Anxiety and depressive symptoms in U.S. Census Bureau assessments of adults: Trends from 2019 to fall 2020 across demographic groups

Biocrude from hydrothermal liquefaction of indigenous municipal solid waste for green energy generation and contribution towards circular economy: A case study of urban Pakistan

In this study, biocrude was successfully produced by the hydrothermal liquefaction of municipal solid waste collected from the landfill site of Lahore, the capital of Punjab, Pakistan, boasting a population of 12 million and an annual waste collection of 10 million tons. The hydrothermal liquefaction process was performed at reaction parameters of 350 °C and 165 bars with 15 min of residence time. The solid waste was found to have 78 % dry matter, 22 % moisture contents, 22.2 % ash, 22.69 MJ/kg higher heating value, 52.062 % C, 8.007 % H, 0.764 % N, and 39.164 % O. Non-catalytic process only produced 10.57 % oil, however when using the catalytic process, the biocrude yield improved to 17.61 %, with 22.61 % energy recovery for biocrude and 12.14 % for solids, when using 2 g dose of K2CO3. The resultant biocrude has a 28.61 MJ/kg higher heating value, having 60.28 % C and 9.28 % H. In contrast, the aqueous phase generated had 4.43 pH, 71.5 g/L TOC, and 1.35 g/L Total Nitrogen. TGA indicated that biocrude contains approximately 80 % of volatile fractions of different fuels. The organic compounds having the six highest peak areas in GC-MS were Ethyl ether 25.74 %, 2-pentanone, 4-hydroxy-4-methyl 9.08 %, 2-propanone, 1,1-dimethoxy 5.62 %, Silane, dimethyl (docosyloxy) butoxy 5.08 %, 1-Hexanol, 2-ethyl 4.53 %, and. Phenol 4.07 %. This work makes the first-ever successful use of indigenous solid waste from a landfill dumping site in Lahore to successfully produce useful biocrude with aims of waste reduction and management, circular economy, and energy recovery.

Temporal dynamics of socioeconomic inequalities in depressive and anxiety symptoms during the COVID-19 pandemic: a scoping review

Background

The existence of socioeconomic inequalities in the prevalence of symptoms of depression and anxiety is widely acknowledged, and individuals from lower socioeconomic backgrounds tend to exhibit higher rates of symptoms. However, the direction in which the COVID-19 pandemic has influenced these disparities remains uncertain. We therefore aimed to systematically outline the available evidence on the temporal dynamics of socioeconomic inequalities in symptoms related to depression and anxiety during the COVID-19 pandemic across high-income countries.

Methods

A scoping review was conducted by searching the databases Embase, Scopus and PsycINFO. According to pre-defined eligibility criteria, two reviewers independently screened titles and abstracts as well as full texts of the compiled records. Data from the included studies were extracted using a standardised data-extraction form and analysed numerically and narratively. The scoping review followed the PRISMA-ScR guidelines.

Results

A total of 49 studies comprising 149 analyses of socioeconomic indicators in relation to symptoms of depression and anxiety were included. Despite heterogeneous study designs and results, there was a tendency of increasing (40.9%; n = 61) or persistent (38.2%; n = 57) inequality trends to the detriment of those in socially more disadvantaged positions. Increasing inequalities were most pronounced when income was used as a socioeconomic indicator. Groups with lower socioeconomic status appeared most vulnerable in the initial phase of the COVID-19 pandemic. Throughout the pandemic, dynamics were diverse, with persistent trends most frequently reported.

Conclusion

Overall, to the detriment of those with lower socioeconomic status, mental-health inequalities persisted or increased in most analyses. Continually monitoring socioeconomic inequalities over time is crucial, since this makes it possible to adapt prevention and intervention strategies to specific pandemic phases. Interventions targeting job security, income security and educational attainment could reduce mental-health inequalities. The results can contribute to preparedness plans for future pandemics and crises.

Assets and depression in U.S. adults during the COVID-19 pandemic: a systematic review

PURPOSE

Mental health is shaped by social and economic contexts, which were altered during the COVID-19 pandemic. No study has systematically reviewed the literature on the relation between different assets and depression during the COVID-19 pandemic.

METHODS

We conducted a systematic review of the literature on financial (e.g. income/savings), physical (e.g., home ownership), and social (e.g., marital status, educational attainment) assets and depression in U.S. adults. For each asset type, we created binary comparisons to report on the direction of the relationship and described if each study reported insignificant, positive, negative, or mixed associations.

RESULTS

Among the 41 articles identified, we found that income was the most studied asset (n=34), followed by education (n=25), marital status (n=18), home ownership (n=5), and savings (n=4). 88%, 100%, and 100% of articles reported a significant association of higher income, home ownership, and higher savings, respectively, with less depression. The association between marital status and education with depression was more nuanced: 72% (13 of 18) studies showed that unmarried persons had greater risk of depression than married or cohabitating persons and 52% (13 of 25) of studies reported no significant difference in depression across educational groups.

CONCLUSION

This work adds to the literature a deeper understanding of how different assets relate to depression. In the context of largescale traumatic events, policies that maintain and protect access to social, physical, and financial assets may help to protect mental health.

Opioid Overdose Hospitalizations During COVID-19: The Experience of Pennsylvania

Objective

The COVID-19 pandemic placed extreme burden on hospitals, while opioid overdose is another challenging public health issue. This study aimed to examine the trends and outcomes of opioid overdose hospitalizations in Pennsylvania during 2018 to 2021.

Design

We identified opioid overdose hospitalizations in the state of Pennsylvania using the state-wide hospital discharge database (PHC4) 2018 to 2021. We examined the number of opioid overdose hospitalizations, the corresponding mortality and discharges against medical advice comparing the pre-COVID period (2018-2019) and the COVID period (2020-2021). We also assessed what patient and hospital characteristics were associated with in-hospital death or leaving against medical advice.

Results

A total of 13 446 opioid-related hospitalizations were identified in 2018 to 2021. Compared to pre-pandemic, a higher percentage of cases involving synthetics (17.0%vs 10.3%, P < .0001) were observed during COVID. After controlling for covariates, there was no significant difference in opioid overdose in-hospital deaths in the years 2020 to 2021 compared to 2018 to 2019 (OR = 0.846, 95% CI: 0.71-1.01, P = .065). The COVID period was significantly associated with more leaving against medical advice compared to years 2018 to 2019 (OR = 1.265, 95% CI: 1.11-1.44, P = .0003). Compared to commercial insurance, Medicaid insurance was associated with higher odds of both in-hospital death (OR = 1.383, 95% CI: 1.06-1.81, P = .0176) and leaving against medical advice (OR = 1.903, 95% CI: 1.56-2.33, P < .0001).

Conclusion

There were no substantial changes in the number of overall opioid overdose cases and deaths at hospitals following the outbreak of COVID-19 in Pennsylvania. This observation suggests that an increased number of patients may have succumbed to overdoses outside of hospital settings, possibly due to a higher severity of overdoses. Further, we found that patients were more likely to leave against medical advice during the COVID-19 pandemic.

Do early life traumas moderate the impact of cumulative pandemic stress on anger?

Do early life traumas condition the psychological consequences of pandemic stressors? Using national data from the Crime, Health, and Politics Survey (May-June 2021), we examine whether early life traumas buffer or amplify the impact of cumulative pandemic stressors (CPS) on anger, an understudied measure of emotional distress. We examine two competing perspectives. The trauma amplification perspective posits that people who experience early life traumas are especially vulnerable to subsequent stressors, while the trauma resiliency perspective suggests the opposite, that people who experience traumas in early life are less vulnerable to subsequent stressors. The trauma resiliency perspective was partially supported by our analyses. Although early life traumas abated the impact of three or more pandemic stressors on anger, we failed to observe any attenuation at lower levels of pandemic stress exposure. We extend previous research by recasting the common stress proliferation model as a stress modification model and by focusing on feelings of anger. Findings are discussed in the context of social stress, mental health, and the COVID-19 pandemic.

Evolution of Depression and Anxiety During the COVID-19 Pandemic and Across Demographic Groups in a Large Sample of U.S. Adults

Introduction

This study aimed to document the trends of feelings of depression and anxiety over the course of the COVID-19 pandemic within and across age, gender, education, and employment groups.

Methods

Using a large, national, serial cross-sectional sample of adults in the U.S. collected through the COVID-19 Trends and Impact Survey conducted in partnership with Facebook, we examined trends in feelings of depression and anxiety from April 2020 through June 2022 (N=21,359,165).

Results

Over time, differences in feelings of anxiety and depression widened for educational attainment, stayed consistent between employment groups, and narrowed for female versus male and age groups. The odds of frequent feelings of anxiety or depression were significantly lower in the studied final quarter (April-June 2022) than in the studied first quarter (October-December 2020) for the overall population (p<0.001). In April-June 2022, younger persons reported 6-7 times the odds (AOR for depression=6.07; 95% CI=5.72, 6.43 and AOR for anxiety=6.69; 95% CI=6.33, 7.07), nonbinary persons reported 5 times the odds (AOR for depression=5.35, 95% CI=4.89, 5.86 and AOR for anxiety=5.35, 95% CI=4.9, 5.85), persons with a high school degree reported 2 times the odds (AOR for depression=2.07, 95% CI=1.92, 2.22 and AOR for anxiety=1.68, 95% CI=1.57, 1.8), and persons who were not employed reported 1.3-1.5 times the odds (AOR for depression=1.46, 95% CI=1.42, 1.51 and AOR for anxiety=1.34, 95% CI=1.3, 1.38) of frequent feelings depression and anxiety, respectively, than counterparts who were older, were male, had graduate degrees, or were employed.

Conclusions

The risk factors most highly associated with poor mental health 2 years into the pandemic were young age, nonbinary gender, and low educational attainment.

Changes in mental health among U.S. military veterans during the COVID-19 pandemic: A network analysis

Increases of symptoms of posttraumatic stress disorder (PTSD), anxiety and depression have been observed among individuals exposed to potentially traumatic events in the first months of the COVID-19 pandemic. Similarly, associations among different aspects of mental health, such as symptoms of PTSD and suicidal ideation, have also been documented. However, studies including an assessment prior to the onset and during the height of the pandemic are lacking. We investigated changes in symptoms of PTSD, depression, anxiety, suicidal ideation, and posttraumatic growth in a population-based sample of 1232 U.S. military veterans who experienced a potentially traumatic event during the first year of the pandemic. Symptoms were assessed prior to (fall/winter 2019) and one year into the pandemic (fall/winter 2020). We compared changes in symptom interrelations using network analysis, and assessed their associations with pandemic-related PTSD and posttraumatic growth symptoms. A subtle increase in psychopathological symptoms and a decrease in posttraumatic growth was observed one year into the pandemic. The peripandemic network was more densely connected, and pandemic-related PTSD symptoms were positively associated with age, anxiety, worst-event PTSD symptoms, and pandemic-related posttraumatic growth. Our findings highlight the resilience of veterans exposed to a potentially traumatic event during the first year of a pandemic. Similarly, the networks did not fundamentally change from prepandemic to one year into the pandemic. Despite this relative stability on a group level, individual reactions to potentially traumatic events could have varied substantially. Clinicians should individualize their assessments but be aware of the general resilience of most veterans.

Cumulative Pandemic Stressors, Psychosocial Resources, and Psychological Distress: Toward a More Comprehensive Test of a Pandemic Stress Process

Although the mental health consequences of individual COVID-19 stressors (e.g., bereavement, job loss, or financial strain) have been well-documented, little is known about the cumulative toll of multiple pandemic stressors. Using national data from the Crime, Health, and Politics Survey (May–June 2021), we test whether the accumulation of pandemic stressors is associated with greater psychological distress. We also consider whether this association is moderated by psychosocial resources (i.e., mastery, self-esteem, and social support). Our findings suggest that individuals who report three or more pandemic stressors tend to exhibit greater psychological distress than those who report fewer pandemic stressors or no pandemic stressors. While mastery offsets the impact of pandemic stressors at higher levels of stress exposure (i.e., two or more COVID-19 stressors), social support and self-esteem played a stress-buffering role to a point, but became ineffective at the highest levels of pandemic stress. The current study provides new insights into the pandemic stress process by conceptualizing and operationalizing the cumulative impact of COVID-19 stressors. We also confirm the continued significance of traditional coping resources in the context of novel pandemic stressors.

Social Support and Technology Use and Their Association With Mental and Physical Health During the COVID-19 Pandemic Among Asian Americans: The COMPASS Cross-sectional Study

BACKGROUND

The global COVID-19 pandemic disproportionately affected Asian Americans and Pacific Islanders (AAPIs) and revealed significant health disparities with reports of increased discrimination and xenophobia. Among AAPIs, the pandemic exacerbated their social, linguistic, and geographic isolation. Social support may be especially important for AAPIs given the salience of collectivism as a cultural value. Another mechanism for support among AAPIs was technology use, as it is generally widespread among this population. However, older adults may not perceive the same benefits.

OBJECTIVE

We examined social support and technology use and their relationships with mental and physical health outcomes through the COVID-19 pandemic among AAPIs.

METHODS

Data were drawn from the COVID-19 Effects on the Mental and Physical Health of AAPI Survey Study (COMPASS) for the time period of October 2020 to February 2021. COMPASS was a cross-sectional, multilingual, national survey conducted online, by phone, and in person with AAPI adults who were ≥18 years of age, in collaboration with academic and community partners in the United States. Data were analyzed using multivariable linear regression using the outcome variables of mental and physical health with various predictors such as social support and technology use. We tested for interactions specific to age and ethnicity.

RESULTS

Among 4631 AAPIs (mean age 45.9, SD 16.3 years; 2992/4631, 63.1% female), we found that (1) increased social support was associated with better physical health, (2) total social support was positively associated with better mental health, (3) higher technology use was associated with poorer mental health and inversely associated with poorer physical health, (4) the association of technology use with mental health was weaker among those with low social support (vs those with high social support), (5) adults younger than 60 years old (vs ≥60 years old) were more negatively affected with social support and mental health, and (6) Korean Americans appeared to be a high-risk group for poor physical health with increased technology use.

CONCLUSIONS

Our paper identified mental and physical health needs along with supportive therapies observed among AAPIs during the pandemic. Future research on how social support can be leveraged, especially among AAPIs younger than 60 years old, and how various types of technology are being utilized are important to guide the recovery efforts to address both mental and physical disparities across communities as a result of the COVID-19 pandemic.

Social media use as a coping mechanism during the COVID-19 pandemic: A multidimensional perspective on adolescents' well-being

Introduction

Social media use was previously characterized as both a maladaptive coping mechanism, and a source of engagement with peers, suggesting an ambivalent effect. The present study explored how adolescents might use social media as a coping mechanism during the COVID-19 pandemic, using a multidimensional perspective on well-being.

Methods

Our sample consisted of 259 Romanian teenagers aged 11-16 (M = 13.38, SD = 0.93, 57% males). We investigated the potential indirect effect of social media use, i.e., its cognitive, affective, and behavioral dimensions on the relationship between depressive symptoms and adolescents' well-being.

Results

Across all mediation analyses, our results suggested that social media use positively predicted adolescents' well-being. Given the multidimensional approach to both social media use and well-being, our findings suggested that adolescents' well-being was predicted not only by actual social media use behaviors but also by cognitions related to the expectation of receiving gratification on social media and the intense affective states related to the desire to use social media. Also, our data suggested that adolescents with high levels of depressive symptoms might be more likely to capitalize on social media use and have expectations related to receiving approval from others in the context of social media use.

Discussion

Depressive symptoms might be more relevant when explaining the cognitive and affective involvement during social media use. However, their ability to predict the actual social media use behaviors may be limited. Furthermore, adolescents that present depressive symptoms might be more prone to use social media, in order to improve their well-being.

News media exposure and life satisfaction in the COVID-19 pandemic: a moderated mediation model of COVID-19 fear and worries and gender

BACKGROUND

Research has found that news media exposure may have both positive and negative consequences for well-being in times of crisis. However, the internal mechanisms underlying that relationship need further investigation. The purpose of the research presented in the paper was to explore the role of COVID-19 fear and worries and users' gender in the relationship between news media exposure and life satisfaction.

PARTICIPANTS AND PROCEDURE

Three hundred seventy-one media users aged 19 to 65 (M = 28.88, SD = 10.25) were surveyed with news media exposure, COVID-19 fear and worries, and life satisfaction scales. Correlation analyses and moderated mediation analyses were performed.

RESULTS

The study demonstrated a significant positive association between news media exposure and life satisfaction, and an indirect effect of news exposure on life satisfaction via COVID-19 fear moderated by gender: elevated COVID-19 fear decreases the positive association between news exposure and life satisfaction, and this effect is stronger for women.

CONCLUSIONS

The present study expands our understanding of the role that news media can play in shaping the user's well-being in a time of a health crisis. It demonstrates that the effects of exposure to news media during a crisis are twofold. On the one hand, the use of news media is associated with a more positive evaluation of one's life, which may indicate that media use is a way to cope with a crisis. On the other hand, frequent use of news media leads to an elevated level of fear related to COVID-19, which, in turn, lowers the user's well-being.

Increasing psychological distress among Californians from 2013 to 2020: Race/ethnic differences

The influence of the COVID-19 pandemic on mental health is of mounting concern to population-health researchers. While early reports indicated increases in mental health problems, noticeably absent from these studies is how mental health has changed in 2020 compared to previous years (2013-2019) and whether such trends vary by race/ethnicity. The present study used repeated cross-sectional data from the California Health Interview Survey (n ​= ​168,216) to systematically document trends in psychological distress scores (Kessler-6 scale; K6) and severe psychological distress scores (K6; 13+) from 2013 to 2020 and by race/ethnicity over the same period. Among all Californians we find that the reported average psychological distress scores increased by 22% between 2013 and 2020. Reported severe psychological distress scores increased 61% from 2013 to 2020. These increases were largely concentrated in the years 2017-2020. Increases in psychological distress were also especially pronounced among non-Latino/a White Californians (29% increase in K6 from 2013 to 2020), Latino/a Californians (14% increase in K6 from 2013 to 2020), and Asian Californians (35% increase in K6 from 2013 to 2020). Multiple and logistic regression models that accounted for sociodemographic and behavioral health covariates echoed these findings. Future research should continue to investigate secular trends in mental health that coincided with the COVID-19 pandemic and carefully situate the shifts into broader temporal perspective.

Population Health Metrics During the Early Stages of the COVID-19 Pandemic: Correlative Pilot Study

BACKGROUND

COVID-19 has caused nearly 1 million deaths in the United States, not to mention job losses, business and school closures, stay-at-home orders, and mask mandates. Many people have suffered increased anxiety and depression since the pandemic began. Not only have mental health symptoms become more prevalent, but alcohol consumption has also increased during this time. Helplines offer important insight into both physical and mental wellness of a population by offering immediate, anonymous, cheap, and accessible resources for health and substance use disorders (SUD) that was unobstructed by many of the mandates of the pandemic. Further, the pandemic also launched the use of wastewater surveillance, which has the potential for tracking not only population infections but also consumption of substances such as alcohol.

OBJECTIVE

This study assessed the feasibility of using multiple public surveillance metrics, such as helpline calls, COVID-19 cases, and alcohol metabolites in wastewater, to better understand the need for interventions or public health programs in the time of a public health emergency.

METHODS

Ethanol metabolites were analyzed from wastewater collected twice weekly from September 29 to December 4, 2020, in a Midwestern state. Calls made to the helpline regarding housing, health care, and mental health/SUD were correlated with ethanol metabolites analyzed from wastewater samples, as well as the number of COVID-19 cases during the sampling period.

RESULTS

Correlations were observed between COVID-19 cases and helpline calls regarding housing and health care needs. No correlation was observed between the number of COVID-19 cases and mental health/SUD calls. COVID-19 cases on Tuesdays were correlated with the alcohol metabolite ethyl glucuronide (EtG). Finally, EtG levels were negatively associated with mental health/SUD helpline calls.

CONCLUSIONS

Although helpline calls provided critical services for health care and housing-related concerns early in the pandemic, evidence suggests helpline calls for mental health/SUD-related concerns were unrelated to COVID-19 metrics. Instead, COVID metrics were associated with alcohol metabolites in wastewater. Although this research was formative, with continued and expanded monitoring of population metrics, such as helpline usage, COVID-19 metrics, and wastewater, strategies can be implemented to create precision programs to address the needs of the population.

Food Insecurity–Related Interventions and Mental Health Among US Adults During the COVID-19 Pandemic, April 2020 through August 2021

Objectives:

Financial hardships, job losses, and social isolation during the COVID-19 pandemic have increased food insecurity. We examined associations between food insecurity–related interventions and mental health among US adults aged ≥18 years from April 2020 through August 2021.

Methods:

We pooled data from the Household Pulse Survey from April 2020 through August 2021 (N = 2 253 567 adults). To estimate associations between mental health and food insecurity, we examined the following interventions: the Supplemental Nutrition Assistance Program (SNAP), Economic Impact Payments (stimulus funds), unemployment insurance, and free meals. We calculated psychological distress index (PDI) scores (Cronbach α = 0.91) through principal components analysis using 4 mental health variables: depression, anxiety, worry, and lack of interest (with a standardized mean score [SD] = 100 [20]). We conducted multivariable linear regression to estimate the interactive effects of the intervention and food insecurity on psychological distress, controlling for sociodemographic characteristics.

Results:

During the study period, adults with food insecurity had higher mean PDI scores than adults without food insecurity. Food insecurity was associated with increased PDI scores after controlling for sociodemographic characteristics. In stratified models, negative associations between food insecurity and mental health (as shown by reductions in PDI scores) were mitigated by SNAP (−4.5), stimulus fund (−4.1), unemployment insurance (−4.4), and free meal (−4.4) interventions. The mitigation effects of interventions on PDI were greater for non-Hispanic White adults than for non-Hispanic Black or Asian adults.

Conclusions:

Future research on food insecurity and mental health should include investigations on programs and policies that could be of most benefit to racial and ethnic minority groups.

Estimated Prevalence of and Factors Associated With Clinically Significant Anxiety and Depression Among US Adults During the First Year of the COVID-19 Pandemic

Importance

Claims of dramatic increases in clinically significant anxiety and depression early in the COVID-19 pandemic came from online surveys with extremely low or unreported response rates.

Objective

To examine trend data in a calibrated screening for clinically significant anxiety and depression among adults in the only US government benchmark probability trend survey not disrupted by the COVID-19 pandemic.

Design, Setting, and Participants

This survey study used the US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS), a monthly state-based trend survey conducted over the telephone. Participants were adult respondents in the 50 US states and District of Columbia who were surveyed March to December 2020 compared with the same months in 2017 to 2019.

Exposures

Monthly state COVID-19 death rates.

Main Outcomes and Measures

Estimated 30-day prevalence of clinically significant anxiety and depression based on responses to a single BRFSS item calibrated to a score of 6 or greater on the 4-item Patient Health Questionnaire (area under the receiver operating characteristic curve, 0.84). All percentages are weighted based on BRFSS calibration weights.

Results

Overall, there were 1 429 354 respondents, with 1 093 663 in 2017 to 2019 (600 416 [51.1%] women; 87 153 [11.8%] non-Hispanic Black; 826 334 [61.5%] non-Hispanic White; 411 254 [27.8%] with college education; and 543 619 [56.8] employed) and 335 691 in 2020 (182 351 [51.3%] women; 25 517 [11.7%] non-Hispanic Black; 250 333 [60.5%] non-Hispanic White; 130 642 [29.3%] with college education; and 168 921 [54.9%] employed). Median within-state response rates were 45.9% to 49.4% in 2017 to 2019 and 47.9% in 2020. Estimated 30-day prevalence of clinically significant anxiety and depression was 0.4 (95% CI, 0.0 to 0.7) percentage points higher in March to December 2020 (12.4%) than March to December 2017 to 2019 (12.1%). This estimated increase was limited, however, to students (2.4 [95% CI, 0.8 to 3.9] percentage points) and the employed (0.9 [95% CI, 0.5 to 1.4] percentage points). Estimated prevalence decreased among the short-term unemployed (-1.8 [95% CI, -3.1 to -0.5] percentage points) and those unable to work (-4.2 [95% CI, -5.3 to -3.2] percentage points), but did not change significantly among the long-term unemployed (-2.1 [95% CI, -4.5 to 0.5] percentage points), homemakers (0.8 [95% CI, -0.3 to 1.9] percentage points), or the retired (0.1 [95% CI, -0.6 to 0.8] percentage points). The increase in anxiety and depression prevalence among employed people was positively associated with the state-month COVID-19 death rate (1.8 [95% CI, 1.2 to 2.5] percentage points when high and 0.0 [95% CI, -0.7 to 0.6] percentage points when low) and was elevated among women compared with men (2.0 [95% CI, 1.4 to 2.5] percentage points vs 0.2 [95% CI, -0.1 to 0.6] percentage points), Non-Hispanic White individuals compared with Hispanic and non-Hispanic Black individuals (1.3 [95% CI, 0.6 to 1.9] percentage points vs 1.1 [95% CI, -0.2 to 2.5] percentage points and 0.7 [95% CI, -0.1 to 1.5] percentage points), and those with college educations compared with less than high school educations (2.5 [95% CI, 1.9 to 3.1] percentage points vs -0.6 [95% CI, -2.7 to 1.4] percentage points).

Conclusions and Relevance

In this survey study, clinically significant US adult anxiety and depression increased less during 2020 than suggested by online surveys. However, this modest aggregate increase could mask more substantial increases in key population segments (eg, first responders) and might have become larger in 2021 and 2022.

Dose Optimization of Anxiolytic Compounds Group in Valeriana jatamansi Jones and Mechanism Exploration by Integrating Network Pharmacology and Metabolomics Analysis

Anxiety disorder impacts the quality of life of the patients. The 95% ethanol extract of rhizomes and roots of Valeriana jatamansi Jones (Zhi zhu xiang, ZZX) has previously been shown to be effective for the treatment of anxiety disorder. In this study, the dose ratio of each component of the anxiolytic compounds group (ACG) in a 95% ethanol extract of ZZX was optimized by a uniform design experiment and mathematical modeling. The anxiolytic effect of ACG was verified by behavioral experiments and biochemical index measurement. Network pharmacology was used to determine potential action targets, as well as predict biological processes and signaling pathways, which were then verified by molecular docking analysis. Metabolomics was then used to screen and analyze metabolites in the rat hippocampus before and after the administration of ZZX-ACG. Finally, the results of metabolomics and network pharmacology were integrated to clarify the anti-anxiety mechanism of the ACG. The optimal dose ratio of ACG in 95% ethanol extract of ZZX was obtained, and our results suggest that ACG may regulate ALB, AKT1, PTGS2, CYP3A4, ESR1, CASP3, CYP2B6, EGFR, SRC, MMP9, IGF1, and MAPK8, as well as the prolactin signaling pathway, estrogen signaling pathway, and arachidonic acid metabolism pathway, thus affecting the brain neurotransmitters and HPA axis hormone levels to play an anxiolytic role, directly or indirectly.

Changes in Prevalence of Mental Illness Among US Adults During Compared with Before the COVID-19 Pandemic

The authors review trend and cohort surveys and administrative data comparing prevalence of mental disorders during, versus, and before the COVID-19 pandemic and changes in mental health disparities. Best evidence suggests clinically significant anxiety-depression point prevalence increased by relative-risk (RR) = 1.3 to 1.5 during the pandemic compared with before. This level of increase is much less than the implausibly high RR = 5.0 to 8.0 estimates reported in trend studies early in the pandemic based on less-appropriate comparisons. Changes in prevalence also occurred during the pandemic, but relative prevalence appears not to have changed substantially over this time.