Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic
Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic
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DOI：
10.1001/jamanetworkopen.2020.19686
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发表时间：
2020-09-02
影响因子：
13.8
通讯作者：
Galea, Sandro
中科院分区：
文献类型：
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作者：
Ettman, Catherine K.;Abdalla, Salma M.;Galea, Sandro
与2019冠状病毒病（COVID-19）大流行之前相比，美国成年人在2019冠状病毒病（COVID-19）大流行期间的抑郁症状负担是什么？与抑郁症状相关的危险因素是什么？在这项调查研究中，包括1441名来自COVID-19大流行期间的受访者和5065名来自COVID-19大流行之前的受访者，在COVID-19大流行期间抑郁症状的患病率比之前高出3倍以上。在2019冠状病毒病期间，收入较低、储蓄不足5000美元以及面临更多压力源与更大的抑郁症状风险相关。这些发现表明，在美国，与COVID-19大流行相关的抑郁症状负担很高，而且这种负担不成比例地落在了已经处于更高风险中的个人身上。2019年冠状病毒病（COVID-19）大流行及其控制政策在美国几乎无处不在，对抑郁症状的影响尚不清楚。目的评估2019冠状病毒病大流行期间与之前美国成年人抑郁症状的患病率及其相关危险因素。设计、环境和参与者：这项具有全国代表性的调查研究采用了2项基于人群的调查，调查对象为18岁及以上的美国成年人。在2019冠状病毒病期间，根据2020年3月31日至2020年4月13日进行的“2019冠状病毒病和生活压力源对心理健康和福祉的影响”研究得出的估计数。在2019冠状病毒病之前，估计数据来自2017年至2018年进行的全国健康和营养检查调查。数据分析时间为2020年4月15日至20日。COVID-19大流行以及与缓解措施相关的结果。抑郁症状，使用患者健康问卷-9分值为10或更高来定义。抑郁症状的分类定义为无（评分0-4）、轻度（评分5-9）、中度（评分10-14）、中度重度（评分15-19）和重度（评分>= 20）。结果共有1470名参与者完成了新冠肺炎和生活压力源对心理健康和福祉的影响调查（完成率为64.3%），剔除数据缺失者后，最终样本包括1441名参与者，其中18-39岁参与者619名（43.0%），男性723名（50.2%），非西班牙裔白人933名（64.7%）。covid -19前样本包括5065名参与者（18-39岁1704名参与者（37.8%），女性2588名参与者（51.4%），非西班牙裔白人1790名参与者（62.9%））。在COVID-19期间，所有类别的抑郁症状患病率均高于前（轻度：24.6% [95% CI, 21.8%-27.7%]对16.2% [95% CI, 15.1%-17.4%]；中度：14.8% [95% CI, 12.6%-17.4%]对5.7% [95% CI, 4.8%-6.9%]；中度严重：7.9% [95% CI, 6.3%-9.8%]对2.1% [95% CI, 1.6%-2.8%]；重度：5.1% [95% CI, 3.8%-6.9%]对0.7% [95% CI, 0.5%-0.9%]）。在COVID-19期间，抑郁症状的高风险与收入较低（优势比，2.37 [95% CI, 1.26-4.43]）、储蓄低于5000美元（优势比，1.52 [95% CI, 1.02-2.26]）以及暴露于更多压力源（优势比，3.05 [95% CI, 1.95-4.77]）相关。这些发现表明，与COVID-19大流行之前相比，COVID-19期间美国抑郁症状的患病率高出3倍以上。社会资源较低、经济资源较低、暴露于压力源（如失业）较多的个体报告的抑郁症状负担更大。covid -19后的计划应考虑到精神疾病的可能增加，特别是在高危人群中。本调查研究调查了2019年冠状病毒病（COVID-19）大流行期间美国成年人抑郁症状的患病率与大流行前的比较。
Question What is the burden of depression symptoms among US adults during the coronavirus disease 2019 (COVID-19) pandemic compared with before COVID-19, and what are the risk factors associated with depression symptoms? Findings In this survey study that included 1441 respondents from during the COVID-19 pandemic and 5065 respondents from before the pandemic, depression symptom prevalence was more than 3-fold higher during the COVID-19 pandemic than before. Lower income, having less than $5000 in savings, and having exposure to more stressors were associated with greater risk of depression symptoms during COVID-19. Meaning These findings suggest that there is a high burden of depression symptoms in the US associated with the COVID-19 pandemic and that this burden falls disproportionately on individuals who are already at increased risk.Importance The coronavirus disease 2019 (COVID-19) pandemic and the policies to contain it have been a near ubiquitous exposure in the US with unknown effects on depression symptoms. Objective To estimate the prevalence of and risk factors associated with depression symptoms among US adults during vs before the COVID-19 pandemic. Design, Setting, and Participants This nationally representative survey study used 2 population-based surveys of US adults aged 18 or older. During COVID-19, estimates were derived from the COVID-19 and Life Stressors Impact on Mental Health and Well-being study, conducted from March 31, 2020, to April 13, 2020. Before COVID-19 estimates were derived from the National Health and Nutrition Examination Survey, conducted from 2017 to 2018. Data were analyzed from April 15 to 20, 2020. Exposures The COVID-19 pandemic and outcomes associated with the measures to mitigate it. Main Outcomes and Measures Depression symptoms, defined using the Patient Health Questionnaire-9 cutoff of 10 or higher. Categories of depression symptoms were defined as none (score, 0-4), mild (score, 5-9), moderate (score, 10-14), moderately severe (score, 15-19), and severe (score, >= 20). Results A total of 1470 participants completed the COVID-19 and Life Stressors Impact on Mental Health and Well-being survey (completion rate, 64.3%), and after removing those with missing data, the final during-COVID-19 sample included 1441 participants (619 participants [43.0%] aged 18-39 years; 723 [50.2%] men; 933 [64.7%] non-Hispanic White). The pre-COVID-19 sample included 5065 participants (1704 participants [37.8%] aged 18-39 years; 2588 [51.4%] women; 1790 [62.9%] non-Hispanic White). Depression symptom prevalence was higher in every category during COVID-19 compared with before (mild: 24.6% [95% CI, 21.8%-27.7%] vs 16.2% [95% CI, 15.1%-17.4%]; moderate: 14.8% [95% CI, 12.6%-17.4%] vs 5.7% [95% CI, 4.8%-6.9%]; moderately severe: 7.9% [95% CI, 6.3%-9.8%] vs 2.1% [95% CI, 1.6%-2.8%]; severe: 5.1% [95% CI, 3.8%-6.9%] vs 0.7% [95% CI, 0.5%-0.9%]). Higher risk of depression symptoms during COVID-19 was associated with having lower income (odds ratio, 2.37 [95% CI, 1.26-4.43]), having less than $5000 in savings (odds ratio, 1.52 [95% CI, 1.02-2.26]), and exposure to more stressors (odds ratio, 3.05 [95% CI, 1.95-4.77]). Conclusions and Relevance These findings suggest that prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Individuals with lower social resources, lower economic resources, and greater exposure to stressors (eg, job loss) reported a greater burden of depression symptoms. Post-COVID-19 plans should account for the probable increase in mental illness to come, particularly among at-risk populations.This survey study examines the prevalence of depression symptoms among US adults during the coronavirus disease 2019 (COVID-19) pandemic compared with before the pandemic.