未观察到的异质性程度,比较了样本之间的点估计值。使用多重插补(通过链式方程的多变量插补实现)来替换缺失数据。通过模拟方法估计效应大小的统计功效。

结果

先前存在的心理健康问题、情感/情绪障碍的诊断、在疫情第一波期间最近被诊断出患有重大疾病以及(仅对男性而言)失业是最重要的风险因素。性别之间出现了统计学差异,女性经历的抑郁程度更高,心理健康恶化程度也更大。

结论

要确定在疫情期间更容易出现抑郁恶化的人群,非常重要的是要考虑他们先前的心理和一般健康状况,并区分严重程度水平。在人群层面上,还必须分别按性别评估抑郁障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a02/8848543/4e25757998d5/gr1_lrg.jpg

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