COVID-19 Pandemic-related Risk Factors of Depression: A 2-City Randomized Survey from Kazakhstan

Objectives: The impact of the COVID-19 pandemic on psycho-social, economic, and biological factors on depression trajectories are poorly understood. The aim of this study was to determine the association of pandemic-related social and economic risk factors with depression. This baseline survey provides a foundation for the longitudinal panel study to assess the trajectory of psychopathologies and mental health resilience as the societal recovery from this pandemic occurs. Methods: We telephonically surveyed 2000 randomly selected participants 18 years-and-older, stratified by 2 cosmopolitan cities in the high middle-income former-Soviet country of Kazakhstan. Survey-adjusted Poisson regression analyses produced probable depression (CESD-16) prevalence ratios (PRs) for COVID-19 death and disease, economic duress, and other sociopsychological factors. Results: Household suspected having-or-diagnosed with COVID-19 with prevalence ratio (PR) = 1.48 (95% CI 1.09-2.02; P = 0 013), friends/coworkers diagnosed with COVD-19 with PR = 1.43 (1.04-1.95; P = 0.026), lost employment PR = 1.80 (1.04-3.11; P = 0.037), and insufficient income for food PR = 1.54 (1.15-2.06; P = 0.004) were independently associated with depression. Having COVID-19 deaths among family/friends or acquaintances/coworkers were not associated with depression, but family stress had a dose-response association, with PR = 13.42 (7.11-25.32; P < 0.001) for very high stress. Conclusions: The study findings can inform future effective interventions and policies for protecting population mental health during and after extended periods of the pandemics.