Suchergebnisse

IMPORTANCE: Claims of dramatic increases in clinically significant anxiety and depression early in the COVID-19 pandemic came from online surveys with extremely low or unreported response rates. OBJECTIVE: To examine trend data in a calibrated screening for clinically significant anxiety and depression among adults in the only US government benchmark probability trend survey not disrupted by the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: This survey study used the US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS), a monthly state-based trend survey conducted over the telephone. Participants were adult respondents in the 50 US states and District of Columbia who were surveyed March to December 2020 compared with the same months in 2017 to 2019. EXPOSURES: Monthly state COVID-19 death rates. MAIN OUTCOMES AND MEASURES: Estimated 30-day prevalence of clinically significant anxiety and depression based on responses to a single BRFSS item calibrated to a score of 6 or greater on the 4-item Patient Health Questionnaire (area under the receiver operating characteristic curve, 0.84). All percentages are weighted based on BRFSS calibration weights. RESULTS: Overall, there were 1 429 354 respondents, with 1 093 663 in 2017 to 2019 (600 416 [51.1%] women; 87 153 [11.8%] non-Hispanic Black; 826 334 [61.5%] non-Hispanic White; 411 254 [27.8%] with college education; and 543 619 [56.8] employed) and 335 691 in 2020 (182 351 [51.3%] women; 25 517 [11.7%] non-Hispanic Black; 250 333 [60.5%] non-Hispanic White; 130 642 [29.3%] with college education; and 168 921 [54.9%] employed). Median within-state response rates were 45.9% to 49.4% in 2017 to 2019 and 47.9% in 2020. Estimated 30-day prevalence of clinically significant anxiety and depression was 0.4 (95% CI, 0.0 to 0.7) percentage points higher in March to December 2020 (12.4%) than March to December 2017 to 2019 (12.1%). This estimated increase was limited, however, to students (2.4 [95% CI, 0.8 to 3.9] percentage ...

Persistent suicide ideation (SI) is known to be a risk factor for subsequent suicidal behaviors. Reducing SI persistence among people with a history of SI consequently might be a useful target for preventive intervention; however, basic information is lacking about patterns and predictors of SI persistence. We report preliminary retrospective data on annual SI persistence in a representative sample of 3,501 U.S. Army soldiers with lifetime SI from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Reports about age-of-onset and number of years with SI were used to estimate two definitions of persistence: persistence beyond year-of-onset and proportional annual persistence (i.e., percentage of years with SI since year-of-onset). Results revealed that for 47.8% of respondents with lifetime SI, their SI did not persist beyond the year-of-onset. For the 52.2% whose SI did persist beyond the year-of-onset, the median (inter-quartile range) proportional annual persistence was 33% (17–67%). Significant predictors of increased persistence were different for respondents with pre-enlistment SI onset (prior histories of attention-deficit/hyperactivity disorder [ADHD], bipolar disorder, and panic disorder) and post-enlistment SI onset (male, combat support military occupation specialty, prior histories of ADHD, panic disorder, and posttraumatic stress disorder). These predictors of persistence are different from the predictors of SI onset, suggesting that secondary preventive interventions to reduce SI persistence may need to focus on different factors than primary preventive interventions to reduce SI onset.

The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multi-component epidemiological and neurobiological study of unprecedented size and complexity designed to generate actionable evidence-based recommendations to reduce U.S. Army suicides and increase basic knowledge about determinants of suicidality by carrying out coordinated component studies. A number of major logistical challenges were faced in implementing these studies. The current report presents an overview of the approaches taken to meet these challenges, with a special focus on the field procedures used to implement the component studies. As detailed in the paper, these challenges were addressed at the onset of the initiative by establishing an Executive Committee, a Data Coordination Center (the Survey Research Center [SRC] at the University of Michigan), and study-specific design and analysis teams that worked with staff on instrumentation and field procedures. SRC staff, in turn, worked with the Office of the Deputy Under Secretary of the Army (ODUSA) and local Army Points of Contact (POCs) to address logistical issues and facilitate data collection. These structures, coupled with careful fieldworker training, supervision, and piloting contributed to the major Army STARRS data collection efforts having higher response rates than previous large-scale studies of comparable military samples.