Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland.
Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland.
Public Health. 2023 Apr;217:65-73. doi: 10.1016/j.puhe.2023.01.010. Epub 2023 Jan 16.
During the pandemic, Switzerland avoided stringent lockdowns and provided funds to stabilize the economy. To assess whether and in what subgroups the pandemic impacted on depressive symptoms in this specific Swiss context, we derived depression trajectories over an extended pandemic period in a Swiss cohort and related them to individuals' sociodemographic characteristics.
This was a population-based cohort study.
The population-based COVCO-Basel cohort in North-Western Switzerland invited 112,848 adult residents of whom 12,724 participated at baseline. Between July 2020 and December 2021, 6396 participants answered to additional 18 monthly online questionnaires. Depression symptoms were repeatedly measured by the DASS-21 scale. Group-based Trajectory Models methods were applied to identify clusters of similar depression trajectories. Trajectory clusters were characterized descriptively and with a Multinomial response model.
Three distinct trajectories were identified. The 'Highly affected' trajectory (13%) had a larger presence of younger and female participants with lower average income, higher levels of past depression, and living alone. A majority of individuals in the 'Unaffected' trajectory (52%) were of medium or high average income, older average age, without previous depression symptoms, and not living alone. The 'Moderately affected' trajectory (35%) had a composition intermediate between the two opposite 'extreme' trajectories.
This study is among few studies investigating depression trajectories up to the time when COVID-19 vaccination was readily available to the entire population. During these 18 months of the pandemic, depressive symptoms increased in a substantial percentage of participants. Economic support, high-quality health care system, and moderate containment measures did not sufficiently protect all population subgroups from adverse, potentially long-term psychological pandemic impacts.
在大流行期间，瑞士避免了严格的封锁措施，并提供资金来稳定经济。为了评估大流行是否以及在哪些亚组中对瑞士特定环境中的抑郁症状产生影响，我们在瑞士队列中得出了一个扩展大流行期间的抑郁轨迹，并将其与个体的社会人口统计学特征相关联。
这是一项基于人群的队列研究。
位于瑞士西北部的基于人群的 COVCO-Basel 队列邀请了 112848 名成年居民，其中 12724 人参加了基线调查。在 2020 年 7 月至 2021 年 12 月期间，有 6396 名参与者回答了另外 18 个每月在线问卷。抑郁症状通过 DASS-21 量表反复测量。采用基于群组的轨迹模型方法识别具有相似抑郁轨迹的群组。轨迹群组进行描述性和多项反应模型特征描述。
确定了三个不同的轨迹。“高度受影响”轨迹（13%）的参与者更年轻、女性比例较高，平均收入较低，过去有更高的抑郁水平，独居。“未受影响”轨迹（52%）的大多数参与者收入处于中等或较高水平，平均年龄较大，没有过去的抑郁症状，也不是独居。“中度受影响”轨迹（35%）的组成处于两个相反的“极端”轨迹之间。
本研究是少数研究之一，调查了 COVID-19 疫苗广泛提供给整个人群之前的抑郁轨迹。在这 18 个月的大流行期间，相当一部分参与者的抑郁症状有所增加。经济支持、高质量的医疗保健系统和适度的遏制措施并没有充分保护所有人群亚组免受潜在的长期心理大流行影响。
