Shen Yanhan, Penrose Kate, Robertson McKaylee, Piltch-Loeb Rachael, Fleary Sasha, Kulkarni Sarah, Teasdale Chloe, Balasubramanian Subha, Yadav Surabhi, Chan Bai Xi Jasmine, Sanborn Jenna, Sahr Josefina Nuñez, Srivastava Avantika, Nash Denis, Parcesepe Angela
Institute for Implementation Science in Population Health (ISPH), City University of New York (CUNY), New York, NY, USA.
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY, USA.
Epidemiol Psychiatr Sci. 2024 Dec 3;33:e74. doi: 10.1017/S2045796024000763.
The enduring impact of the COVID-19 pandemic on mental health and its implications for COVID-19 vaccine uptake necessitate comprehensive investigation. We aimed to characterize the persistence of moderate to severe anxiety and depression symptoms from July 2020 to July 2023, explore demographic associations with symptom persistence, and assess how these symptoms affected COVID-19 vaccination uptake between May 2021 and July 2023.
Participants from the national community-based CHASING COVID Cohort were enrolled between March and June 2020 and completed quarterly follow-ups until December 2023. Scores ≥10 on the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaire 8-item at 14 follow-up assessments indicated moderate to severe anxiety and depression symptoms, respectively. Missing scores were imputed. Persistent anxiety and depression were defined as experiencing moderate to severe anxiety and depression symptoms ≥7 out of 14 follow-up assessments, respectively.
Among 4,851 participants, 15.9% experienced persistent anxiety symptoms and 19.3% persistent depression symptoms from July 2020 to July 2023. Demographic factors associated with symptom persistence included younger age, female or non-binary gender, Hispanic ethnicity, lower education level, household income <$100k, presence of children <18 in the household, greater healthcare barriers and comorbidities. Participants with ongoing moderate to severe anxiety and depression symptoms had 0.95 (95% CI: 0.94, 0.97) and 0.95 (95% CI: 0.93, 0.96) times rates of receiving additional COVID-19 vaccine doses between May 2021 and July 2023, respectively.
Customized support for individuals with mental disorders may mitigate barriers to vaccine uptake. Further investigation is warranted to validate these findings and inform targeted interventions.
2019冠状病毒病疫情对心理健康的持久影响及其对2019冠状病毒病疫苗接种的影响需要进行全面调查。我们旨在描述2020年7月至2023年7月中度至重度焦虑和抑郁症状的持续情况，探讨与症状持续相关的人口统计学关联，并评估这些症状如何影响2021年5月至2023年7月期间的2019冠状病毒病疫苗接种情况。
来自全国社区的“追踪新冠队列”的参与者于2020年3月至6月入组，并完成季度随访直至2023年12月。在14次随访评估中，广泛性焦虑障碍7项量表和患者健康问卷8项量表得分≥10分别表明存在中度至重度焦虑和抑郁症状。缺失分数进行了插补。持续性焦虑和抑郁分别定义为在14次随访评估中至少有7次出现中度至重度焦虑和抑郁症状。
在4851名参与者中，2020年7月至2023年7月期间，15.9%的人出现持续性焦虑症状，19.3%的人出现持续性抑郁症状。与症状持续相关的人口统计学因素包括年龄较小、女性或非二元性别、西班牙裔、教育水平较低、家庭收入低于10万美元、家中有18岁以下儿童、更大的医疗障碍和合并症。在2021年5月至2023年7月期间，持续存在中度至重度焦虑和抑郁症状的参与者接种额外2019冠状病毒病疫苗剂量的比率分别为0.95（95%CI：0.94，0.97）和0.95（95%CI：0.93，0.96）。
为精神障碍患者提供定制化支持可能会减轻疫苗接种的障碍。有必要进一步调查以验证这些发现并为有针对性的干预措施提供依据。
