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Persistence of anxiety among Asian Americans: racial and ethnic heterogeneity in the longitudinal trends in mental well-being during the COVID-19 pandemic

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Abstract

Purpose

To examine within-individual time trends in mental well-being and factors influencing heterogeneity of these trends.

Methods

Longitudinal telephone survey of adults over 3 waves from the New York City (NYC) Metropolitan area during the COVID-19 Pandemic. Participants reported depression using the Patient Health Questionnaire (PHQ)-8, anxiety using the Generalized Anxiety Disorder (GAD)-7, and past 30-day increases in tobacco or alcohol use at each wave. Adjusted mixed effects logistic regression models assessed time trends in mental well-being.

Results

There were 1227 respondents. Over 3 study waves, there were statistically significant decreasing time trends in the odds of each outcome (adjusted OR (95% CI) 0.47 (0.37, 0.60); p < 0.001 for depression; aOR (95% CI) 0.55 (0.45, 0.66); p < 0.001 for anxiety; aOR (95% CI) 0.50 (0.35, 0.71); p < 0.001 for past 30-day increased tobacco use; aOR (95% CI) 0.31 (0.24, 0.40); p < 0.001 for past 30-day increased alcohol use). Time trends for anxiety varied by race and ethnicity (p value for interaction = 0.05, 4 df); anxiety declined over time among white, Black, Hispanic, and Other race and ethnicity but not among Asian participants.

Conclusions

In a demographically varied population from the NYC Metropolitan area, depression, anxiety and increased substance use were common during the first months of the pandemic, but decreased over the following year. While this was consistently the case across most demographic groups, the odds of anxiety among Asian participants did not decrease over time.

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Data availability

After the acceptance for publication of the main findings from the final data set de-identified study data will be shared upon request with qualified researchers, subject to the terms of a data sharing agreement.

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Acknowledgements

We thank William Keating for editorial assistance.

Funding

This work was supported by an NIH Social, Behavioral, and Economic (SBE) Health Impacts of COVID-19 Supplement (R01 DA038154-05S3; PI: C.W. Hoven).

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Authors and Affiliations

  1. Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, 1051 Riverside Drive Unit 23, New York, NY, 10032, USA

    Keely Cheslack-Postava, Sarah Forthal, George J. Musa, Megan Ryan, Michaeline Bresnahan, Rosemarie G. Sapigao, Susan Lin, Bin Fan, Connie Svob, Lupo Geronazzo-Alman, Yi-ju Hsu & Christina W. Hoven

  2. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA

    Sarah Forthal, George J. Musa, Michaeline Bresnahan, Connie Svob & Christina W. Hoven

  3. CUNY Graduate School of Public Health and Health Policy, New York, USA

    Rosemarie G. Sapigao

  4. Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Norbert Skokauskas

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  1. Keely Cheslack-Postava
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Contributions

CH, GM, MR, MB, and LGA contributed to conception and design of the study; CH, GM, MR, and YH contributed to acquisition of the data; CH, KCP, RGS, CS, and NS formulated the research question; KCP, SF, SL, GM, and FB analysed the data. KCP, SF, and RGS drafted the article and all authors revised it critically for intellectual content and approved the final version.

Corresponding author

Correspondence to Keely Cheslack-Postava.

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Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethics approval

All procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. All procedures involving human subjects/patients were approved by the institutional review board of the New York State Psychiatric Institute (protocol #8051).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Previous presentation

Meeting of the National Institute of Health—Social, Behavioral, and Economic (NIH–SBE) Health Impacts of COVID-19 webinar, online, April 27–28, 2022.

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Cheslack-Postava, K., Forthal, S., Musa, G.J. et al. Persistence of anxiety among Asian Americans: racial and ethnic heterogeneity in the longitudinal trends in mental well-being during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol 59, 599–609 (2024). https://doi.org/10.1007/s00127-023-02553-6

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