Description

Background: Isolation and uncertainty resulting from the COVID-19 pandemic has had an adverse impact on mental health.1,2 This impact is exacerbated among those with comorbid chronic health conditions.3 The aim of this study was to explore the relationship between sociodemographic characteristics and change in depression symptoms pre- and post-lockdown measures among Type-2 Diabetes patients in San Diego. Methods: Analyses were executed using electronic health records from Type-2 Diabetes patients at Family Health Centers of San Diego, Inc. The outcome of interest was change in depression symptoms (no change/increase in symptoms/decrease in symptoms) from the year prior to the start of the COVID-19 pandemic through the first year of the pandemic. Depression symptoms were categorized (major depressive disorder (MDD) likely vs. not likely) using the Patient Health Questionnaire-2 (PHQ-2), a validated depression screening tool (range 0-6) where a score of three or more indicates MDD likely. Sociodemographic characteristics of interest included age, race/ethnicity, language, gender, marital status, and income. Bivariate associations and polychotomous logistic regression analyses were used to examine the association between characteristics and change in depressive symptoms from pre- to post-lockdown measures. Bias analyses were conducted to assess the strength of unmeasured confounding necessary to negate findings. Results: A total of 4698 patients completed at least one PHQ-2 screening within one year pre- and post-lockdown. Mean age was 54.3 years and a majority of patients identified as Hispanic (59.7%) followed by Non-Hispanic White (15.4%) and Non-Hispanic Black (8.9%). Patients most often identified as married (40.6%) or single (35.8%) and more than 80% reported income ≤ 100% of the federal poverty level (FPL). 676 (14.2%) and 278 (5.8%) of screenings were flagged as MDD likely during pre- and post-lockdown periods, respectively. Regression and bias analyses are pending. Discussion: Results will describe characteristics associated with MDD status change and inform future care procedures for patients who may be vulnerable to mental health changes resulting from COVID-19 lockdown.