Baltimore, MD—As the most accessible healthcare professionals for many Americans, pharmacists completely understand that not all of the adverse effects of COVID-19 are physical and related to infection.

A research letter published in JAMA reveals that serious psychological distress was reported by 13.6% of U.S. adults in April 2020 versus 3.9% in 2018.

Johns Hopkins Bloomberg School of Public Health–led researchers sought to determine how psychological distress has changed over the course of the coronavirus disease 2019 (COVID-19) pandemic.

To do that, researchers fielded wave 2 of the Johns Hopkins COVID-19 Civic Life and Public Health Survey from July 7 to July 22, 2020, among U.S. adults who responded to wave 1 from April 7 to April 13, 2020.

The online survey measured psychological distress in the past 30 days using the Kessler 6 scale. A score of 13 or more on the 0- to 24-point scale indicated the validated measure of serious distress. The survey then asked, “During the past 30 days, have any of the following negatively impacted your mental health?”

At that point, respondents selected from a list of potential stressors affecting them or their family members, including concern about contracting COVID-19 or experiencing adverse effects related to COVID-19 on employment, finances, education, health insurance, and ability to obtain healthcare or childcare.

The prevalence of serious psychological distress overall and among demographic subgroups was compared for July versus April. Results indicate that, of 1,227 respondents, 13.0% (95% CI, 10.1%-16.5%) reported serious distress in July 2020 versus 14.2% (95% CI, 11.3%-17.7%) in April 2020 (P = .73).

The authors note that reported prevalence of serious distress did not significantly differ in July as compared with April for any specific subgroups, however. At both points in time, they explain, reported prevalence was highest among adults aged 18 to 29 years (25.4% [95% CI, 16.0%-38.0%] in April; 26.5% [95% CI, 16.1%-40.5%] in July), those with income less than $35,000 (20.2% [95% CI, 14.4%-27.5%] in April; 21.2% [95% CI, 14.7%-29.6%] in July), and Hispanics (17.9% [95% CI, 10.3%-29.4%] in April; 19.2% [95% CI, 11.1%-31.2%] in July). In fact, the study determined that 72% (95% CI, 60.1%-81.3%) of adults reporting serious distress in July also reported serious distress in April.

“Adults with serious distress were statistically significantly more likely than those without serious distress to report all stressors except ability to obtain childcare,” according to the researchers who list the most common stressors reported by 132 respondents with serious distress as:
• Concerns about contracting COVID-19 (65.9% [95% CI, 51.8%-77.7%])
• Pandemic effects on employment (65.1% [95% CI, 53.6%-75.1%])
• Strain on finances (60.6% [95% CI, 48.0%-72.0%]).

Educational interruptions were pinpointed as major stressors among the subgroup of adults with serious distress attending college and/or with school-aged children (n = 52), 69.0% (95% CI, 50.3%-83.1%), according to the survey.

“Reported prevalence of serious psychological distress among US adults was 13.6% in April 2020 and 13% in July 2020,” the authors write, adding, “High prevalence at both time points suggests that the pandemic’s longer-term disruptions are important drivers of distress. More than 60% of adults with serious distress reported that pandemic-related disruptions to education, employment, and finances negatively affected their mental health. These stressors may be particularly salient to young adults, about a quarter of whom reported serious distress in both April and July.”

The sample was drawn from the AmeriSpeak panel of approximately 35,000 members sourced from the geographic area of NORC, a University of Chicago research institution, and from a U.S. Postal Service address–based sample covering 97% of U.S. households.

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