Abstract
Introduction: No studies have reported mental health symptom comparisons prior to and during COVID-19 in vulnerable medical populations. Objective: To compare anxiety and depression symptoms among people with a pre-existing medical condition and factors associated with changes. Methods: Pre-COVID-19 Scleroderma Patient-centered Intervention Network Cohort data were linked to COVID-19 data from April 2020. Multiple linear and logistic regression were used to assess factors associated with continuous change and ≥ 1 minimal clinically important difference (MCID) change for anxiety (PROMIS Anxiety 4a v1.0; MCID = 4.0) and depression (Patient Health Questionnaire-8; MCID = 3.0) symptoms, controlling for pre-COVID-19 levels. Results: Mean anxiety symptoms increased 4.9 points (95% confidence interval [CI] 4.0 to 5.7). Depression symptom change was negligible (0.3 points; 95% CI -0.7 to 0.2). Compared to France (N = 159), adjusted anxiety symptom change scores were significantly higher in the United Kingdom (N = 50; 3.3 points, 95% CI 0.9 to 5.6), United States (N = 128; 2.5 points, 95% CI 0.7 to 4.2), and Canada (N = 98; 1.9 points, 95% CI 0.1 to 3.8). Odds of ≥1 MCID increase were 2.6 for the United Kingdom (95% CI 1.2 to 5.7) but not significant for the United States (1.6, 95% CI 0.9 to 2.9) or Canada (1.4, 95% CI 0.7 to 2.5). Older age and adequate financial resources were associated with less continuous anxiety increase. Employment and shorter time since diagnosis were associated with lower odds of a ≥ 1 MCID increase. Conclusions: Anxiety symptoms, but not depression symptoms, increased dramatically during COVID-19 among people with a pre-existing medical condition.
| Original language | English (US) |
|---|---|
| Article number | 110262 |
| Journal | Journal of Psychosomatic Research |
| Volume | 139 |
| DOIs | |
| State | Published - Dec 2020 |
Funding
The study was supported by funding from the Canadian Institutes of Health Research McGill University, the McGill Interdisciplinary Initiative in Infection and Immunity Emergency COVID-19 Research Fund; Scleroderma Canada, made possible by an educational grant for patient support programming from Boehringer Ingelheim; Scleroderma Society of Ontario; Scleroderma Manitoba; Scleroderma Atlantic; Scleroderma Australia; Scleroderma New South Wales; Scleroderma Victoria; Scleroderma Queensland; Scleroderma SASK; Scleroderma Association of BC; and Scl\u00E9rodermie Qu\u00E9bec. Dr. Thombs was supported by a Tier 1 Canada Research Chair and a Fonds de recherche du Qu\u00E9bec - Sant\u00E9 (FRQ-S) researcher salary award, Dr. Benedetti was supported by a FRQ-S researcher salary award, Dr. Henry was supported by a Mitacs postdoctoral fellowship award, and Mr. Harb was supported by a CIHR Canada Graduate Scholarship-Master's award, all outside of the present work. No sponsor had any role in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; or in the decision to submit the paper for publication.All authors have completed the ICJME uniform disclosure form. Dr. Mouthon reported personal fees from Actelion/Johnson & Johnson, grants from LFB, non-financial support from Octapharma, and non-financial support from Grifols, all outside the submitted work. All other authors declared: no support from any organization for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Keywords
- Adult
- Anxiety
- COVID-19
- Clinical epidemiology
- Depressed mood
- Depressive symptoms
- Epidemiology
- Pandemic
- Scleroderma
- Systemic sclerosis
ASJC Scopus subject areas
- Clinical Psychology
- Psychiatry and Mental health