Effect of lockdown on mental health in Australia: evidence from a natural experiment analysing a longitudinal probability sample survey.
Effect of lockdown on mental health in Australia: evidence from a natural experiment analysing a longitudinal probability sample survey.
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DOI：
10.1016/s2468-2667(22)00082-2
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发表时间：
2022-05
影响因子：
50
通讯作者：
Wooden, Mark
中科院分区：
文献类型：
--
作者：
Butterworth, Peter;Schurer, Stefanie;Trong-Anh Trinh;Vera-Toscano, Esperanza;Wooden, Mark
许多研究调查了 COVID-19 大流行期间人群的心理健康状况，但无法找出封锁的直接影响。本研究的目的是通过准实验设计来研究 15 岁及以上澳大利亚人在 COVID-19 大流行期间心理健康的变化，以解开封锁效应。我们分析了澳大利亚纵向家庭、收入和劳动力动态 (HILDA) 调查的十个年度（2011-20）的数据，以确定从 COVID-19 之前（2011-19）到 COVID-19 期间（2020）受访者心理健康的变化。使用双重差分模型比较了在 2020 年采访时处于封锁状态的维多利亚州受访者（治疗组）和居住在澳大利亚其他地方的受访者（生活相对不受限制；对照组）之间的这些变化。这些模型包括州、年份（调查波）和特定于个人的固定效应。使用五项心理健康量表（MHI-5）评估心理健康状况，该量表包含在调查期间进行的自填问卷中。分析样本包括从 2011 年至 2020 年从 20 839 个人获得的 151 583 个观察结果。治疗组包括 3568 名个体，总共 37 578 个观察结果（COVID-19 之前的 34 010 个观察结果和 COVID-19 期间的 3568 个观察结果），对照组包括 17 271 个观察结果的个体。 114 005 个观测值（在 COVID-19 之前为 102 867 个，在 COVID-19 期间为 11 138 个）。在 COVID-19 之前，治疗组（72·9 分 [95% CI 72·8–73·2]）和对照组（73·2 分 [73·1–73·3]）之间的平均 MHI-5 评分没有差异。在 COVID-19 期间，治疗组（69·6 分 [69·0–70·2]）和对照组（70·8 分 [70·5–71·2]）的平均得分均下降。双重差分估计显示，封锁对 MHI-5 评分的影响虽小，但在统计上显着，2020 年维多利亚州居民的下降幅度比澳大利亚其他地区的居民更大（差异 –1·4 分 [95% CI –1·7 至 –1·2]）。分层分析表明，这种封锁效应对于女性（−2·2 分 [–2·6 至 –1·7]）比男性（−0·6 [–0·8 至 –0·5]）更大，对于有 15 岁以下子女的夫妇中的女性（−4·4 分 [–5·0 至 –3·8]）以及居住在公寓或公寓的女性（−4·1 分 [–5·4 至 –5·4]）甚至更大。 –2·8]）或半独立式住宅、联排别墅或联排别墅（−4·8 点 [–6·4 至 –3·2]）。实施封锁与总体人口心理健康状况出现适度的负面变化有关。结果表明，封锁对心理健康的影响因人群而异，对于某些人群来说可能夸大了心理健康方面现有的不平等。尽管封锁一直是抑制 COVID-19 社区传播的重要公共卫生工具，但仍需要对此类干预措施的潜在社会心理影响进行更多研究，以为其未来的使用提供信息。美国国立卫生研究院。
Many studies have examined population mental health during the COVID-19 pandemic but have been unable to isolate the direct effect of lockdowns. The aim of this study was to examine changes in the mental health of Australians aged 15 years and older during the COVID-19 pandemic using a quasi-experimental design to disentangle the lockdown effect. We analysed data from ten annual waves (2011–20) of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) Survey to identify changes in the mental health of respondents from the pre-COVID-19 period (2011–19) to the COVID-19 period (2020). Difference-in-differences models were used to compare these changes between respondents in the state of Victoria who were exposed to lockdown at the time of the 2020 interviews (treatment group) and respondents living elsewhere in Australia (who were living relatively free of restrictions; control group). The models included state, year (survey wave), and person-specific fixed effects. Mental health was assessed using the five-item Mental Health Inventory (MHI-5), which was included in the self-complete questionnaire administered during the survey. The analysis sample comprised 151 583 observations obtained from 20 839 individuals from 2011 to 2020. The treatment group included 3568 individuals with a total of 37 578 observations (34 010 in the pre-COVID-19 and 3568 in the COVID-19 period), and the control group included 17 271 individuals with 114 005 observations (102 867 in the pre-COVID-19 and 11 138 in the COVID-19 period). Mean MHI-5 scores did not differ between the treatment group (72·9 points [95% CI 72·8–73·2]) and control group (73·2 points [73·1–73·3]) in the pre-COVID-19 period. In the COVID-19 period, decreased mean scores were seen in both the treatment group (69·6 points [69·0–70·2]) and control group (70·8 points [70·5–71·2]). Difference-in-differences estimation showed a small but statistically significant effect of lockdown on MHI-5 scores, with greater decline for residents of Victoria in 2020 than for those in the rest of Australia (difference –1·4 points [95% CI –1·7 to –1·2]). Stratified analyses showed that this lockdown effect was larger for females (−2·2 points [–2·6 to –1·7]) than for males (−0·6 [–0·8 to –0·5]), and even larger for women in couples with children younger than 15 years (−4·4 points [–5·0 to –3·8]), and for females who lived in flats or apartments (−4·1 points [–5·4 to –2·8]) or semi-detached houses, terraced houses, or townhouses (−4·8 points [–6·4 to –3·2]). The imposition of lockdowns was associated with a modest negative change in overall population mental health. The results suggest that the mental health effects of lockdowns differ by population subgroups and for some might have exaggerated existing inequalities in mental health. Although lockdowns have been an important public health tool in suppressing community transmission of COVID-19, more research is needed into the potential psychosocial impacts of such interventions to inform their future use. US National Institutes of Health.