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Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States

Pandemic coronavirus disease 2019 (COVID-19) may lead to significant mental health stresses, potentially with modifiable risk factors. We performed an internet-based cross-sectional survey of an age-, sex-, and race-stratified representative sample from the US general population. Degrees of anxiety,...

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Autores principales: Kantor, Bella Nichole, Kantor, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793873/
https://www.ncbi.nlm.nih.gov/pubmed/33424655
http://dx.doi.org/10.3389/fpsyt.2020.569083
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author Kantor, Bella Nichole
Kantor, Jonathan
author_facet Kantor, Bella Nichole
Kantor, Jonathan
author_sort Kantor, Bella Nichole
collection PubMed
description Pandemic coronavirus disease 2019 (COVID-19) may lead to significant mental health stresses, potentially with modifiable risk factors. We performed an internet-based cross-sectional survey of an age-, sex-, and race-stratified representative sample from the US general population. Degrees of anxiety, depression, and loneliness were assessed using the 7-item Generalized Anxiety Disorder-7 scale (GAD-7), the 9-item Patient Health Questionnaire, and the 8-item UCLA Loneliness Scale, respectively. Unadjusted and multivariable logistic regression analyses were performed to determine associations with baseline demographic characteristics. A total of 1,005 finished surveys were returned of the 1,020 started, yielding a completion rate of 98.5% in the survey panel. The mean (standard deviation) age of the respondents was 45 (16) years, and 494 (48.8%) were male. Overall, 264 subjects (26.8%) met the criteria for an anxiety disorder based on a GAD-7 cutoff of 10; a cutoff of 7 yielded 416 subjects (41.4%), meeting the clinical criteria for anxiety. On multivariable analysis, male sex (odds ratio [OR] = 0.65, 95% confidence interval [CI] [0.49, 0.87]), identification as Black (OR = 0.49, 95% CI [0.31, 0.77]), and living in a larger home (OR = 0.46, 95% CI [0.24, 0.88]) were associated with a decreased odds of meeting the anxiety criteria. Rural location (OR 1.39, 95% CI [1.03, 1.89]), loneliness (OR 4.92, 95% CI [3.18, 7.62]), and history of hospitalization (OR = 2.04, 95% CI [1.38, 3.03]) were associated with increased odds of meeting the anxiety criteria. Two hundred thirty-two subjects (23.6%) met the criteria for clinical depression. On multivariable analysis, male sex (OR = 0.71, 95% CI [0.53, 0.95]), identifying as Black (OR = 0.62, 95% CI [0.40, 0.97]), increased time outdoors (OR = 0.51, 95% CI [0.29, 0.92]), and living in a larger home (OR = 0.35, 95% CI [0.18, 0.69]) were associated with decreased odds of meeting depression criteria. Having lost a job (OR = 1.64, 95% CI [1.05, 2.54]), loneliness (OR = 10.42, 95% CI [6.26, 17.36]), and history of hospitalization (OR = 2.42, 95% CI [1.62, 3.62]) were associated with an increased odds of meeting depression criteria. Income, media consumption, and religiosity were not associated with mental health outcomes. Anxiety and depression are common in the US general population in the context of the COVID-19 pandemic and are associated with potentially modifiable factors.
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spelling pubmed-77938732021-01-09 Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States Kantor, Bella Nichole Kantor, Jonathan Front Psychiatry Psychiatry Pandemic coronavirus disease 2019 (COVID-19) may lead to significant mental health stresses, potentially with modifiable risk factors. We performed an internet-based cross-sectional survey of an age-, sex-, and race-stratified representative sample from the US general population. Degrees of anxiety, depression, and loneliness were assessed using the 7-item Generalized Anxiety Disorder-7 scale (GAD-7), the 9-item Patient Health Questionnaire, and the 8-item UCLA Loneliness Scale, respectively. Unadjusted and multivariable logistic regression analyses were performed to determine associations with baseline demographic characteristics. A total of 1,005 finished surveys were returned of the 1,020 started, yielding a completion rate of 98.5% in the survey panel. The mean (standard deviation) age of the respondents was 45 (16) years, and 494 (48.8%) were male. Overall, 264 subjects (26.8%) met the criteria for an anxiety disorder based on a GAD-7 cutoff of 10; a cutoff of 7 yielded 416 subjects (41.4%), meeting the clinical criteria for anxiety. On multivariable analysis, male sex (odds ratio [OR] = 0.65, 95% confidence interval [CI] [0.49, 0.87]), identification as Black (OR = 0.49, 95% CI [0.31, 0.77]), and living in a larger home (OR = 0.46, 95% CI [0.24, 0.88]) were associated with a decreased odds of meeting the anxiety criteria. Rural location (OR 1.39, 95% CI [1.03, 1.89]), loneliness (OR 4.92, 95% CI [3.18, 7.62]), and history of hospitalization (OR = 2.04, 95% CI [1.38, 3.03]) were associated with increased odds of meeting the anxiety criteria. Two hundred thirty-two subjects (23.6%) met the criteria for clinical depression. On multivariable analysis, male sex (OR = 0.71, 95% CI [0.53, 0.95]), identifying as Black (OR = 0.62, 95% CI [0.40, 0.97]), increased time outdoors (OR = 0.51, 95% CI [0.29, 0.92]), and living in a larger home (OR = 0.35, 95% CI [0.18, 0.69]) were associated with decreased odds of meeting depression criteria. Having lost a job (OR = 1.64, 95% CI [1.05, 2.54]), loneliness (OR = 10.42, 95% CI [6.26, 17.36]), and history of hospitalization (OR = 2.42, 95% CI [1.62, 3.62]) were associated with an increased odds of meeting depression criteria. Income, media consumption, and religiosity were not associated with mental health outcomes. Anxiety and depression are common in the US general population in the context of the COVID-19 pandemic and are associated with potentially modifiable factors. Frontiers Media S.A. 2020-12-09 /pmc/articles/PMC7793873/ /pubmed/33424655 http://dx.doi.org/10.3389/fpsyt.2020.569083 Text en Copyright © 2020 Kantor and Kantor. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Kantor, Bella Nichole
Kantor, Jonathan
Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States
title Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States
title_full Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States
title_fullStr Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States
title_full_unstemmed Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States
title_short Mental Health Outcomes and Associations During the COVID-19 Pandemic: A Cross-Sectional Population-Based Study in the United States
title_sort mental health outcomes and associations during the covid-19 pandemic: a cross-sectional population-based study in the united states
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793873/
https://www.ncbi.nlm.nih.gov/pubmed/33424655
http://dx.doi.org/10.3389/fpsyt.2020.569083
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