Centre for Longitudinal Studies, University College London, London, UK.
Soc Psychiatry Psychiatr Epidemiol. 2023 May;58(5):779-794. doi: 10.1007/s00127-022-02377-w. Epub 2023 Jan 19.
Financial adversity in times of economic recession have been shown to have an unequal effect on individuals with prior mental health problems. This study investigated the relationship between mental health groupings across the adult life-course and change in financial situation and employment status during the COVID-19 pandemic, as well as the use of financial measures to mitigate the economic shock.
Using two nationally representative British birth cohorts, the National Child Development Study (1958) n = 17,415 and 1970 British Cohort Study n = 17,198, we identified 5 different life-course trajectories of psychological distress from adolescence to midlife which were similar but not identical across the two cohorts. We explored their relation to changes in financial and employment circumstances at different stages during the pandemic from May 2020 to March 2021, applying multinomial logistic regression and controlling for numerous early life covariates, including family socio-economic status (SES). In addition, we ran modified Poisson models with robust standard errors to identify whether different mental health trajectories were supported by government and used other methods to mitigate their financial situation.
We found that the financial circumstances of pre-pandemic trajectories of psychological distress with differential onset, severity, and chronicity across the life-course were exacerbated by the COVID-19 economic shock. The 'stable-high' (persistent severe symptoms) and 'adult-onset' (symptoms developing in 30s, but later decreasing) groups were vulnerable to job loss. Compared to pre-pandemic trajectory groupings with no, minor, or psychological distress symptoms in early adulthood, the 'stable-high', 'midlife-onset' (symptoms developing in midlife), and 'adult-onset' trajectory groups were more likely to seek support from the UK governments economic response package. However, trajectories with pre-pandemic psychological distress were also at greater risk of reducing consumption, dis-saving, relying on increased financial help from family and friends, and also taking payment holidays (agreements with lenders to pause mortgage, credit card or loan payments for a set period) and borrowing.
This work highlights different trajectories of pre-pandemic psychological distress, compared to groups with no symptoms were more vulnerable to pandemic-related economic shock and job loss. By adopting unsustainable mitigating measures (borrowing and payment holidays) to support their financial circumstances during COVID-19, these mental health trajectories are at even more risk of lasting adverse impacts and future economic difficulties.
经济衰退时期的经济困境对先前存在心理健康问题的个人产生了不平等的影响。本研究调查了成年期心理卫生分组与 COVID-19 大流行期间财务状况和就业状况的变化以及使用财政措施减轻经济冲击之间的关系。
使用两个具有全国代表性的英国出生队列，即国家儿童发展研究（1958 年）n=17415 和 1970 年英国队列研究 n=17198，我们从青春期到中年确定了 5 种不同的心理困扰生命轨迹，这两种队列之间相似但不完全相同。我们探讨了它们与 2020 年 5 月至 2021 年 3 月大流行期间不同阶段财务和就业情况变化的关系，应用多项逻辑回归并控制了包括家庭社会经济地位（SES）在内的许多早期生活协变量。此外，我们运行了修正泊松模型，采用稳健标准差，以确定不同的心理健康轨迹是否得到政府的支持，并使用其他方法来缓解其财务状况。
我们发现，在生命过程中出现不同发病、严重程度和持续性的心理困扰的前流行轨迹的财务状况因 COVID-19 经济冲击而加剧。“稳定高”（持续严重症状）和“成年发病”（症状出现在 30 多岁，但后来减少）组容易失业。与成年早期没有、轻度或心理困扰症状的前流行轨迹分组相比，“稳定高”、“中年发病”（症状出现在中年）和“成年发病”轨迹分组更有可能寻求英国政府经济应对方案的支持。然而，有前流行心理困扰的轨迹也更有可能减少消费、不储蓄、依赖家人和朋友增加经济帮助，并且还采用延期付款（与贷款方达成协议，暂停抵押贷款、信用卡或贷款支付一段时间）和借款。
这项工作强调了与没有症状的群体相比，前流行心理困扰的不同轨迹更容易受到大流行相关经济冲击和失业的影响。通过在 COVID-19 期间采用不可持续的缓解措施（借款和延期付款）来支持其财务状况，这些心理健康轨迹面临着更大的持续不利影响和未来经济困难的风险。
