Government response moderates the mental health impact of COVID-19: A systematic review and meta-analysis of depression outcomes across countries

JOURNAL OF AFFECTIVE DISORDERS

卷:290

Review

Lee, Yena^1,2  Lui, Leanna M. W.¹  Chen-Li, David¹  Liao, Yuhua^3,4  Mansur, Rodrigo B.^1,5  Brietzke, Elisa^6,7  Rosenblat, Joshua D.^1,5  Ho, Roger⁸  Rodrigues, Nelson B.¹  Lipsitz, Orly¹  Nasri, Flora¹  Cao, Bing⁹  Subramaniapillai, Mehala¹  Gill, Hartej¹  Lu, Ciyong³  McIntyre, Roger S.^1,2,3,5,10 

[1] Univ Hlth Network, Toronto Western Hosp, Mood Disorders Psychopharmacol Unit, Toronto, ON M5T 2S8, Canada

[2] Univ Toronto, Inst Med Sci, Toronto, ON M5S 1A8, Canada

[3] Sun Yat Sen Univ, Sch Publ Hlth, Dept Med Stat & Epidemiol, Guangzhou, Peoples R China

[4] Shenzhen Nanshan Ctr Chron Dis Control, Dept Psychiat, Shenzhen, Peoples R China

[5] Univ Toronto, Dept Psychiat, Toronto, ON M5S 1A8, Canada

[6] Queens Univ, Sch Med, Dept Psychiat, Kingston, ON, Canada

[7] Queens Univ, Ctr Neurosci Studies, Kingston, ON, Canada

[8] Natl Univ Singapore, Dept Psychol Med, Singapore 119228, Singapore

[9] Southwest Univ, Fac Psychol, Minist Educ, Key Lab Cognit & Personal, Chongqing 400715, Peoples R China

[10] Univ Toronto, Dept Pharmacol, Toronto, ON M5S 1A8, Canada

关键词: Depression;    Depressive Disorder;    Public Health;    Pandemic;    COVID-19;   

DOI  :  10.1016/j.jad.2021.04.050

来源: Elsevier

【 摘 要 】

Background: The COVID-19 pandemic represents a public health, economic and mental health crisis. We hypothesized that timely government implementation of stringent measures to reduce viral transmission would benefit mental health, as evidenced by reduced rates of depressive symptoms (i.e., Patient Health Questionnaire [PHQ]-9>10, PHQ-2>3). Methods: The systematic review herein (PROSPERO CRD42020200647) evaluated to what extent differences in government-imposed stringency and timeliness of response to COVID-19 moderate the prevalence of depressive symptoms across 33 countries (k=114, N=640,037). We included data from six lower-middle-income countries, nine upper-middle-income countries, and 18 higher-income countries. Government-imposed stringency and timeliness in response were operationalized using the Oxford COVID-19 Government Response (Stringency) Index. Results: The overall proportion of study participants with clinically significant depressive symptoms was 21.39% (95% CI 19.37-23.47). The prevalence of clinically significant depressive symptoms was significantly lower in countries wherein governments implemented stringent policies promptly. The moderating effect of government response remained significant after including the national frequency of COVID cases at the time of study commencement, Healthcare Access and Quality index, and the inclusion of COVID patients in the study. Limitations: Factors that may have confounded our results include, for example, differences in lockdown duration, lack of study participant and outcome assessor blinding, and retrospective assessment of depressive symptom severity. Conclusions: Governments that enacted stringent measures to contain the spread of COVID-19 benefited not only the physical, but also the mental health of their population.

【 授权许可】

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