Institute for Global Health, University College London, London, UK.
Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
Psychol Health Med. 2022 Jan-Dec;27(sup1):239-255. doi: 10.1080/13548506.2022.2108087. Epub 2022 Aug 11.
The COVID-19 pandemic has substantially affected the lives of young people living in sub-Saharan Africa (SSA), leading to poorer short-term mental health outcomes. However, longitudinal data investigating changes in mental health from pre-COVID levels and their predictors are lacking. Our longitudinal sample comprised = 233 young people (mean age: 17.8 years at baseline, 55.6% female) living in a deprived neighbourhood near Cape Town, South Africa. Symptoms of depression (PHQ-9), anxiety (GAD-7) and alcohol use (AUDIT) were assessed during two waves of data collection, pre-pandemic (2018/19) and via phone interviews in June to October 2020, during South Africa's first COVID wave and subsequent case decline. Latent change score models were used to investigate predictors of changes in mental health. Controlling for baseline levels, we found increases in depression and anxiety but not alcohol use symptoms during the COVID-19 pandemic. Higher baseline symptoms were associated with smaller increases on all measures. Socio-economic deprivation (lack of household income, food insecurity) before and during COVID were associated with higher anxiety and depression symptom increases. Having had more positive experiences during COVID was associated with lower post-COVID onset anxiety and depression increases, and marginally with less alcohol use, while negative experiences (household arguments, worries) were linked to stronger symptom increases. Overall, in a sample of young people from an adverse environment in South Africa, we found increased mental health difficulties during the COVID-19 pandemic, though higher baseline symptoms did not necessarily predict stronger increases. Several factors pre- and post-COVID onset were identified that could be relevant for determining risk and resilience. In the long term, it will be key to address these structural drivers of well-being and to ensure mental health needs of young people are being met to support SSA countries in building back successfully from COVID-19 and preparing for future shock events.
标题：COVID-19 大流行对撒哈拉以南非洲年轻人生活的影响，以及对其心理健康的影响
摘要：COVID-19 大流行对撒哈拉以南非洲（SSA）年轻人的生活产生了重大影响，导致其短期心理健康状况恶化。然而，目前缺乏关于 COVID-19 前心理健康水平变化及其预测因素的纵向数据。我们的纵向样本包括 233 名居住在南非开普敦附近贫困社区的年轻人（基线时的平均年龄为 17.8 岁，女性占 55.6%）。在两次数据收集期间，即 COVID-19 大流行前（2018/19 年）和 2020 年 6 月至 10 月通过电话访谈，评估了抑郁症状（PHQ-9）、焦虑症状（GAD-7）和饮酒（AUDIT）。使用潜在变化得分模型来研究心理健康变化的预测因素。在控制基线水平的情况下，我们发现 COVID-19 大流行期间抑郁和焦虑症状增加，但饮酒症状没有增加。所有措施的基线症状较高与较小的增加有关。COVID-19 前和期间的社会经济剥夺（缺乏家庭收入、粮食不安全）与焦虑和抑郁症状的增加有关。在 COVID-19 期间经历更多积极体验与 COVID-19 后焦虑和抑郁症状的增加减少有关，与饮酒减少有关，而负面体验（家庭争吵、担忧）与症状增加有关。总体而言，在南非不利环境中，我们发现年轻人的心理健康问题在 COVID-19 大流行期间有所增加，尽管较高的基线症状并不一定预示着更强的增加。确定风险和弹性的几个与 COVID-19 前和后相关的因素已经确定。从长远来看，解决这些幸福的结构性驱动因素，并确保满足年轻人的心理健康需求，以支持 SSA 国家从 COVID-19 成功恢复并为未来的冲击事件做好准备，将是关键。
