Association among income loss, financial strain and depressive symptoms during COVID-19: Evidence from two longitudinal studies.
Association among income loss, financial strain and depressive symptoms during COVID-19: Evidence from two longitudinal studies.
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DOI：
10.1101/2020.09.15.20195339
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发表时间：
2021-08-01
影响因子：
6.6
通讯作者：
Barzilay, Ran
中科院分区：
文献类型：
--
作者：
Hertz-Palmor, Nimrod;Moore, Tyler M;Barzilay, Ran
背景：新冠肺炎大流行对全球健康和经济产生了重大影响，人们越来越担心经济衰退和对心理健康的影响。在这里，我们调查了新冠肺炎大流行相关的收入损失与经济压力和心理健康轨迹之间的关系，历时1个月。方法：在疫情爆发初期(2020年3-4月，T1；N=4 171)和1个月的随访(T2；N=1 559)，在美国和以色列进行了两项独立研究。应用混合效应模型来评估新冠肺炎相关的收入损失、经济压力和大流行相关的健康担忧、焦虑和抑郁之间的关系，并控制包括新冠肺炎前收入在内的多个协变量。研究结果：在两项研究中，收入损失和经济压力与T1时更严重的抑郁症状、T1以上和T1以后的焦虑、对健康的担忧和新冠肺炎前的收入有关。在这两项研究中，收入损失的恶化与T2时抑郁的加重有关。在一项研究(美国)中，主观经济压力的恶化与T2时抑郁的恶化有关。干预：收入损失和经济压力与抑郁症状和症状随时间的恶化唯一相关，超过了与大流行相关的焦虑。考虑到封锁和重启的痛苦困境，以及公共健康和经济福祉之间的权衡，我们的发现提供了证据，表明新冠肺炎的经济影响对心理健康具有负面影响。基金：这项研究得到了国家心理健康研究所、美以双国科学基金会、多拉基金会和克尔什基金会的资助。背景：新冠肺炎大流行对全球健康和经济产生重大影响，人们越来越担心经济衰退和对心理健康的影响。在这里，我们在两个独立的队列中，在一个月的过程中调查了与大流行相关的收入损失与经济压力和精神健康轨迹之间的关系。方法：在疫情开始时(2020年3月至4月，T1；研究I：2904，研究II：N=1267)和一个月的随访(T2；研究I：N=1318，研究II：N=241)，在美国和以色列进行了两项独立研究。应用混合效应模型评估了新冠肺炎相关收入损失、经济压力和大流行相关的健康担忧、焦虑和抑郁之间的关系，并控制了包括新冠肺炎前收入在内的多个协变量。结果：在两项研究中，收入损失和经济压力与T1时更严重的抑郁症状、T1以上和T1以后的焦虑、对健康的担忧和新冠肺炎前收入相关。在这两项研究中，收入损失的恶化与T2时抑郁的加重有关。在一项研究(美国)中，主观经济压力的恶化与T2时抑郁的恶化有关。结论：收入损失和经济压力与抑郁症状及其随时间的恶化唯一相关，超过了与大流行相关的焦虑。在无数应激源影响全球心理健康的时代，我们的发现揭示了新冠肺炎的经济影响和精神结果之间的特定联系。
BACKGROUND: The COVID-19 pandemic has major ramifications for global health and the economy, with growing concerns about economic recession and implications for mental health. Here we investigated the associations between COVID-19 pandemic-related income loss with financial strain and mental health trajectories over a 1-month course.METHODS: Two independent studies were conducted in the U.S and in Israel at the beginning of the outbreak (March-April 2020, T1; N = 4 171) and at a 1-month follow-up (T2; N = 1 559). Mixed-effects models were applied to assess associations among COVID-19-related income loss, financial strain, and pandemic-related worries about health, with anxiety and depression, controlling for multiple covariates including pre-COVID-19 income.FINDINGS: In both studies, income loss and financial strain were associated with greater depressive symptoms at T1, above and beyond T1 anxiety, worries about health, and pre-COVID-19 income. Worsening of income loss was associated with exacerbation of depression at T2 in both studies. Worsening of subjective financial strain was associated with exacerbation of depression at T2 in one study (US).INTERPRETATION: Income loss and financial strain were uniquely associated with depressive symptoms and the exacerbation of symptoms over time, above and beyond pandemic-related anxiety. Considering the painful dilemma of lockdown versus reopening, with the tradeoff between public health and economic wellbeing, our findings provide evidence that the economic impact of COVID-19 has negative implications for mental health.FUNDING: This study was supported by grants from the National Institute of Mental Health, the US-Israel Binational Science Foundation, Foundation Dora and Kirsh Foundation.BACKGROUND: COVID-19 pandemic has major ramifications for global health and economy, with growing concerns about economic recession and implications for mental health. Here we investigated the associations between pandemic-related income loss with financial strain and mental health trajectories over a 1-month course, in two independent cohorts.METHODS: Two independent studies were conducted in the U.S and in Israel at the beginning of the outbreak (March-April 2020, T1; study I: N=2904, study II: N=1267) and at a 1-month follow-up (T2; study I: N=1318, study II: N=241). Mixed-effects models were applied to assess associations among COVID-19-related income loss, financial strain, and pandemic-related worries about health, with anxiety and depression, controlling for multiple covariates including pre-COVID-19 income.RESULTS: In both studies, income loss and financial strain were associated with greater depressive symptoms at T1, above and beyond T1 anxiety, worries about health, and pre-COVID-19 income. Worsening of income loss was associated with exacerbation of depression at T2 in both studies. Worsening of subjective financial strain was associated with exacerbation of depression at T2 in one study (US).CONCLUSIONS: Income loss and financial strain were uniquely associated with depressive symptoms and their exacerbation over time, above and beyond pandemic-related anxiety. In times when a myriad of stressors are affecting mental health worldwide, our findings reveal specific links between the economic impact of COVID-19 and psychiatric outcomes.