Sex differences in changes of depressive symptoms among older adults before and during the COVID-19 pandemic: evidence from two longitudinal cohorts

Trajectories of depressive symptoms across different age groups from adolescence to old age before and during the COVID-19 pandemic: A national household survey in China

OBJECTIVE

The COVID-19 pandemic has been associated with depressive symptoms. However, little is known about trajectories across different age groups. This study aimed to examine trajectories of depressive symptoms before and during the COVID-19 pandemic across different age groups and identify factors associated with these trajectories.

METHODS

This population-based household survey included 19,545 participants from various age groups (10-18 years, n = 2260; 19-34 years, n = 4801; 35-49 years, n = 4892; 50-64 years, n = 5238; 65+ years, n = 2354) in two waves conducted in 2018 and 2020. Depressive symptoms were measured using the short version of the Center for Epidemiologic Studies Depression Scale (CES-D). Logistic regressions were used for data analysis.

RESULTS

An increase in depressive symptoms was observed during the COVID-19 pandemic compared to the pre-COVID period. Four trajectories of depressive symptoms were identified: High-risk, increasing, decreasing, and low-risk. Female gender and lower income in older age groups, as well as lower levels of exercise in older age groups, poorer physical health in all ages, and lower well-being in all ages were identified as risk factors for experiencing depressive symptom trajectories compared with the low-risk trajectory.

LIMITATIONS

Self-reported tools other than clinical diagnosis were employed.

CONCLUSIONS

This population-based study highlights the importance of tailoring prevention and intervention strategies for different age groups, considering specific risk and protective factors. Such targeted approaches can effectively address the diverse trajectories of depressive symptoms observed during the COVID-19 pandemic.

The impact of the COVID-19 pandemic on symptoms of depression and anxiety among older adults: the MYHAT study

OBJECTIVES

To identify subgroups of older adults whose mental health was affected by the COVID-19 pandemic.

METHODS

Interrupted time series (ITS) analyses were used to measure the long-term impact of the COVID-19 pandemic on symptoms of depression (mCES-D) and anxiety (GAD-7) among participants aged 65 years and older (n = 708) from a prospective, longitudinal cohort study.

RESULTS

Symptoms of depression, but not anxiety, significantly increased at the start of the pandemic, while long-term trends in depression and anxiety during the pandemic were similar to pre-pandemic trends. Participants aged 75 years and older exhibited a more rapid decline in depression symptoms over time than expected after an initial increase. Women experienced a greater immediate increase in anxiety that decreased over time, while men's anxiety increased over time. Cognitively normal participants experienced a greater than expected immediate increase in symptoms of depression that decreased over time, while symptoms were unchanged by the pandemic for those with cognitive impairment.

CONCLUSION

Despite an initial increase in depression symptoms, the pandemic did not result in elevated symptoms of depression and anxiety long-term. The impact of the pandemic on mental health varied by age, gender, and cognitive status, suggesting some groups may have been more vulnerable than others.

Depression, Anxiety, Resilience, and Family Functioning Among Different Age Groups During the COVID-19 Pandemic: A One-Year Longitudinal Study

Background/Objectives: The COVID-19 pandemic has profoundly disrupted mental health globally, affecting individuals across all age groups. Understanding its long-term impact is crucial for identifying age-specific vulnerabilities and informing targeted mental health interventions. This longitudinal study aimed to investigate the within-person changes in mental health across different age groups in Greece from the first to the third pandemic wave of coronavirus disease 2019 (COVID-19) (i.e., one year later) during nationwide lockdowns. It further compared the mental health outcomes of three distinct age groups, stratified based on their vulnerability to COVID-19-younger adults (18-29 years), adults (30-59 years), and older adults (60-84 years)-and examined correlates of depression and anxiety during the third pandemic wave. Methods: A total of 720 participants-92 younger adults, 543 adults, and 85 older adults-completed the same set of questionnaires during the first (April-May 2020) and third (March-May 2021) pandemic-related lockdowns. At both time points, participants provided data on the Generalized Anxiety Disorder-2, Patient Health Questionnaire-2, Systemic Clinical Outcome and Routine Evaluation-15, Connor-Davidson Resilience Scale-2, and demographic information. Results: Results indicated a within-individual increase in depression and a decrease in resilience for all participants, irrespective of age. Anxiety increased only among younger adults and adults, whereas family functioning remained stable across all age groups one year post-pandemic onset. Furthermore, younger adults reported higher levels of depression and anxiety, lower resilience, and more impaired family functioning compared to the older age groups in both lockdowns. Among the different age groups, factors independently associated with depression and anxiety were identified through stepwise regression analyses. Conclusions: The present study provides evidence for mental health deterioration during the pandemic across all age groups, with younger adults exhibiting heightened vulnerability.

Depressive symptoms during the transition to adolescence: Left hippocampal volume as a marker of social context sensitivity

The transition to adolescence is a critical period for mental health development. Socio-experiential environments play an important role in the emergence of depressive symptoms with some adolescents showing more sensitivity to social contexts than others. Drawing on recent developmental neuroscience advances, we examined whether hippocampal volume amplifies social context effects in the transition to adolescence. We analyzed 2-y longitudinal data from the Adolescent Brain Cognitive Development (ABCD®) study in a diverse sample of 11,832 youth (mean age: 9.914 y; range: 8.917 to 11.083 y; 47.8% girls) from 21 sites across the United States. Socio-experiential environments (i.e., family conflict, primary caregiver's depressive symptoms, parental warmth, peer victimization, and prosocial school environment), hippocampal volume, and a wide range of demographic characteristics were measured at baseline. Youth's symptoms of major depressive disorder were assessed at both baseline and 2 y later. Multilevel mixed-effects linear regression analyses showed that negative social environments (i.e., family conflict, primary caregiver's depressive symptoms, and peer victimization) and the absence of positive social environments (i.e., parental warmth and prosocial school environment) predicted greater increases in youth's depressive symptoms over 2 y. Importantly, left hippocampal volume amplified social context effects such that youth with larger left hippocampal volume experienced greater increases in depressive symptoms in more negative and less positive social environments. Consistent with brain-environment interaction models of mental health, these findings underscore the importance of families, peers, and schools in the development of depression during the transition to adolescence and show how neural structure amplifies social context sensitivity.

Understanding resilience: Lifestyle-based behavioral predictors of mental health and well-being in community-dwelling older adults during the COVID-19 pandemic

BACKGROUND

Changes in sleep, physical activity and mental health were observed in older adults during early stages of the COVID-19 pandemic. Here we describe effects of the COVID-19 pandemic on older adult mental health, wellbeing, and lifestyle behaviors and explore predictors of better mid-pandemic mental health and wellbeing.

METHODS

Participants in the Adult Changes in Thought study completed measures of lifestyle behaviors (e.g., sleep, physical activity) and mental health and wellbeing both pre-pandemic during regular study visits and mid-pandemic via a one-time survey. We used paired t-tests to compare differences in these measures pre- vs. mid-pandemic. Using multivariate linear regression, we further explored demographic, health, and lifestyle predictors of pandemic depressive symptoms, social support, and fatigue. We additionally qualitatively coded free text data from the mid-pandemic survey for related comments.

RESULTS

Participants (N = 896) reported significant changes in mental health and lifestyle behaviors at pre-pandemic vs. mid-pandemic measurements (p < 0.0001). Qualitative findings supported these behavioral and wellbeing changes. Being male, never smoking, and lower pre-pandemic computer time and sleep disturbance were significantly associated with lower pandemic depressive symptoms. Being partnered, female, never smoking, and lower pre-pandemic sleep disturbance were associated with higher pandemic social support. Pre-pandemic employment, more walking, less computer time, and less sleep disturbance were associated with less pandemic fatigue. Participant comments supported these quantitative findings, highlighting gender differences in pandemic mental health, changes in computer usage and physical activity during the pandemic, the value of spousal social support, and links between sleep disturbance and mental health and wellbeing. Qualitative findings also revealed additional factors, such as stresses from personal and family health situations and the country's concurrent political environment, that impacted mental health and wellbeing.

CONCLUSIONS

Several demographic, health, and lifestyle behaviors appeared to buffer the effects of the COVID-19 pandemic and may be key sources of resilience. Interventions and public health measures targeting men and unpartnered individuals could promote social support resilience, and intervening on modifiable behaviors like sleep quality, physical activity and sedentary activities like computer time may promote resilience to fatigue and depressive symptoms during future community stressor events. Further research into these relationships is warranted.

Characteristics of drug overdose suicide attempts presenting to the psychiatric emergency department of Beijing Anding Hospital

BACKGROUND

Overdose-related suicide attempts represent a significant portion of self-harm presentations in the psychiatric emergency department (ED). Identifying specific patient characteristics associated with these attempts holds promise for pinpointing drug classes with elevated risk and paving the way for tailored suicide prevention interventions. This study aims to examine the demographic profiles of ED patients who had experienced overdose-related suicide attempts.

METHODS

This retrospective study was conducted at Beijing Anding Hospital, Capital Medical University, from January 2020 to December 2021. Patients with psychiatric drug overdose suicide attempts presenting to the psychiatric ED were included. Sociodemographic characteristics and the specific classes of drugs involved were collected, and analysed descriptively.

RESULTS

This study examined 252 overdose patients, excluding 51 patients treated with alcohol or nonpsychiatric drugs, and a total 201 cases were included. The mean age of the patients was 28 ± 16 years (median 23, range 12-78), and 82% (n = 165) of the sample were females. Notably, nearly half (45%) of the patients were aged ≤ 20 years. While the number of cases decreased with increasing age, a significant increase was observed in 2021 compared to 2020. Benzodiazepines (BZDs) were the most frequently implicated substance class (n = 126, 63%), followed by antidepressants (n = 96, 48%), antipsychotics (n = 44, 22%), Z-drugs (n = 43, 21%), and mood stabilizers (n = 36, 18%). For adolescents, antidepressants (n = 52, 71%) overtook BZDs (n = 38, 52%) as the most common drug. The monthly distribution of cases revealed peaks in April and November. Furthermore, 21% (n = 42) of patients ingested more than two psychotropic medications concurrently. Finally, approximately half (n = 92) of the patients required inpatient admission for further treatment. Comparisons between hospitalized and nonhospitalized patients did not reveal any significant differences.

CONCLUSIONS

The present study revealed a greater prevalence of suicide overdose attempts among young females receiving prescriptions for antidepressants and/or BZDs. This finding suggests a potential need for enhanced monitoring of suicidal behaviour in this specific population when prescribing psychotropic medications. These findings contribute to the growing body of knowledge regarding drug overdose suicide attempts in psychiatric emergency settings and underscore the importance of further research to develop targeted prevention interventions.

Sense of coherence, mental health, and hair cortisol concentrations among older people during the COVID -19 pandemic: a cross-sectional study

BACKGROUND

A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC).

METHOD

A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety.

RESULTS

SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001).

CONCLUSION

Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.

COVID-19 And Mental Health Outcomes Of Older Adults: Evidence From Mexico

Estimates using data from the Mexican Health and Aging Study, a national longitudinal sample of older adults in Mexico, show elevated risk for negative mental health outcomes for those experiencing COVID-19 infection or major COVID-19-related adverse events. Predicted elevated probabilities were greater for a major adverse event than for COVID-19 infection, and they varied across sociodemographic groups defined by age, sex, education, and urban-rural residence.