Objective

Previous literature finds an increase in depressive symptoms, substance use, and suicidal ideation following the COVID-19 pandemic in the US – suicides do not appear to increase. We examine whether 1) state lockdown policies in the US precede an increase in mental health symptoms; and 2) the extent to which using substances amplifies or attenuates the relation.

Methods

We specified, as our exposure variable, the timing of state-level lockdown orders. We used, as the outcome variable, the 4-item Patient Health Questionnaire (PHQ-4) that measures anxiety and depression symptoms. We utilized the Understanding America Study (UAS), a nationally representative sample of 7,597 adults across 50 states in the US, surveyed biweekly between March 10, 2020 and November 11, 2020. Linear fixed effect analyses controlled for time-invariant individual factors, as well as employment status, household income, and previous mental health diagnosis.

Results

Regression results indicate an increase in PHQ-4 scores of approximately 1.70 during lockdown, relative to no lockdown (p < 0.05). Relative to no lockdown, an increase in alcohol use corresponds with a 0.08 unit decrease in PHQ-4 scores during lockdown (p < 0.05).

Conclusion

State lockdown policies precede greater mental health symptoms. Increases in consuming alcohol attenuates the relation between state lockdown policies and mental health symptoms. Results may portend greater addiction following the pandemic warranting further investigation into utilization of substance use treatment.

中文翻译：

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国家封锁政策、心理健康症状和使用药物

客观的

先前的文献发现，在美国发生 COVID-19 大流行后，抑郁症状、药物滥用和自杀意念有所增加——自杀似乎没有增加。我们研究了 1) 美国的国家封锁政策是否先于心理健康症状的增加；2) 使用物质放大或减弱这种关系的程度。

方法

我们将州级锁定命令的时间指定为我们的暴露变量。我们使用测量焦虑和抑郁症状的 4 项患者健康问卷 (PHQ-4) 作为结果变量。我们利用了解美国研究 (UAS)，该研究是美国 50 个州的 7,597 名成年人的全国代表性样本，在 2020 年 3 月 10 日至 2020 年 11 月 11 日期间每两周进行一次调查。线性固定效应分析控制了时间不变的个体因素，如以及就业状况、家庭收入和以前的心理健康诊断。

结果

回归结果表明，与未锁定相比，锁定期间 PHQ-4 得分增加了约 1.70（p < 0.05）。相对于没有锁定，酒精使用的增加对应于锁定期间 PHQ-4 分数降低 0.08 个单位（p < 0.05）。

结论

国家封锁政策先于出现更大的心理健康症状。饮酒量的增加减弱了国家封锁政策与心理健康症状之间的关系。结果可能预示着大流行后会出现更大的成瘾性，需要进一步调查药物滥用治疗的使用情况。