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Symptom trajectories of depression in the Icelandic population during the COVID-19 pandemic

Yue Wang, Fenfen Ge, Thor Aspelund, Unnur Valdimarsdóttir

Introduction Changes in depressive symptom during the COVID-19 pandemic have been described across populations, but data are still scarce on the role of pandemic-specific factors on varying trajectories of depression in the general population. We aim to identify determinants of varying trajectories of depression during the COVID-19 pandemic.

Methods and data We used data from the Icelandic COVID-19 National Resilience Cohort of 8307 individuals 18 years or older with three consecutive response data on depressive symptoms across the pandemic period (April 2020 – July 2021). We assessed 40 candidate features including demographic, lifestyle, physical and psychological health, and pandemic-specific factors. We used latent growth mixture model to identify varying trajectories of depression, and performed both logistic regression and X-GBoost model to identify determinants of unfavorable trajectory vs. favorable trajectory.

Results We identified 4 distinct trajectories during the median 13 months of follow-up with most individuals showing consistently low (83.2%) or improved (5.4%) symptom of depression, while 11.4% participants showed unfavorable trajectories (i.e., deteriorating or consistently high symptom). Both logistic regression model and X-GBoost model showed good performance in distinguishing unfavorable trajectories from favorable trajectories (C-statistics 0.81-0.85). Risk factors identified of unfavorable trajectories were younger age, pre-pandemic existing psychiatric disorders and financial difficulties, while identified protective factors were increased family support, regular exercise and frequent in-person social contact.

Conclusions These data suggest that the majority of the Icelandic population maintained favorable mental health during the COVID-19 pandemic and that social support may be a key factor against unfavorable trajectories of depression.


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