Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study.
Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study.
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DOI：
10.1016/s2215-0366(20)30482-x
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发表时间：
2021-03
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影响因子：
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通讯作者：
Bu F
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作者：
Fancourt D;Steptoe A;Bu F
人们主要担心全球新冠肺炎疫情对心理健康的影响。几项研究表明，在强制隔离(即封锁)之前和期间，许多国家的精神健康状况都在恶化，但尚不清楚在新冠肺炎大流行期间，精神健康是如何每周发生变化的。这项研究旨在探索英国宣布封锁后20周内焦虑和抑郁的轨迹，并比较不同个体特征的成长轨迹。在这项前瞻性的纵向观察性研究中，我们分析了伦敦大学学院新冠肺炎社会研究的数据，这是一项根据人口比例进行加权的小组研究，该研究自2020年3月21日以来每周收集英国的焦虑(使用综合焦虑障碍评估)和抑郁症状(使用患者健康问卷)的信息。我们包括了居住在英国的成年人的数据，他们在2020年3月23日至8月9日期间至少重复测量了三次。分析是使用潜在增长模型进行的，该模型适合于解释社会人口和健康协变量。在3月23日至8月9日期间，伦敦大学学院新冠肺炎社会研究收集了超过7万名 000名成年人的数据。当包括居住在英格兰且有三项跟踪测量且无缺失值的参与者时，我们的分析样本由36名 520名参与者组成。第一周抑郁平均得分为6.6(SD=6.0，范围0-27)，平均焦虑得分为5.7(SD=5.6，范围0-21)。在英国实行封锁后的前20周，焦虑和抑郁水平均有所下降(焦虑的b=-1.93，SE=0.26，p<；0.0001；抑郁症状的b=-2.52，SE=0.28，p<；0.0001)。下降最快的是严格禁闭期(第2周至第5周)，随着进一步放松封锁措施的引入(第16周至第20周)，症状趋于平稳。女性或更年轻，受教育程度较低，收入较低，或既往有精神健康状况，独居或与孩子住在一起，这些都是在封锁开始时焦虑和抑郁水平较高的风险因素。随着封锁的继续，这些体验中的许多不平等现象都有所减少，但在封锁开始20周后，差异仍然明显。这些数据表明，抑郁和焦虑的最高水平出现在封锁的早期阶段，但下降得相当快，可能是因为个人适应了环境。我们的发现强调了在未来的封锁之前支持个人努力减少痛苦的重要性，并强调了在大流行之前就已经面临精神健康不良风险的群体，在整个封锁及其后果中仍然处于危险之中。纳菲尔德基金会、英国研究与创新、惠康信托。
There is major concern about the impact of the global COVID-19 outbreak on mental health. Several studies suggest that mental health deteriorated in many countries before and during enforced isolation (ie, lockdown), but it remains unknown how mental health has changed week by week over the course of the COVID-19 pandemic. This study aimed to explore the trajectories of anxiety and depression over the 20 weeks after lockdown was announced in England, and compare the growth trajectories by individual characteristics. In this prospective longitudinal observational study, we analysed data from the UCL COVID-19 Social Study, a panel study weighted to population proportions, which collects information on anxiety (using the Generalised Anxiety Disorder assessment) and depressive symptoms (using the Patient Health Questionnaire) weekly in the UK since March 21, 2020. We included data from adults living in England who had at least three repeated measures between March 23 and Aug 9, 2020. Analyses were done using latent growth models, which were fitted to account for sociodemographic and health covariates. Between March 23, and Aug 9, data from over 70 000 adults were collected in the UCL COVID-19 Social Study. When including participants living in England with three follow-up measures and no missing values, our analytic sample consisted of 36 520 participants. The average depression score was 6·6 (SD=6·0, range 0–27) and the average anxiety score 5·7 (SD=5·6, range 0–21) in week 1. Anxiety and depression levels both declined across the first 20 weeks following the introduction of lockdown in England (b=–1·93, SE=0·26, p<0·0001 for anxiety; b=–2·52, SE=0·28, p<0·0001 for depressive symptoms). The fastest decreases were seen across the strict lockdown period (between weeks 2 and 5), with symptoms plateauing as further lockdown easing measures were introduced (between weeks 16 and 20). Being a woman or younger, having lower educational attainment, lower income, or pre-existing mental health conditions, and living alone or with children were all risk factors for higher levels of anxiety and depression at the start of lockdown. Many of these inequalities in experiences were reduced as lockdown continued, but differences were still evident 20 weeks after the start of lockdown. These data suggest that the highest levels of depression and anxiety occurred in the early stages of lockdown but declined fairly rapidly, possibly because individuals adapted to circumstances. Our findings emphasise the importance of supporting individuals in the lead-up to future lockdowns to try to reduce distress, and highlight that groups already at risk for poor mental health before the pandemic have remained at risk throughout lockdown and its aftermath. Nuffield Foundation, UK Research and Innovation, Wellcome Trust.