西班牙新冠疫情期间年龄与抑郁、焦虑及创伤后应激症状的关联：孤独及疫情前精神障碍的作用
The Association of Age With Depression, Anxiety, and Posttraumatic Stress Symptoms During the COVID-19 Pandemic in Spain: The Role of Loneliness and Prepandemic Mental Disorder.
作者信息
Gabarrell-Pascuet Aina, Koyanagi Ai, Felez-Nobrega Mireia, Cristóbal-Narváez Paula, Mortier Philippe, Vilagut Gemma, Olaya Beatriz, Alonso Jordi, Haro Josep Maria, Domènech-Abella Joan
机构信息
From the Teaching, Research & Innovation Unit (Gabarrell-Pascuet, Koyanagi, Félez-Nobrega, Cristóbal-Narváez, Olaya, Haro, Domènech-Abella), Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona; Instituto de Salud Carlos III (Koyanagi, Cristóbal-Narváez, Olaya, Haro, Domènech-Abella), Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid; Institució Catalana de Recerca i Estudis Avançats (ICREA) (Koyanagi); Health Services Research Unit (Mortier, Vilagut, Alonso), IMIM (Hospital del Mar Medical Research Institute); Department of Experimental and Health Sciences (Alonso), Pompeu Fabra University (UPF), Barcelona; Instituto de Salud Carlos III (Mortier, Vilagut, Alonso), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP); Instituto de Investigación Sanitaria Princesa (IP) (Haro), Madrid; Department of Sociology (Domènech-Abella), Universitat de Barcelona, Barcelona, Spain.
出版信息
Psychosom Med. 2023 Jan 1;85(1):42-52. doi: 10.1097/PSY.0000000000001146. Epub 2022 Sep 30.
OBJECTIVE
Older adults may be at lower risk of common mental disorders than younger adults during the coronavirus disease 2019 (COVID-19) pandemic. Previous research has shown shown differences by age in psychosocial well-being during the pandemic and have highlighted the moderating effect of prepandemic mental disorders on that association. In this line, we examined the association of age with self-reported symptoms of loneliness, depression, anxiety, and posttraumatic stress, as well as potential roles of loneliness symptoms and prepandemic mental disorders on the association between age and mental disorder symptoms.
METHODS
Cross-sectional data of 2000 adults in Spain interviewed by telephone during the COVID-19 pandemic (February-March 2021) were analyzed. Depression, anxiety, and posttraumatic stress were measured with the eight-item Patient Health Questionnaire, the seven-item Generalized Anxiety Disorder Scale, and the four-item checklist for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), respectively. Loneliness was measured with the three-item University of California at Los Angeles Loneliness Scale. Several regression models were constructed to assess factors related to loneliness and mental disorders.
RESULTS
According to cutoff points used, 12.4% of participants revealed depression, 11.9% revealed anxiety, and 11.6% revealed posttraumatic stress. Age was negatively related to mental disorder symptoms and loneliness. Loneliness was associated with higher levels of mental disorder symptoms. This association was stronger in younger adults without prepandemic mental disorders and in older adults with them. The association between age and loneliness was stronger in those with prepandemic mental disorders. Loneliness mediated the association of age with mental disorder symptoms.
CONCLUSIONS
Interventions focused on loneliness could alleviate the impact of the COVID-19 pandemic on mental health.
目的
在2019年冠状病毒病（COVID-19）大流行期间，老年人患常见精神障碍的风险可能低于年轻人。先前的研究表明，大流行期间心理社会幸福感存在年龄差异，并强调了大流行前的精神障碍对这种关联的调节作用。在此基础上，我们研究了年龄与自我报告的孤独、抑郁、焦虑和创伤后应激症状之间的关联，以及孤独症状和大流行前的精神障碍在年龄与精神障碍症状关联中的潜在作用。
方法
分析了在COVID-19大流行期间（2021年2月至3月）通过电话采访的2000名西班牙成年人的横断面数据。分别用八项患者健康问卷、七项广泛性焦虑障碍量表和四项《精神疾病诊断与统计手册》（第五版）清单来测量抑郁、焦虑和创伤后应激。用三项加州大学洛杉矶分校孤独量表来测量孤独感。构建了几个回归模型来评估与孤独和精神障碍相关的因素。
结果
根据所使用的临界值，12.4%的参与者有抑郁症状，11.9%有焦虑症状，11.6%有创伤后应激症状。年龄与精神障碍症状和孤独感呈负相关。孤独感与较高水平的精神障碍症状相关。这种关联在没有大流行前精神障碍的年轻人和有大流行前精神障碍的老年人中更强。在有大流行前精神障碍的人群中，年龄与孤独感之间的关联更强。孤独感介导了年龄与精神障碍症状之间的关联。
结论
针对孤独感的干预措施可以减轻COVID-19大流行对心理健康的影响。
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