Abstract
Trajectory studies of the COVID-19 pandemic have described patterns of symptoms over time. Yet, few have examined whether social determinants of health predict the progression of depression and anxiety symptoms during COVID-19 or identified which social determinants worsen symptom trajectories. Using a racially, ethnically, and linguistically diverse sample of adults participating in a randomized clinical trial with pre-existing moderate to severe depression and/or anxiety symptoms, we compare symptom patterns before and during COVID-19; characterize symptom trajectories over a 20-week follow-up period; and evaluate whether social determinants are associated with within- and between- person differences in symptom trajectories. Data were collected before and during COVID-19 in Massachusetts and North Carolina. On average, depression and anxiety symptoms did not seem to worsen during the pandemic compared to pre-pandemic. During COVID-19, anxiety scores at follow-up were higher for participants with baseline food insecurity (vs no food insecurity). Depression scores at follow-up were higher for participants with food insecurity and for those with utilities insecurity (vs no insecurity). Participants with child or family care responsibilities at baseline had depression symptoms decreasing at a slower rate than those without these responsibilities. We discuss the important implications of these findings.
Keywords: Anxiety; COVID-19; Depression; Racial/ethnic minorities; Social determinants of health; Trajectories.
【저자키워드】 COVID-19, Anxiety, Depression, social determinants of health, Racial/ethnic minorities, Trajectories., Trajectories, 【초록키워드】 randomized clinical trial, pandemic, food insecurity, COVID-19 pandemic, Symptom, progression, Health, trajectory, Follow-up, utility, Care, moderate, predict, anxiety symptoms, determinant, average, participant, North, implication, anxiety symptom, severe depression, described, collected, evaluate, examined, Massachusett, baseline, social determinant, 【제목키워드】 Symptom, North, role, Massachusett, social determinant,