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Disclosures: Czeisler reports numerous relevant financial disclosures. Please see the study for his and all other authors’ relevant financial disclosures.
February 23, 2021
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Adverse mental health symptoms remain elevated among U.S. adults in pandemic's later phase

Disclosures: Czeisler reports numerous relevant financial disclosures. Please see the study for his and all other authors’ relevant financial disclosures.
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The prevalence of adverse mental health symptoms among U.S. adults remained elevated in the later phase of the COVID-19 pandemic vs. prepandemic, according to results of a research letter published in JAMA Network Open.

“Given suggestions that acute increases in the prevalence of adverse mental health symptoms may represent a transient response to mass trauma, we sought to determine whether these patterns persisted in September 2020 and to examine disproportionately affected demographic groups,” Mark É. Czeisler, AB, of the Turner Institute for Brain and Mental Health at Monash University in Australia, and colleagues wrote.

Crowd with masks
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The researchers conducted a survey study between August 28, 2020, and Sept. 6, 2020, and analyzed data of 5,186 U.S. adults aged 18 years or older who completed 139-item online surveys through Qualtrics for the COVID-19 Outbreak Public Evaluation Initiative. Participant data included demographic characteristics and answers to questions that assessed attitudes, behaviors and beliefs about COVID-19, mitigation measures and mental and behavioral health. The researchers used or adapted brief, validated instruments, when possible.

Results showed anxiety or depression symptoms among 1,710 (33%) participants, COVID-19-related trauma- and stressor-related disorder symptoms among 1,536 (29.6%) participants, increased substance use among 781 (15.1%) participants, serious consideration for suicide attempt among 618 (11.9%) participants and at least one of these symptoms among 2,237 (43.1%) participants. Adults aged younger than 65 years vs. those aged 65 years or older, multigenerational caregivers vs. noncaregivers and participants with prior psychiatrics diagnoses vs. those with no prior diagnoses were all at increased risk for adverse mental or behavioral health symptoms. This risk was also increased among participants with disabilities or insomnia symptoms vs. those without, caregivers for adults vs. noncaregivers, essential workers and unemployed participants vs. nonessential workers and participants who were lesbian, gay or bisexual vs. heterosexual. Prevalence of adverse mental health symptoms remained largely the same between June 2020 and September 2020 among participants who were recontacted after June 2020.

“Although quota sampling and survey weighting were used, internet-based survey samples are limited and may not fully represent the 2020 U.S. population,” Czeisler and colleagues wrote. “Nonetheless, evidence of sustained adverse mental health symptoms among more than 5000 community-dwelling U.S. adults highlights the need to promote preventive behaviors, expand mental health care access and integrate medical and behavioral health services to mitigate the mental health effects of COVID-19.”