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在新冠疫情期间,耻辱感和低连贯感作为人群中抑郁和焦虑症状的长期预测因素

STIGMA AND LOW SENSE OF COHERENCE AS LONG-TERM PREDICTORS OF DEPRESSIVE AND ANXIETY SYMPTOMS IN THE POPULATION AMID THE COVID-19 PANDEMIC.

作者信息

Mihevc Matic, Petek Šter Marija

机构信息

Community Health Centre Trebnje, Trebnje, Slovenia.

Community Health Centre Ljubljana, Ljubljana, Slovenia.

出版信息

Psychiatr Danub. 2023 Summer;35(2):250-259. doi: 10.24869/psyd.2023.250.

Abstract

BACKGROUND

The COVID-19 has had a profound negative impact on the population's mental health. This study aimed to determine the prevalence of depressive and anxiety symptoms in the general population during the third wave of the COVID-19 pandemic and to identify risk factors associated with these symptoms after implementing initial prevention strategies.

SUBJECTS AND METHODS

A cross-sectional study was conducted among 200 visitors to five general practices in February 2021 in Slovenia. The response rate was 82.0% (164/200). A structured survey was used to assess sociodemographic factors, depressive and anxiety symptoms, exposure to COVID-19 stressors, stress coping strategies used, and sense of coherence (SOC). A score of ≥10 points on the Patient Health Questionnaire-9 and ≥10 points on the General Anxiety Disorder-7 questionnaire were considered as cut-offs for screened depression and anxiety, respectively. The Mann-Whitney U test, chi-square test, and binary logistic regression were used for statistical analysis.

RESULTS

The prevalence of screened depression and anxiety was 24.4% and 12.9%, respectively. Independent predictors of depression were stigma related to COVID-19 (OR 2.42, 95% CI 1.57-3.73, p<0.001), low SOC (OR 5.89, 95% CI 2.21-15.72, p<0.001), and smoking (OR 3.53, 95% CI 1.23-10.10. p=0.019). Independent predictors of anxiety were religious rituals cancellation (OR 1.64, 95% CI 1.02-2.65, p=0.040), childcare responsibilities (OR 1.70, 95% CI 1.07-2.69, p=0.025), increased contact with close ones (OR 1.92, 95% CI 1.11-3.29, p=0.019), and low SOC (OR 5.21, 95% CI 1.22-22.31, p=0.026).

CONCLUSIONS

Despite efforts to address the pandemic through prevention strategies and the burden of the pandemic decreasing, we still found a high prevalence of depressive and anxiety symptoms. While some risk factors can be addressed quickly, such as by providing stable childcare and schooling and enabling assess to mental health services for vulnerable families, others require a longer-term approach, such as strengthening SOC and reducing stigma.

摘要

背景

新冠疫情对民众心理健康产生了深远的负面影响。本研究旨在确定新冠疫情第三波期间普通人群中抑郁和焦虑症状的患病率,并在实施初步预防策略后识别与这些症状相关的风险因素。

对象与方法

2021年2月,在斯洛文尼亚对五家普通诊所的200名访客进行了一项横断面研究。回复率为82.0%(164/200)。采用结构化调查评估社会人口学因素、抑郁和焦虑症状、接触新冠应激源情况、所采用的压力应对策略以及连贯感(SOC)。患者健康问卷-9得分≥10分和广泛性焦虑障碍-7问卷得分≥10分分别被视为筛查出抑郁和焦虑的临界值。采用曼-惠特尼U检验、卡方检验和二元逻辑回归进行统计分析。

结果

筛查出的抑郁和焦虑患病率分别为24.4%和12.9%。抑郁的独立预测因素为与新冠相关的污名(比值比2.42,95%置信区间1.57 - 3.73,p<0.001)、低连贯感(比值比5.89,95%置信区间2.21 - 15.72,p<0.001)以及吸烟(比值比3.53,95%置信区间1.23 - 10.10.p = 0.019)。焦虑的独立预测因素为宗教仪式取消(比值比1.64,95%置信区间1.02 - 2.65,p = 0.040)、育儿责任(比值比1.70,95%置信区间1.07 - 2.69,p = 0.025)、与亲密者接触增加(比值比1.92,95%置信区间1.11 - 3.29,p = 0.019)以及低连贯感(比值比5.21,95%置信区间1.22 - 22.31,p = 0.026)。

结论

尽管通过预防策略应对疫情且疫情负担有所减轻,但我们仍发现抑郁和焦虑症状的患病率较高。虽然一些风险因素可以迅速解决,比如提供稳定的育儿和教育服务以及让弱势家庭能够获得心理健康服务,但其他因素则需要长期方法,比如增强连贯感和减少污名。

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