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Depression Associated with Pandemic Economic Duress, Knowing Someone with COVID-19, But Not with COVID-19 Deaths in Kazakhstan: A Two-City Randomized Baseline Survey for a Longitudinal Panel Study
15 Pages Posted: 6 Apr 2021More...
Background: Impact of pandemic psychological, economic, and biological factors on mental health trajectories are poorly understood. Long-term studies on earthquake disasters show depression requires specialized psychiatric/psychological interventions. However, the pandemic characterized by long-term isolation and lockdowns, economic adversity, and disease and death may produce distinctive mental health demands for the future. This baseline survey aims to evaluate the associations of pandemic factors with depression.
Methods: We surveyed 2000 participants 18 years-and-older by two-city stratified telephonic random sampling in Kazakhstan. Survey-adjusted Poisson regression analyses produced probable depression prevalence ratios (PRs) for COVID-19 death and disease related factors, and pandemic-related economic and socio-psychological factors. CESD-16 was utilized to measure depression.
Findings: Pandemic factors including household suspected having-or-diagnosed with COVID-19 with depression PR=1·48 (95% CI 1·09-2·02; p=0·013), friends/coworkers diagnosed with COVD-19 with PR=1·43 (1·04-1·95; p=0·026), lost employment PR=1·80 (1·04-3·11; p=0·037), and insufficient income for food PR=1·54 (1·15-2·06; p=0·004) were independently associated with probable depression. Contrastingly, having COVID-19 deaths among family/friends or acquaintances/coworkers were not associated with depression. Neither was fear of developing disease or perceived threat of COVID-19, but family stress had a dose-response association, with PR=13·42 (7·11-25·32; p<0·001) for very high stress. Associated non-pandemic factors included female sex, younger age, lower education, marriage status and chronic diseases.
Interpretation: Some pandemic depression factors relate to economic survival. Disease among family, friends and others may increase awareness of risk. For deaths, bereavement is time-limited, thus appears not associated with depression. Psychopathology trajectory may be closer to that of earthquake survivors.
Funding: Nazarbayev University
Declaration of Interest: None to declare.
Ethical Approval: Our study protocol for the two-city randomized telephonic baseline survey was approved by the Internal Review Ethics Committee of the Nazarbayev University, Nursultan, Kazakhstan.
Suggested Citation: Suggested Citation