key: cord-0793359-47dt3v0v
authors: Czeisler, Mark É.; Lane, Rashon I.; Wiley, Joshua F.; Czeisler, Charles A.; Howard, Mark E.; Rajaratnam, Shantha M. W.
title: Follow-up Survey of US Adult Reports of Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic, September 2020
date: 2021-02-19
journal: JAMA Netw Open
DOI: 10.1001/jamanetworkopen.2020.37665
sha: c71f31d0d032acaf7c93e07fb3e1735be4d99607
doc_id: 793359
cord_uid: 47dt3v0v

This survey study compared patterns of mental health concerns, substance use, and suicidal ideation during June and September 2020 of the COVID-19 pandemic and examined at-risk demographic groups.

was specified as the traumatic exposure to record peri-and posttraumatic symptoms associated with the range of stressors introduced by the COVID-19 pandemic. Those who scored at least 1.75 of 4 were considered symptomatic. Trauma-and stressorrelated symptoms assessed were common to multiple TSRDs, including posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and adjustment disorders (ADs) to capture COVID-19-specific trauma and stress symptoms responsive to prolonged exposures that do not meet diagnostic criteria for PTSD. 3, 4 Symptoms of insomnia were assessed via the 2-item Sleep Condition Indicator (SCI-02). 5 Those who scored less than or equal to 2 of 8 were considered symptomatic. Persons who had disabilities were defined as such based on a response indicating limitations of activities because of physical, mental, or emotional conditions, or health conditions that require special equipment, based on the CDC Behavioral Risk Factor Surveillance System. Substance use was defined as use of "alcohol, legal or illegal drugs, or prescriptions drugs that are taken in a way not recommended by your doctor," and respondents were given the opportunity to respond "Yes", "No", or "Prefer not to say." Suicidal ideation was indicated by responses to the question: "At any time in the past 30 days, did you seriously think about trying to kill yourself?" For this analysis, race and ethnicity were combined into the following categories: White, non-Hispanic; Black, non-Hispanic; Asian, non-Hispanic; Multiple races or Other race, non-Hispanic; and Hispanic, any race or races.

Race and ethnicity were assessed in this study given mental health disparities documented during the COVID-19 pandemic.

Following Qualtrics standard screening procedures, the investigators conducted a secondary screening, including removal of duplicate respondents, those who reported

A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population

Screening for posttraumatic stress disorder in ARDS survivors: validation of the Impact of Event Scale-6 (IES-6)

Is posttraumatic stress disorder meaningful in the context of the COVID-19 pandemic: response to Van Overmeire's commentary on

Traumatic stress in the age of COVID-19: call to close critical gaps and adapt to new realities

The Sleep Condition Indicator: a clinical screening tool to evaluate insomnia disorder

Mental health, substance use, and suicidal ideation during the COVID-19 pandemic

Participants who completed June 2020 surveys, including first-time June 2020 respondents and those recontacted from April 2020, were reweighted for longitudinal analyses. McNemar χ² test with continuity correction was used to test for changes in prevalence of all 5 mental or behavioral health measures between June 2020 and September 2020.

For regression models, respondents who did not provide characterizable responses to variables included in the model were excluded, including the following: sexual orientation ("Something else," "I don't know the answer," and "Prefer not to say"; total n = 174 [3.4%]) and disability status ("Prefer not to say"; n = 216 [4.2%]).