Key Points Question Are sociodemographic, psychosocial, and health-related factors associated with risk of poor mental health during the COVID-19 pandemic in the UK? Findings This cohort study using data from a large panel study including 51 417 adults found that the risks of moderate and severe depressive symptom trajectories were significantly higher among people experiencing abuse or low social support, individuals with low socioeconomic position, and those with preexisting mental and physical health conditions. Meaning These findings suggest that mental health and socioeconomic interventions in the current or future pandemics should be targeted toward people with these risk factors.
Objective. Evidence from anti-inflammatory drug trials for the treatment of depression has been inconsistent. This may be ascribed to the differing symptom-specific effects of inflammation.Accordingly, we explored the associations between systemic inflammation and an array of individual symptoms of depression across multiple studies.Method. This random-effects pooled analysis included 15 population-based cohorts and 56,351 individuals aged 18 years and older. Serum or plasma concentrations of C-reactive protein and interleukin-6 were measured at baseline. Using validated self-report measures, 24 depression symptoms were ascertained in 15 cross-sectional studies, and, in 7 cohorts, also assessed at follow-up (mean 3.2 years).Results. Prevalence of depressive symptoms ranged between 1.1% ('suicidal ideation') and 21.5% ('sleep problems'). In cross-sectional analyses, higher concentrations of C-reactive protein were robustly associated with an increased risk of experiencing four physical symptoms ('changes in appetite', 'felt everything was an effort'; 'loss of energy', 'sleep problems') and one cognitive symptom ('little interest in doing things'). These associations remained after adjustment for sociodemographic variables, behavioural factors, and chronic conditions; in sex-and age-stratified analyses; in longitudinal analyses; when using interleukin-6 as the inflammatory marker of interest; in depressed individuals; and after excluding chronically ill individuals. For four exclusively emotional symptoms ('bothered by things', 'hopelessness about the future', 'felt fearful', 'life had been a failure'), the overall evidence was strongly against an association with inflammation.Conclusions. These findings suggest symptom-specific rather than generalised effects of systemic inflammation on depression. Future trials exploring anti-inflammatory treatment regimens for depression could target individuals presenting with symptom profiles characterised by distinct inflammation-related physical and cognitive symptoms.
Objective: The coronavirus disease 2019 (COVID-19) pandemic has affected many aspects of the human condition, including mental health and psychological wellbeing. This study examined trajectories of depressive symptoms (DST) over time among vulnerable individuals in the UK during the COVID-19 pandemic. Methods: The sample consisted of 51,417 adults recruited from the COVID-19 Social Study. Depressive symptoms were measured on seven occasions (21st March - 2nd April), using the Patient Health Questionnaire (PHQ-9). Sociodemographic vulnerabilities included non-white ethnic background, low socio-economic position (SEP), and type of work (keyworker versus no keyworker). Health-related and psychosocial vulnerabilities included pre-existing physical and mental health conditions, experience of psychological and/or physical abuse, and low social support. Group-based DST were derived using latent growth mixture modelling and multivariate logistic regression models were fitted to examine the association between these vulnerabilities and DSTs. Model estimates were adjusted for age, sex, and suspected COVID-19 diagnosis. Results: Three DSTs were identified: low [N=30,850 (60%)] moderate [N=14,911 (29%)], and severe [N=5,656 (11%)] depressive symptoms. DSTs were relatively stable across the first 6 weeks of lockdown. After adjusting for covariates, experiences of physical/psychological abuse (OR 13.16, 95% CI 12.95-13.37), pre-existing mental health conditions (OR 13.00 95% CI 12.87-13.109), pre-existing physical health conditions (OR 3.41, 95% CI 3.29-3.54), low social support (OR 12.72, 95% CI 12.57-12.86), and low SEP (OR 5.22, 95% CI 5.08-5.36) were significantly associated with the severe DST. No significant association was found for ethnicity (OR 1.07, 95% 0.85-1.28). Participants with key worker roles were less likely to experience severe depressive symptoms (OR 0.66, 95% 0.53-0.80). Similar but smaller patterns of associations were found for the moderate DST. Conclusions: People with psychosocial and health-related risk factors, as well as those with low SEP seem to be most vulnerable to experiencing moderate or severe depressive symptoms during the COVID-19 pandemic.
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