COVID-19 stressors and one-year changes in depression and anxiety in a longitudinal cohort of low-income adults in the United States.
COVID-19 stressors and one-year changes in depression and anxiety in a longitudinal cohort of low-income adults in the United States.
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DOI：
10.1016/j.pmedr.2022.101730
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发表时间：
2022-04
影响因子：
2.8
通讯作者：
Levy DE
中科院分区：
文献类型：
--
作者：
Thorndike AN;Fung V;McCurley JL;Clark CR;Howard S;Levy DE
新数据表明，低收入成年人遭受 COVID-19 相关压力源和精神健康障碍的风险最高。本研究旨在确定在大流行开始一年后，一组低收入成年人中与 COVID-19 相关的压力源是否与抑郁和焦虑恶化有关。参与者包括来自马萨诸塞州波士顿周围 5 个社区卫生中心的 253 名医疗补助和商业责任护理组织接受者，他们于 2019 年 12 月至 2020 年 3 月参加了一项针对医疗补助计划的更大规模纵向研究。参与者完成了基线调查和一年随访，测量抑郁（患者健康问卷-8 [PHQ-8]）和焦虑（广泛性焦虑症-7 [GAD-7]）症状。后续调查评估了过去 12 个月内经历的与 COVID-19 相关的压力源。压力源评分包括与 COVID-19 相关的传染病、社会和经济压力源，分为三等分（低，0-3；中，4-6；高，7-19）。平均年龄 (SD) 为 45.2 (11.5) 岁； 71.2% 为女性，42.3% 为西班牙裔，14.6% 为黑人。基线时，126 人 (49.8%) 患有中度或重度抑郁症 (PHQ-8 ≥ 10)，109 人 (43.1%) 患有中度或重度焦虑症 (GAD-7 ≥ 10)。 COVID-19 压力源的平均 (SD) 数量为 4.9 (3.1)；最常见的是粮食不安全（52.2%）和工作或收入损失（43.9%）。与低三分位数相比，高三分位数和中三分位数的抑郁和焦虑症状一年内增加幅度显着更大。低收入成年人面临多种与 COVID-19 相关的压力源，特别是与健康相关的社会需求，在一年多的时间里心理健康症状不断恶化。迫切需要采取干预措施来解决与健康相关的社会需求和 COVID-19 加剧的不良心理健康的双重负担。
Emerging data suggest that adults with low income are at highest risk for COVID-19-related stressors and mental health disorders. This study aimed to determine if COVID-19-related stressors were associated with worsening depression and anxiety in a cohort of low-income adults one year after the start of the pandemic. Participants included 253 Medicaid and commercial accountable care organization recipients from 5 community health centers around Boston, MA who enrolled December 2019-March 2020 in a larger longitudinal study of a Medicaid program. Participants completed surveys at baseline and one-year follow-up that measured depression (Patient Health Questionnaire-8 [PHQ-8]) and anxiety (Generalized Anxiety Disorder-7 [GAD-7]) symptoms. Follow-up surveys assessed COVID-19-related stressors experienced over the prior 12 months. A stressor score included COVID-19-related infectious, social, and economic stressors categorized into tertiles (low, 0–3; medium, 4–6; high, 7–19). Mean age (SD) was 45.2 (11.5) years; 71.2% were female, 42.3% Hispanic and 14.6% Black. At baseline, 126 (49.8%) had moderate or severe depression (PHQ-8 ≥ 10), and 109 (43.1%) had moderate or severe anxiety (GAD-7 ≥ 10). The mean (SD) number of COVID-19 stressors was 4.9 (3.1); the most frequent were food insecurity (52.2%) and job or income loss (43.9%). Compared to the low tertile, those in high and medium tertiles had significantly greater one-year increases in depression and anxiety symptoms. Low-income adults facing multiple COVID-19-related stressors, particularly health-related social needs, had worsening mental health symptoms over one year. Interventions are urgently needed to address the dual burden of health-related social needs and poor mental health exacerbated by COVID-19.
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