Depression trajectories during the COVID-19 pandemic in the high-quality health care setting of Switzerland: the COVCO-Basel cohort

N Probst-Hensch; A Jeong; D Keidel; M Imboden; G Lovison

doi:10.1016/j.puhe.2023.01.010

Depression trajectories during the COVID-19 pandemic in the high-quality health care setting of Switzerland: the COVCO-Basel cohort

Public Health. 2023 Apr:217:65-73. doi: 10.1016/j.puhe.2023.01.010. Epub 2023 Jan 16.

Authors

N Probst-Hensch¹, A Jeong², D Keidel², M Imboden², G Lovison³

Affiliations

¹ Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland. Electronic address: nicole.probst@swisstph.ch.
² Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland.
³ Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland; Department of Economics, Business and Statistics, University of Palermo, Italy.

Abstract

Objectives: During the pandemic, Switzerland avoided stringent lockdowns and provided funds to stabilize the economy. To assess whether and in what subgroups the pandemic impacted on depressive symptoms in this specific Swiss context, we derived depression trajectories over an extended pandemic period in a Swiss cohort and related them to individuals' sociodemographic characteristics.

Study design: This was a population-based cohort study.

Methods: The population-based COVCO-Basel cohort in North-Western Switzerland invited 112,848 adult residents of whom 12,724 participated at baseline. Between July 2020 and December 2021, 6396 participants answered to additional 18 monthly online questionnaires. Depression symptoms were repeatedly measured by the DASS-21 scale. Group-based Trajectory Models methods were applied to identify clusters of similar depression trajectories. Trajectory clusters were characterized descriptively and with a Multinomial response model.

Results: Three distinct trajectories were identified. The 'Highly affected' trajectory (13%) had a larger presence of younger and female participants with lower average income, higher levels of past depression, and living alone. A majority of individuals in the 'Unaffected' trajectory (52%) were of medium or high average income, older average age, without previous depression symptoms, and not living alone. The 'Moderately affected' trajectory (35%) had a composition intermediate between the two opposite 'extreme' trajectories.

Conclusions: This study is among few studies investigating depression trajectories up to the time when COVID-19 vaccination was readily available to the entire population. During these 18 months of the pandemic, depressive symptoms increased in a substantial percentage of participants. Economic support, high-quality health care system, and moderate containment measures did not sufficiently protect all population subgroups from adverse, potentially long-term psychological pandemic impacts.

Keywords: COVID-19; Cohort; Depression; Longitudinal; Mental health; Population-based; Trajectory clusters.

MeSH terms

Adult
COVID-19 Vaccines
COVID-19* / epidemiology
Cohort Studies
Communicable Disease Control
Delivery of Health Care
Depression* / psychology
Female
Humans
Longitudinal Studies
Pandemics
Switzerland / epidemiology

Substances

COVID-19 Vaccines