Background

During the COVID-19 pandemic, many Americans have experienced mental distress, which may be partially characterized by a rise in mental illnesses. However, COVID-19 specific psychological distress may also be separate from diagnosable conditions, a distinction that has not been well established in the context of the pandemic.

Methods

Data came from an online survey of US adults collected in March 2020. We used factor analysis to assess the relationship between COVID-19 related mental distress and depressive symptoms. Using four questions on psychological distress modified for COVID-19 and eight depressive symptoms, we conducted an exploratory factor analysis (EFA) to identify the factor structure and then estimated a confirmatory factor analysis (CFA).

Results

The EFA model indicated a two-factor solution, where the COVID-19 distress items loaded onto the first factor and depression items loaded onto the second. Only two items cross-loaded between factors: feeling fearful and being bothered by things that do not usually bother the participant. The CFA indicated that this factor structure fit the data adequately (RMSEA=0.106, SRMR=0.046, CFI=0.915, TLI=0.890).

Limitations

It is possible that there are additional important symptoms of COVID-19 distress that were not included. Depression symptoms were measured via the CES-D-10, which while validated is not equivalent to a clinician diagnosis.

Conclusions

As COVID-19 related mental distress appears to be distinct from, though related to, depression, public health responses must consider what aspects of depression treatment may apply to this phenomenon. For COVID-related distress, it may be more appropriate to treat symptomatically and with supportive psychotherapy.

中文翻译：

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COVID-19 时期的痛苦：了解美国成年人 COVID-19 特定精神痛苦和抑郁症之间的区别

背景

在 COVID-19 大流行期间，许多美国人都经历过精神痛苦，其部分特征可能是精神疾病的增加。然而，COVID-19 特定的心理困扰也可能与可诊断的情况不同，这种区别在大流行的背景下尚未得到很好的确立。

方法

数据来自于 2020 年 3 月收集的美国成年人在线调查。我们使用因子分析来评估与 COVID-19 相关的精神困扰和抑郁症状之间的关系。我们使用针对 COVID-19 修改的关于心理困扰的四个问题和八种抑郁症状，进行了探索性因素分析 (EFA) 以确定因素结构，然后估计了验证性因素分析 (CFA)。

结果

EFA 模型表明了一个双因素解决方案，其中 COVID-19 痛苦项目加载到第一个因素上，抑郁项目加载到第二个因素上。只有两个项目在因素之间交叉加载：感到恐惧和被通常不会打扰参与者的事情所困扰。CFA 表明该因子结构充分拟合数据（RMSEA=0.106，SRMR=0.046，CFI=0.915，TLI=0.890）。

限制

可能还有未包括在内的其他重要的 COVID-19 困扰症状。抑郁症状是通过 CES-D-10 测量的，虽然经过验证，但并不等同于临床医生的诊断。

结论

由于与 COVID-19 相关的精神困扰似乎与抑郁症不同，但与抑郁症相关，因此公共卫生应对措施必须考虑抑郁症治疗的哪些方面可能适用于这种现象。对于与 COVID 相关的痛苦，对症治疗和支持性心理治疗可能更合适。