Association between COVID-19 pandemic declaration and depression/anxiety among U.S. adults

Abstract

Background Although studies have investigated the impact of the COVID-19 on mental health, few studies have attempted to compare the prevalence of depression/anxiety symptoms among U.S. adults before and after the COVID-19 pandemic declaration. We examined the prevalence and association between depression/anxiety symptoms and COVID-19 pandemic declaration among U.S. adult population and subgroups. Methods A nationally representative cross-sectional study of the Health Information National Trends Survey (HINTS 5, Cycle 4) assessing health-related information and behaviors in U.S. adults aged ≥18 years from February through June 2020. The primary dependent variable was current depression/anxiety derived from Patient Health Questionnaire-4. The main independent variable was responses before and after the COVID-19 pandemic declaration in addition to sexual identity heterosexual identity, /race/ethnicity and rural-urban commuting areas. Covariates were sociodemographic factors, and health risk behaviors. Weighted percentages, multivariable logistic regression, and Chi-square tests were used to establish the prevalence and association between current depression/anxiety and the independent variables and covariates. Results A total of 3,865 participants completed the survey and included 35.3% of the participants before the COVID-19 pandemic declaration. Most of the sample were aged 50–64 years [33.0%]; males [51.0%]; and non-Hispanic Whites [70.1%]). The post-pandemic declaration included participants, aged 35–49 years [27.0%]; females [52.6%]; and non-Hispanic Whites [59.6%]). The prevalence of depression/anxiety was higher after the COVID-19 pandemic declaration (32.2%) than before the declaration (29.9%). Higher risks of depression/anxiety symptoms after the declaration were associated with being a sexual minority ([adjusted odds ratio] AOR, 2.91 [95% confidence interval (CI), 1.38–6.14]) and having fair/poor general health (AOR, 2.91 [95% CI, 1.76–4.83]). The probability of experiencing depression/anxiety symptoms after the declaration was highest among homosexuals/lesbians/gays (65.6%) compared to bisexuals (39.6%), and heterosexuals (30.1%). Conclusions In this study, young adults, non-Hispanic Whites, and those with fair/poor general health had a higher burden of depression/anxiety symptoms after the pandemic declaration. The development of psychological support strategies to promote wellbeing during the pandemic may reduce psychological distress in the population, especially among at-risk populations.

A Mental Health Pandemic? Assessing the Impact of COVID-19 on Young People’s Mental Health

“…However, whilst gender remained statistically significant in Model 2, the addition of the COVID-19-related variables (physical and mental health status and contact with friends) and identifying as non-heterosexual were more important in predicting poor mental health than gender. The finding that young people who identify as non-heterosexual have poorer mental health than their heterosexual peers offers support for previous research which found poorer mental health among this vulnerable group both pre- and post-pandemic [ 28 , 29 , 30 , 31 ]. One of the key findings emerging from Model 2 was that young people who felt that their mental health had worsened over lockdown had lower GHQ-12 scores than their peers who thought their mental health had stayed the same or improved.…”

“…A lack of support during COVID-19 lockdowns has also been proposed as one explanation for the higher rate of mental ill-health found among populations identifying as non-heterosexual compared to their heterosexual counterparts [ 12 , 28 , 29 ]. The vulnerability of this marginalised group in terms of pre-pandemic mental health has been well-documented as has their increased risk of social exclusion and violence as a result of COVID-19 [ 29 , 30 , 31 ]. For example, research carried out among adults, pre-pandemic, showed a higher rate of prevalence of common mental disorders among those identifying as non-heterosexual [ 31 ].…”

“…The vulnerability of this marginalised group in terms of pre-pandemic mental health has been well-documented as has their increased risk of social exclusion and violence as a result of COVID-19 [ 29 , 30 , 31 ]. For example, research carried out among adults, pre-pandemic, showed a higher rate of prevalence of common mental disorders among those identifying as non-heterosexual [ 31 ]. Similarly, a mental health prevalence survey of children and young people in England found that among the 14 to 19 age group, those who identified as lesbian, gay, bisexual or with another sexual identity (LGBTQ+) were more likely to have a mental disorder (34.9%) than those who identified as heterosexual (13.2%) [ 32 ].…”