Articlegold2021

Mental health consequences of COVID-19: a nationally representative cross-sectional study of pandemic-related stressors and anxiety disorders in the USA

Salma M. Abdalla · Catherine K. Ettman · Gregory H. Cohen · Sandro Galea

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COVID-19 and Mental Health Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Maternal Mental Health During Pregnancy and Postpartum

Abstract

OBJECTIVE: To document the prevalence of anxiety disorders in the USA during the COVID-19 pandemic. DESIGN: A cross-sectional analysis. SETTING: A nationally representative sample in the USA between 31 March and 13 April 2020. PARTICIPANTS: 1450 English-speaking adult participants in the AmeriSpeak Panel. AmeriSpeak is a probability-based panel designed to be representative of households in the USA. MAIN OUTCOME MEASURES: Prevalence of probable generalised anxiety disorder (GAD) using the GAD-7 and post-traumatic stress symptoms (PTSS) using the four-item PTSD (post-traumatic stress disorder) checklist. Both outcomes were stratified by demographics and COVID-19-related stressors. RESULTS: The majority of participants were female (51.8%), non-Hispanic white (62.9%) and reported a household saving of $5000 or more. Those between 18 and 29 years old were the largest age group (38.1%) compared with 40-59 years (32.0%) and 60 years or more (29.9%). The prevalence of probable GAD was 10.9% (95% CI 9.1% to 13.2%) and the prevalence of PTSS was 21.7% (95% CI 19.1% to 24.6%). Among participants reporting five or more COVID-19-related stressors, the prevalence of probable GAD was 20.5% (95% CI 16.1% to 25.8%) and the prevalence of PTSS was 35.7% (95% CI 30.2% to 41.6%). Experiencing five or more COVID-19-related stressors was a predictor of both probable GAD (OR=4.5, 95% CI 2.3 to 8.8) and PTSS (OR=3.3, 95% CI 2.1 to 5.1). CONCLUSIONS: The prevalence of probable anxiety disorders in the USA, as the COVID-19 pandemic and policies implemented to tackle it unfolded, is higher than estimates reported prior to the pandemic and estimates reported following other mass traumatic events. Exposure to COVID-19-related stressors is associated with higher prevalence of both probable GAD and PTSS, highlighting the role these stressors play in increasing the risk of developing anxiety disorders in the USA. Mitigation and recovery policies should take into account the mental health toll the pandemic had on the USA population.

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2006A Brief Measure for Assessing Generalized Anxiety Disorder 2005Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication 2020Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China 2020Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 2020The psychological impact of the COVID-19 epidemic on college students in China 2020Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis 2020Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic 2002Nationwide Longitudinal Study of Psychological Responses to September 11

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