Institute of Public Health, Charité - University Medicine Berlin, Berlin, Germany.
Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Front Public Health. 2024 Jul 3;12:1397392. doi: 10.3389/fpubh.2024.1397392. eCollection 2024.
The existence of socioeconomic inequalities in the prevalence of symptoms of depression and anxiety is widely acknowledged, and individuals from lower socioeconomic backgrounds tend to exhibit higher rates of symptoms. However, the direction in which the COVID-19 pandemic has influenced these disparities remains uncertain. We therefore aimed to systematically outline the available evidence on the temporal dynamics of socioeconomic inequalities in symptoms related to depression and anxiety during the COVID-19 pandemic across high-income countries.
A scoping review was conducted by searching the databases Embase, Scopus and PsycINFO. According to pre-defined eligibility criteria, two reviewers independently screened titles and abstracts as well as full texts of the compiled records. Data from the included studies were extracted using a standardised data-extraction form and analysed numerically and narratively. The scoping review followed the PRISMA-ScR guidelines.
A total of 49 studies comprising 149 analyses of socioeconomic indicators in relation to symptoms of depression and anxiety were included. Despite heterogeneous study designs and results, there was a tendency of increasing (40.9%; = 61) or persistent (38.2%; = 57) inequality trends to the detriment of those in socially more disadvantaged positions. Increasing inequalities were most pronounced when income was used as a socioeconomic indicator. Groups with lower socioeconomic status appeared most vulnerable in the initial phase of the COVID-19 pandemic. Throughout the pandemic, dynamics were diverse, with persistent trends most frequently reported.
Overall, to the detriment of those with lower socioeconomic status, mental-health inequalities persisted or increased in most analyses. Continually monitoring socioeconomic inequalities over time is crucial, since this makes it possible to adapt prevention and intervention strategies to specific pandemic phases. Interventions targeting job security, income security and educational attainment could reduce mental-health inequalities. The results can contribute to preparedness plans for future pandemics and crises.
广泛承认，在抑郁和焦虑症状的流行中存在社会经济不平等现象，社会经济背景较低的个体往往表现出更高的症状发生率。然而，COVID-19 大流行对这些差异的影响方向尚不确定。因此，我们旨在系统概述高收入国家 COVID-19 大流行期间与抑郁和焦虑相关症状的社会经济不平等的时间动态的现有证据。
通过搜索 Embase、Scopus 和 PsycINFO 数据库进行范围综述。根据预先确定的纳入标准，两名审查员独立筛选标题和摘要以及编译记录的全文。使用标准化的数据提取表格提取纳入研究的数据，并进行数值和叙述性分析。范围综述遵循 PRISMA-ScR 指南。
共有 49 项研究，其中包括 149 项与抑郁和焦虑症状相关的社会经济指标分析，纳入研究。尽管研究设计和结果存在异质性，但存在向社会劣势地位不利的趋势，不平等趋势呈增加（40.9%；=61）或持续（38.2%；=57）。当使用收入作为社会经济指标时，不平等加剧的趋势最为明显。社会经济地位较低的群体在 COVID-19 大流行的初始阶段似乎最为脆弱。在整个大流行期间，动态各不相同，最常报告的是持续趋势。
总体而言，在大多数分析中，那些社会经济地位较低的人的心理健康不平等状况持续存在或加剧。随着时间的推移持续监测社会经济不平等现象至关重要，因为这可以使人们能够根据特定的大流行阶段调整预防和干预策略。针对工作保障、收入保障和教育程度的干预措施可以减少心理健康不平等现象。研究结果可以为未来的大流行和危机做好准备计划提供参考。
