Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, Houston, Texas, United States of America.
National Healthy Start Association, Washington, DC, United States of America.
PLoS One. 2022 Dec 30;17(12):e0279963. doi: 10.1371/journal.pone.0279963. eCollection 2022.
Although studies have investigated the impact of the COVID-19 on mental health, few studies have attempted to compare the prevalence of depression/anxiety symptoms among U.S. adults before and after the COVID-19 pandemic declaration. We examined the prevalence and association between depression/anxiety symptoms and COVID-19 pandemic declaration among U.S. adult population and subgroups.
A nationally representative cross-sectional study of the Health Information National Trends Survey (HINTS 5, Cycle 4) assessing health-related information and behaviors in U.S. adults aged ≥18 years from February through June 2020. The primary dependent variable was current depression/anxiety derived from Patient Health Questionnaire-4. The main independent variable was responses before and after the COVID-19 pandemic declaration in addition to sexual identity heterosexual identity, /race/ethnicity and rural-urban commuting areas. Covariates were sociodemographic factors, and health risk behaviors. Weighted percentages, multivariable logistic regression, and Chi-square tests were used to establish the prevalence and association between current depression/anxiety and the independent variables and covariates.
A total of 3,865 participants completed the survey and included 35.3% of the participants before the COVID-19 pandemic declaration. Most of the sample were aged 50-64 years [33.0%]; males [51.0%]; and non-Hispanic Whites [70.1%]). The post-pandemic declaration included participants, aged 35-49 years [27.0%]; females [52.6%]; and non-Hispanic Whites [59.6%]). The prevalence of depression/anxiety was higher after the COVID-19 pandemic declaration (32.2%) than before the declaration (29.9%). Higher risks of depression/anxiety symptoms after the declaration were associated with being a sexual minority ([adjusted odds ratio] AOR, 2.91 [95% confidence interval (CI), 1.38-6.14]) and having fair/poor general health (AOR, 2.91 [95% CI, 1.76-4.83]). The probability of experiencing depression/anxiety symptoms after the declaration was highest among homosexuals/lesbians/gays (65.6%) compared to bisexuals (39.6%), and heterosexuals (30.1%).
In this study, young adults, non-Hispanic Whites, and those with fair/poor general health had a higher burden of depression/anxiety symptoms after the pandemic declaration. The development of psychological support strategies to promote wellbeing during the pandemic may reduce psychological distress in the population, especially among at-risk populations.
尽管已有研究调查了 COVID-19 对心理健康的影响，但鲜有研究尝试比较 COVID-19 大流行宣布前后美国成年人中抑郁/焦虑症状的患病率。我们研究了美国成年人群体及亚组中抑郁/焦虑症状与 COVID-19 大流行宣布之间的相关性和患病率。
这是一项全国性代表性的横断面研究，采用健康信息国家趋势调查（HINTS 5，第 4 周期）评估 2020 年 2 月至 6 月期间≥18 岁美国成年人的健康相关信息和行为。主要因变量为源自患者健康问卷-4 的当前抑郁/焦虑。主要自变量为 COVID-19 大流行宣布前后的回答，以及性认同异性恋认同、种族/族裔和城乡通勤区。协变量为社会人口统计学因素和健康风险行为。采用加权百分比、多变量逻辑回归和卡方检验确定当前抑郁/焦虑与独立变量和协变量之间的相关性和患病率。
共有 3865 名参与者完成了调查，其中包括 COVID-19 大流行宣布前的 35.3%的参与者。大多数样本年龄在 50-64 岁之间（33.0%）；男性（51.0%）；非西班牙裔白人（70.1%）。大流行后宣布的参与者年龄在 35-49 岁之间（27.0%）；女性（52.6%）；非西班牙裔白人（59.6%））。大流行后宣布的抑郁/焦虑患病率（32.2%）高于宣布前（29.9%）。宣布后出现抑郁/焦虑症状的风险较高与性少数群体有关（调整后的优势比（AOR），2.91[95%置信区间（CI），1.38-6.14]）和一般健康状况不佳（AOR，2.91[95%CI，1.76-4.83]）。与双性恋者（39.6%）相比，同性恋/双性恋/跨性别者（65.6%）和异性恋者（30.1%）宣布后经历抑郁/焦虑症状的可能性更高。
在这项研究中，年轻人、非西班牙裔白人以及一般健康状况不佳的人在大流行宣布后抑郁/焦虑症状的负担更高。在大流行期间制定促进幸福感的心理支持策略可能会减轻人群的心理困扰，特别是在高危人群中。
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