Importance The COVID-19 pandemic has coincided with an increase in depressive symptoms as well as a growing awareness of health inequities and structural racism in the United States. Objective To examine the association of mental health with everyday discrimination during the pandemic in a large and diverse cohort of the All of Us Research Program. Design, Setting, and Participants Using repeated assessments in the early months of the pandemic, mixed-effects models were fitted to assess the associations of discrimination with depressive symptoms and suicidal ideation, and inverse probability weights were applied to account for nonrandom probabilities of completing the voluntary survey. Main Outcomes and Measures The exposure and outcome measures were ascertained using the Everyday Discrimination Scale and the 9-item Patient Health Questionnaire (PHQ-9), respectively. Scores for PHQ-9 that were greater than or equal to 10 were classified as moderate to severe depressive symptoms, and any positive response to the ninth item of the PHQ-9 scale was considered as presenting suicidal ideation. Results A total of 62 651 individuals (mean [SD] age, 59.3 [15.9] years; female sex at birth, 41 084 [65.6%]) completed at least 1 assessment between May and July 2020. An association with significantly increased likelihood of moderate to severe depressive symptoms and suicidal ideation was observed as the levels of discrimination increased. There was a dose-response association, with 17.68-fold (95% CI, 13.49-23.17; P < .001) and 10.76-fold (95% CI, 7.82-14.80; P < .001) increases in the odds of moderate to severe depressive symptoms and suicidal ideation, respectively, on experiencing discrimination more than once a week. In addition, the association with depressive symptoms was greater when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino participants at all 3 time points and among non-Hispanic Asian participants in May and June 2020. Furthermore, high levels of discrimination were as strongly associated with moderate to severe depressive symptoms as was history of prepandemic mood disorder diagnosis. Conclusions and Relevance In this large and diverse sample, increased levels of discrimination were associated with higher odds of experiencing moderate to severe depressive symptoms. This association was particularly evident when the main reason for discrimination was race, ancestry, or national origins among Hispanic or Latino participants and, early in the pandemic, among non-Hispanic Asian participants.

中文翻译：

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“我们所有人”研究计划中的“COVID-19 大流行期间日常歧视与抑郁症状和自杀意念的关联”。

重要性 COVID-19 大流行与美国抑郁症状的增加以及对健康不平等和结构性种族主义的认识不断增强同时发生。目的 在“我们所有人研究计划”的一个庞大且多样化的群体中研究心理健康与大流行期间日常歧视的关联。设计、环境和参与者 在大流行的最初几个月进行重复评估，拟合混合效应模型来评估歧视与抑郁症状和自杀意念之间的关联，并应用逆概率权重来解释完成测试的非随机概率。自愿调查。主要结果和测量 分别使用日常歧视量表和 9 项患者健康问卷 (PHQ-9) 确定暴露和结果测量。PHQ-9 分数大于或等于 10 分被归类为中度至重度抑郁症状，对 PHQ-9 量表第九项的任何阳性反应都被认为存在自杀意念。结果 2020 年 5 月至 7 月期间，共有 62 651 名个体（平均 [SD] 年龄，59.3 [15.9] 岁；出生时性别为女性，41 084 [65.6%]）完成了至少 1 项评估。随着歧视程度的增加，观察到中度至重度抑郁症状和自杀意念。存在剂量反应相关性，分别为 17.68 倍（95% CI，13.49-23.17；P < .001）和 10。每周经历一次以上歧视，中度至重度抑郁症状和自杀意念的几率分别增加 76 倍（95% CI，7.82-14.80；P < .001）。此外，在所有 3 个时间点的西班牙裔或拉丁裔参与者以及 2020 年 5 月和 6 月的非西班牙裔亚裔参与者中，当歧视的主要原因是种族、血统或国籍时，与抑郁症状的关联更大。此外，高歧视程度与中度至重度抑郁症状密切相关，就像大流行前情绪障碍诊断史一样。结论和相关性 在这个庞大且多样化的样本中，歧视程度的增加与经历中度至重度抑郁症状的几率较高相关。