P.737 Risk factors for depression vulnerability during the COVID-19 pandemic: findings from the Oxford COSIE (COVID-19, Social Isolation and Emotion) Study

Introduction: The mental health consequences of COVID-19 will be significant Restrictions to our everyday lives as a result of the pandemic mean that many people have experienced a constellation of psychosocial factors associated with increased risk of mental ill-health Given that many people continue to face an extended period of physical distancing and social isolation, we urgently need to identify factors associated with mental health vulnerability or resilience within the current context Developing such a mechanistic understanding is critical to the identification of targets for intervention [1] The use of neurocognitive emotional processing tasks can provide objective markers of depression vulnerability Our previous work suggests that negative bias, as measured by these tasks, precedes and predicts subsequent depression and remediation of negative bias is an early marker of treatment response [2] In this large online study, we used measures of negative bias in order to identify those most at risk, as well as identify protective factors, within this high stress context Method In April 2020, we recruited a diverse UK sample (n=2039, aged 18+) to an online longitudinal study assessing numerous risk/protective factors, self-reported depressive symptoms (CESD;Center for Epidemiological Studies Depression Scale), and performance on a neurocognitive emotional test battery This included a Facial Expression Recognition Task (FERT), in which participants must identify the expression of ambiguous positive or negative faces Four weeks later, participants repeated these questionnaires and tasks in a follow-up session (94% retention of original sample) Data were analysed using multiple linear regression analyses (controlling for gender, age, household income and race/ethnicity) in R, with t values reported for individual predictors within the model Results: At baseline, we identified risk factors independently associated with higher levels of self-reported depressive symptom cross-sectionally – these included loneliness (t=34 888, p< 0 0001), shielding (extreme form of social distancing) (t = 2 288, p = 0 022), and high vulnerability to COVID-19 (t=2 141, p=0 032) We confirmed that a diagnosis of depression is significantly associated with negative bias during the FERT (t=2 286, p =0 02);moreover, controlling for a diagnosis of depression, we identified protective factors associated with reduced negative bias including statin use (t= -2 415, p= 0 015) and high levels of behavioural activation (t=-2 607, p= 0 009) Finally, we identified baseline risk factors independently predictive of self-reported depressive symptoms at follow-up, in people without a diagnosis of depression at baseline, including negative bias (t= 3 002, p= 0 0027), loneliness (t= 25 694, p< 0 0001) and lack of access to out-door space (t=3 113, p= 0 0019) Conclusions: This study highlights core factors that are associated with increased vulnerability to depression during the COVID-19 pandemic, such as loneliness and restricted access to outside space In addition, we identified factors with a protective effect, including statin use and high levels of behavioural activation Importantly, by measuring depression vulnerability using an objective biomarker - negative bias during a facial expression recognition task – we circumvented many of the limitations of self report measures and were able to investigate the manifestation of vulnerability across time and how this can be mitigated by lifestyle and medication No conflict of interest