Dipartimento di Scienze Mediche e Sanità Pubblica. Università di Cagliari, Italy.
Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne, France.
Int J Soc Psychiatry. 2024 Sep;70(6):1128-1137. doi: 10.1177/00207640241264678. Epub 2024 Jul 26.
It is difficult to quantify the impact of the COVID-19 pandemic on mental health as many community surveys have limited quality, rely on screening tests to measure mental health conditions and distress, and often use convenience samples. Moreover, robust surveys come mainly from high-income countries.
To measure the prevalence of depressive disorders with onset during the pandemic in a community of a Lower-Middle-income country (LMIC)-Tunisia.
Clinical semi-structured face-to-face interviews were carried out during the pandemic (September-December 2021) by medical doctors among a representative sample of the general population in the governorate of La Manouba, Tunisia. Psychiatric diagnoses were established according to DSM-IV.
The prevalence of Major Depressive Disorder (MDD) started or recurred after the pandemic was 5.66%. The factors associated with MDD were loss of job and considerably diminished income due to the pandemic (OR = 2.1, 95% CI [1.5, 2.9]) and the perception of having the family's financial situation below the Tunisian average (OR = 2.3, 95% CI [1.7, 3.2]). Female sex, marital status as separated/divorced, and having a COVID-19 infection were associated with MDD only in the overall sample and urban areas, but not in rural areas. Age and having loved ones who passed away due to COVID-19 were not associated with MDD.
In Tunisia, the pandemic seems to have increased the risk of depression in people experiencing a precarious financial situation, also due to the pre-existing economic crisis. Specific local level factors, such as not establishing a rigid lockdown for an extended period, may have protected young people and allowed for better mourning in families suffering the loss of a loved one.
由于许多社区调查的质量有限、依赖于筛查测试来衡量心理健康状况和困扰，且通常使用便利样本，因此难以量化 COVID-19 大流行对心理健康的影响。此外，可靠的调查主要来自高收入国家。
在一个中低收入国家（LMIC）-突尼斯的社区中，测量大流行期间出现的抑郁障碍的患病率。
在大流行期间（2021 年 9 月至 12 月），医生通过医疗医生在突尼斯拉马努巴省的代表性总体人群样本中进行了临床半结构化面对面访谈。根据 DSM-IV 建立了精神科诊断。
大萧条障碍（MDD）的流行率在大流行后开始或复发为 5.66%。与 MDD 相关的因素是因大流行而失业和收入大幅减少（OR=2.1，95%CI[1.5, 2.9]）以及认为家庭经济状况低于突尼斯平均水平（OR=2.3，95%CI[1.7, 3.2]）。在整个样本和城市地区，女性、分居/离婚的婚姻状况以及 COVID-19 感染与 MDD 相关，但在农村地区则不然。年龄和因 COVID-19 而去世的亲人与 MDD 无关。
在突尼斯，大流行似乎增加了处于不稳定财务状况的人患抑郁症的风险，这也与先前的经济危机有关。特定的地方层面因素，例如没有延长严格的封锁期，可能保护了年轻人，并允许在亲人去世的家庭中更好地哀悼。
