(PS2-B47) Distinct Trajectories of Depression Symptoms Before and After the COVID-19 Lockdown: Evidence from Longitudinal Network Analysis

Background: The COVID-19 pandemic has had a significant deleterious effect on mental health. Yet, research regarding whether the symptom pattern of depression has been affected has been mixed. Depression is highly heterogeneous, and it is possible that global events and significant life stressors accompanying them may change how depression is experienced. The goal of this investigation was therefore to understand whether the dynamics of depressive symptoms have changed following COVID-19 pandemic.

Methods: Data for this study came from an international multilingual online depression/suicide screening study (Leykin et al., 2011). Participants in this secondary analysis were individuals who had completed a measure of depression (MDE Screener; Munoz et al., 1998) at least twice before the onset COVID-19 (n = 906) or twice during COVID-19 (n = 785). Cross-lagged panel network (CLPN) analyses were used to compare longitudinal networks for depression prior to and following the onset of the pandemic. Network analysis is a methodology that can be used to evaluate the interrelation of individual symptoms; longitudinal network analyses allow for more nuanced interpretations of interrelated symptom change.

Results: Comparison of the CLPNs suggested that the networks before and during COVID-19 were more similar than different, with 64% of edges replicating across the networks. However, several important differences emerged. First, prior to the onset of the COVID-19, psychomotor retardation and psychomotor agitation were the most likely to predict other symptoms of depression, whereas after the start of the COVID-19 pandemic, anhedonia was most likely to predict other symptoms of depression. Another important difference that emerged was that prior to the start of the COVID-19 pandemic, thoughts of committing suicide led to nearly 50% increased odds of reporting an attempted suicide at the second timepoint (Odds Ratio (OR) = 1.45, 95% CI [1.00, 9.74]), and wanting to die only weakly predicted reporting having attempted suicide at the second timepoint (OR = 1.10, 95% CI [1.00, 12.63]). However, during COVID-19 pandemic, reporting thoughts of committing suicide did not predict reporting a suicide attempt (OR = 1.00, 95% CI [0.93, 4.61]), whereas reporting wanting to die predicted a twofold increase in the odds of reporting a suicide attempt (OR = 2.04, 95% CI [1.00, 15.64]).

Conclusions: Findings suggest that the pandemic may have altered the dynamic of depression symptoms with regards to some of the most central associations. Differences in networks regarding suicide attempt are especially noteworthy – after then onset of COVID-19, wanting to die was a much stronger predictor an attempt than suicidal ideation. Whether these changes in the dynamics of symptoms of depression are due to the global health crisis itself or the effects of mitigation strategies (e.g., isolation due to quarantining or difficulty accessing in-person mental health care) remains to be investigated in future research. A better understanding of the effects of significant events, either global or more localized, on dynamics of depression symptoms may help inform prevention and treatment approaches and adequately serve individuals experiencing symptoms of depression.