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Major depressive disorder is a leading cause of disability worldwide, and a major risk factor for suicide. It is also an illness that is remarkably sensitive to the social determinants of health—worsening depressive symptoms have been associated with adverse childhood experiences, racism and discrimination, unemployment, food insecurity, and a host of other social and environmental factors.1 The coronavirus disease 2019 (COVID-19) pandemic has led to massive social and economic disruptions around the world and in the United States. In their study examining the prevalence of depressive symptoms before and during the pandemic, Ettman et al2 have effectively documented an important mental health implication of the COVID-19 pandemic. The authors found higher prevalence rates of depression across all severity levels during COVID-19 compared with rates of depression before the pandemic in the US. Not surprisingly, for certain populations (eg, people with lower incomes and people with greater levels of stress associated with the pandemic), depressive symptoms were even more pronounced.
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Published: September 2, 2020. doi:10.1001/jamanetworkopen.2020.20104
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Shim RS. JAMA Network Open.
Corresponding Author: Ruth S. Shim, MD, MPH, Department of Psychiatry and Behavioral Sciences, University of California, 2230 Stockton Blvd, Sacramento, CA 95817 (firstname.lastname@example.org).
Conflict of Interest Disclosures: None reported.
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