Elsevier

Psychiatry Research

Volume 298, April 2021, 113773
Psychiatry Research

Prospective prediction of PTSD and depressive symptoms during social unrest and COVID-19 using a brief online tool

https://doi.org/10.1016/j.psychres.2021.113773Get rights and content

Highlights

  • Increased symptoms of PTSD and depression have been observed during COVID-19 and social unrest.

  • PTSD and depressive symptoms after one month can be predicted prospectively from a brief community online screening tool.

  • A pragmatic two-stage process is suggested for identifying those at high risk and those at no significant risk for depression.

  • High rumination and low resilience are both predictors of high-risk PTSD and depression outcomes at one month.

  • Agile screening with predictive capability is crucial for informing early intervention in evolving population stress contexts.

Abstract

Large-scale protracted population stressors, such as social unrest and the coronavirus disease 2019 (COVID-19), are associated with increased symptoms of post-traumatic stress disorder (PTSD) and depression. Cost-effective mental health screening is prerequisite for timely intervention. We developed an online tool to identify prospective predictors of PTSD and depressive symptoms in the context of co-occurring social unrest and COVID-19 in Hong Kong. 150 participants completed baseline and follow-up assessments, with a median duration of 29 days. Three logistic regression models were constructed to assess its discriminative power in predicting PTSD and depressive symptoms at one month. Receiver-operating characteristic analysis was performed for each model to determine their optimal decision thresholds. Sensitivity and specificity of the models were 87.1% and 53.8% for probable PTSD, 77.5% and 63.3% for high-risk depressive symptoms, and 44.7% and 96.4% for no significant depressive symptoms. The models performed well in discriminating outcomes (AUCs range: 0.769–0.811). Probable PTSD was predicted by social unrest-related traumatic events, high rumination, and low resilience. Rumination and resilience also predicted high-risk and no significant depressive symptoms, with COVID-19-related events also predicting no significant depression risk. Accessible screening of probable mental health outcomes with good predictive capability may be important for early intervention opportunities.

Keywords

PTSD symptoms
Depressive symptoms
Trauma exposure
COVID-19
Mass screening
Risk assessment

Cited by (0)

1

Stephanie MY Wong and Eric YN Chen made equal contributions.

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