Novel surveillance of psychological distress during the great recession

Abstract

Background Economic stressors have been retrospectively associated with net population increases in nonspecific psychological distress (PD). However, no sentinels exist to evaluate contemporaneous associations. Aggregate Internet search query surveillance was used to monitor population changes in PD around the United States’ Great Recession. Methods Monthly PD query trends were compared with unemployment, underemployment, homes in delinquency and foreclosure, median home value or sale prices, and S&P 500 trends for 2004–2010. Time series analyses, where economic indicators predicted PD one to seven months into the future, were performed in 2011. Results PD queries surpassed 1,000,000 per month, of which 300,000 may be attributable to the Great Recession. A one percentage point increase in mortgage delinquencies and foreclosures was associated with a 16% (95%CI, 9–24) increase in PD queries one-month, and 11% (95%CI, 3–18) four months later, in reference to a pre-Great Recession mean. Unemployment and underemployment had similar associations half and one-quarter the intensity. “Anxiety disorder,” “what is depression,” “signs of depression,” “depression symptoms,” and “symptoms of depression” were the queries exhibiting the strongest associations with mortgage delinquencies and foreclosures, unemployment or underemployment. Housing prices and S&P 500 trends were not associated with PD queries. Limitations A non-traditional measure of PD was used. It is unclear if actual clinically significant depression or anxiety increased during the Great Recession. Alternative explanations for strong associations between the Great Recession and PD queries, such as media, were explored and rejected. Conclusions Because the economy is constantly changing, this work not only provides a snapshot of recent associations between the economy and PD queries but also a framework and toolkit for real-time surveillance going forward. Health resources, clinician screening patterns, and policy debate may potentially be informed by changes in PD query trends.

A Review of Health Consequences of Recessions Internationally and a Synthesis of the US Response during the Great Recession

“…12,17,18,25,[37][38][39]46,49,51,56,57,59, In the current recession, five studies consistently found that mental health deteriorated. 61,63,75,82,103 The most consistent results relate to suicides. Twenty-one studies examined suicides or attempted suicides and found a marked increase in these outcomes during economic downturns.…”

The relationship between economic conditions and postpartum depression in Taiwan: a nationwide population-based study

“…Ayers et al (2012) revealed that the Standard & Poor's 500 (S & P 500) index trends were not associated with psychological distress queries (Ayers et al, 2012). Lin et al (2015) revealed that a fall in the TAIEX is associated with increases hospitalization for mental disorders, which is significant for males who are aged 45-64 years (Lin et al, 2015).…”

“…Women who suffer from mental stress may not consult a psychologist at the beginning. Ayers et al (2012) found that there was an increase in psychological distress queries over the Internet during the great recession (Ayers et al, 2012). In modern society, in which Internet use is popular, patients with PPD may ask for help using the Internet first instead of seeking a doctor's help.…”

The impact of employment on cognition and cognitive reserve: implications across diseases and aging

“…2,24 In fact, such financial stress has been shown to be a cause of anxiety that contributes to poor mood dysregulation, substance use, and other negative health behaviors, all of which negatively impacts cognitive reserve. 18,25,26 Another way in which employment income can facilitate cognitive reserve is through stimulating active engagement with one's environment. Income can be used for fun things in life (e.g., exotic vacations).…”