Abstract
The COVID-19 pandemic is taking a significant global toll on emotional well-being, but evidence of mental health impacts in the United States remains limited. In April 2020, we conducted an exploratory survey of U.S. residents to understand prevalence of and factors associated with psychological distress during the pandemic. Data collection was conducted using Qualtrics, an online survey platform, and U.S. adult respondents were recruited via Amazon's Mechanical Turk platform. Among 1,366 respondents, 42% (n = 571) reported clinically significant anxiety and 38% (n = 519) reported clinically significant depression. Factors associated with anxiety and depressive symptoms included Hispanic/Latino ethnicity; younger age; lower income; employment as or living with a health care worker-first responder; caregiver status; SARS-CoV-2 infection status; decreased frequency of engagement in healthy behaviors; and changed frequency of engagement in unhealthy behaviors. That some of these factors are associated with elevated distress during the pandemic is not yet widely appreciated and might be useful in informing management of mental health care resources.
Highlights
As the coronavirus disease 2019 (COVID-19) pandemic continues its deadly march across the globe, increased attention is being paid to associated mental health impacts
Significant effects of income were found for both anxiety (F (7,1358) = 5.18, ηp2artial=0.026, p < 0.001) and depression (F (7,1358) = 7.46, η2partial = 0.037, p < 0.001)
In one survey of over 400 Asian Americans and Asians living in the United States, 29% reported increased discrimination, 41% reported increased anxiety symptoms, and 53% reported increased depressive symptoms, where social support buffered against the negative impact of discrimination on depressive symptoms [36]
Summary
As the coronavirus disease 2019 (COVID-19) pandemic continues its deadly march across the globe, increased attention is being paid to associated mental health impacts. In 2018, only 3.9% of U.S adults reported serious distress on the same scale presented in the National Health Interview Survey [18] Another survey fielded from March 31 to April 13, 2020 found that 28% of respondents reported elevated depressive symptoms, which was approximately 3.5 times the prevalence identified in the 2017– 2018 National Health and Nutrition Examination Survey [19]. In June 2020, 31% of 5,412 U.S adults reported elevated anxiety or depressive symptoms on the four-item Patient Health Questionnaire (PHQ-4), with the highest prevalence reported by Hispanic/Latino respondents, respondents aged 18–24 years old, respondents who had not completed high school, and respondents who were unpaid caregivers for adults [20]
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