School of Nursing, Peking Union Medical College, Chinese Academy of Medical Sciences, Shijingshan District, 33 Ba Da Chu Road, Beijing, 100144, China.
Peking University Clinical Research Institute, Peking University First Hospital, Haidian District, No. 38 Xueyuan Road, Beijing, 100191, China.
BMC Geriatr. 2023 Feb 1;23(1):64. doi: 10.1186/s12877-023-03744-1.
BACKGROUND: Major concerns about the adverse mental health impact of the rapidly spread COVID-19 pandemic have been raised. Previous studies on changes of depressive symptoms during the COVID-19 pandemic have yielded inconsistent results regarding the sex differences. Since women have higher depressive symptoms even without the pandemic, it is essential to consider the pre-existing change of depressive symptoms of a similar period to discern the effect of the pandemic on depression. This study aimed to evaluate sex differences in depressive symptoms before and during the pandemic. METHODS: Data from the Health and Retirement Study (HRS; waves 13 to 15) and the English Longitudinal Study of Ageing (ELSA; wave 8 to COVID-19 wave 2) were analyzed. Depressive symptoms were assessed by the 8-item Center for Epidemiological Studies Depression (CES-D) scale. According to the time of COVID-19 outbreak in the US and the UK, the intervals from waves 13 to 14 surveys of the HRS and from waves 8 to 9 surveys of the ELSA were employed as pre-pandemic periods to control for the pre-existing depressive symptoms, respectively. Changes of CES-D scores during the pre-pandemic and pandemic periods were assessed by linear mixed models. RESULTS: Nine thousand, seven hundred thirty-seven participants (mean age: 66.7 ± 10.7 years) from the HRS and 5,098 participants (mean age: 68.7 ± 10.0 years) from the ELSA were included. CES-D scores among women were significantly higher than those among men at all waves in both cohorts. During the pre-pandemic period, no significant sex difference on changes of CES-D scores was detected in either the HRS or the ELSA. During the pandemic period, CES-D scores were increased in both men and women and the sex differences in CES-D increments of the two cohorts were both significant. Enlarged sex differences were demonstrated in increments of CES-D scores during the pandemic period. CONCLUSIONS: Our results suggest women suffered from worse depressive symptoms in response to the pandemic, although the changes of depression were similar between men and women before the pandemic. These findings underscore the necessity to support the vulnerable populations, especially women, to manage the distress brought by the pandemic and maintain optimal mental health status.
背景：人们对 COVID-19 大流行迅速蔓延对心理健康产生的不良影响表示担忧。此前关于 COVID-19 大流行期间抑郁症状变化的研究，关于性别差异的结果不一致。由于即使在没有大流行的情况下，女性的抑郁症状也更高，因此必须考虑到类似时期内抑郁症状的预先变化，以辨别大流行对抑郁症的影响。本研究旨在评估大流行前后抑郁症状的性别差异。
方法：分析了来自健康与退休研究（HRS；第 13 波至 15 波）和英国老龄化纵向研究（ELSA；第 8 波至 COVID-19 波 2）的数据。抑郁症状通过 8 项中心流行病学研究抑郁量表（CES-D）进行评估。根据 COVID-19 在美英两国的爆发时间，HRS 第 13 波至 14 波调查期间和 ELSA 第 8 波至 9 波调查期间被分别用作大流行前时期，以控制预先存在的抑郁症状。通过线性混合模型评估大流行前和大流行期间 CES-D 评分的变化。
结果：纳入 HRS 的 9737 名参与者（平均年龄：66.7±10.7 岁）和 ELSA 的 5098 名参与者（平均年龄：68.7±10.0 岁）。在两个队列的所有波次中，女性的 CES-D 评分均显著高于男性。在大流行前期间，在 HRS 或 ELSA 中，CES-D 评分变化均无性别差异。在大流行期间，男性和女性的 CES-D 评分均升高，两个队列 CES-D 增量的性别差异均具有统计学意义。在大流行期间，CES-D 评分的性别差异增大。
结论：我们的研究结果表明，女性在应对大流行时遭受了更严重的抑郁症状，尽管在大流行之前，男性和女性的抑郁变化相似。这些发现强调了支持弱势群体，尤其是女性，以应对大流行带来的困扰并保持最佳心理健康状态的必要性。
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