Correlates of Mental Health Symptoms Among US Adults During COVID-19, March–April 2020

Abstract

Objectives An understanding of mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic is critical to ensure that health policies adequately address the mental health needs of people in the United States. The objective of this study was to examine mental health symptoms among US adults in an early stage of the COVID-19 pandemic. Methods We conducted a cross-sectional study in late March 2020 with a national sample of 963 US adults using an online research platform. Participants self-reported state of residence, psychosocial characteristics, and levels of anxiety, depression, anger, cognitive function, and fatigue in the context of COVID-19 using validated patient-reported outcomes scales in the Patient-Reported Outcome Measurement Information System measures. We used analysis of variance and multivariate linear regression to evaluate correlates of mental health symptoms. Results Overall, participants reported high levels of anxiety (mean [SD], 57.2 [9.3]) and depression (mean [SD], 54.2 [9.5]). Levels of anger, anxiety, cognitive function, depression, and fatigue were significantly higher among the Millennial Generation and Generation X (vs Baby Boomers), those with not enough or enough (vs more than enough) financial resources, females vs males), those with self-reported disability (vs no self-reported disability), and those with inadequate (vs adequate) health literacy. In adjusted models, being in Generation X and the Millennial Generation (vs Baby Boomer), having not enough or enough vs more than enough) financial resources, and having inadequate (vs adequate) health literacy were most strongly correlated with worse mental health symptoms. Conclusions Results suggest that mental health symptoms during the early stages of the COVID-19 pandemic were prevalent nationally, regardless of state of residence and especially among young, psychosocially vulnerable groups.