Fear of Covid-19, anxiety, and depression during the pandemic: A network analysis

Introduction: Covid-19 has generated several psychological impacts on people's lives and brought new challenges for dealing with the pandemic's repercussions. Objective: The objective was to analyse the relationship between the symptoms of fear of Covid-19, anxiety, and depression using different samples extracted at three distinct time-points. This study performed a network analysis of the fear of Covid-19 and anxiety- and depression -related symptoms based on data collected during the Covid-19 pandemic. Method: Three yearly cross-sectional surveys were conducted based on independent samples (2020-2022) of Brazilian adults (Time-point 1, Time-point 2, and Time-point 3 with 1,520, 1,523, and 1,517 participants, respectively). The Fear of Covid-19 Scale, the Generalised Anxiety Disorder Scale (7 items), and the Patient Health Questionnaire (9 items) were applied. The network structure invariance, the global strength invariance, and the strength of centrality index between the samples were compared. Results: Items from the three instruments had high values (>70%) in all samples (excluding the fear of Covid-19 at Time-point 3). Depression and anxiety symptoms increased, while fear-related behaviours decreased. Network analysis indicates that networks became progressively more parsimonious, and few edges connected different scales. Network comparisons revealed similar structures, but key differences were found: Time-point 1 showed significantly higher global connectivity, and changes in edge weights were observed only within the scales. Conclusions: Our findings suggest that the pandemic had a greater disorganising impact at its beginning, with a continuous increase in the mental health symptomatology and a reduction in the ratio between fear and anxiety and/or depression.

Introducción: El COVID-19 generó varios impactos psicológicos en la vida de las personas imponiendo nuevos desafíos para confrontar la pandemia. Objetivo: Analizar la relación entre los síntomas de miedo al COVID-19, ansiedad y depresión utilizando diferentes muestras extraídas durante tres períodos de tiempo distintos. Fueron analizadas redes del miedo y los síntomas de ansiedad y depresión usando datos recolectados durante la pandemia de COVID-19. Método: Tres encuestas transversales anuales basadas en muestras independientes (2020-2022) de adultos brasileños (punto temporal 1, punto temporal 2 y punto temporal 3 con 1520, 1523 y 1517 participantes, respectivamente). Se aplicaron la Escala de Miedo al COVID-19, la Escala de Trastorno de Ansiedad Generalizada (7 ítems) y el Cuestionario de Salud del Paciente (9 ítems). Se compararon la invariancia de la estructura de la red, la invariancia de la fuerza global y la fuerza del índice de centralidad entre los tres puntos temporales. Resultados: Los ítems de los tres instrumentos tuvieron valores altos (> 70 %) en todos los puntos temporales (excluyendo el miedo al COVID-19 en el punto temporal 3). A lo largo de los tres puntos temporales, los síntomas de depresión y ansiedad aumentaron, mientras que el miedo disminuyó. Las redes se volvieron progresivamente más parsimoniosas y pocas aristas conectaron diferentes escalas, con estructuras similares. Conclusiones: La pandemia tuvo un mayor impacto desorganizador en su inicio, con un aumento continuo de la sintomatología de salud mental y una disminución de la relación entre miedo y ansiedad o depresión.

Intolerance of uncertainty and mental health in Brazil during the Covid-19 pandemic / Intolerância a incerteza e saúde mental no Brasil durante a pandemia de Covid-19

Abstract The first Brazilian diagnosed with COVID-19 was identified on February 25th, resulting in a series of governmental actions to prepare the population for the effects of the pandemic. Nevertheless, geographic and socioeconomic characteristics of the country, and the strategies adopted may have contributed to generating a widespread feeling of uncertainty in the population; uncertainty about the disease, how to prevent it, its severity, and its impact on political and economic issues. This study was designed to investigate the relationship between intolerance of uncertainty and common mental health disorders. Participants were contacted via social media messages and encouraged to fill out an online questionnaire with socioeconomic questions, a short measure of intolerance of uncertainty (IUS-12), and a measure of mental health indicator (DASS-21). With a sample of 924 participants from Sergipe, Brazil, three binomial logistic regressions were performed, one for each DASS-21 outcome, categorized by a median. The women in the sample showed a higher probability of having stress, anxiety and depression scores above the median. Over the entire sample, both subscales of IUS-12 were significantly and positively related to all three DASS-21 subscales. These findings are discussed in the context of mental health during a pandemic, and future directions for research are also presented.

Resumo O primeiro brasileiro diagnosticado com COVID-19 foi identificado dia 25 de fevereiro, resultando em uma série de ações governamentais para preparar a população para os efeitos da pandemia. No entanto, características geográficas e socioeconômicas do país, e as estratégias adotadas, podem ter contribuído para a criação de uma sensação generalizada de incerteza na população; incerteza a respeito da doença, como preveni-la, sua gravidade, e seu impacto em questões políticas e econômicas. Este estudo foi elaborado para investigar a relação entre Intolerância à Incerteza e transtornos mentais comuns. Os participantes foram contactados por mensagens em redes sociais e convidados a preencher um questionário online com questões socioeconômicas, um instrumento breve de Intolerância a Incerteza (IUS-12) e um indicador de saúde mental (DASS-12). Com uma amostra de 924 participantes de Sergipe, Brasil, três regressões logísticas binomiais foram realizadas, uma para cada desfecho do DASS21, categorizados pela mediana. As mulheres da amostra apresentaram maior probabilidade de escores estresse, ansiedade e depressão acima da mediana. Em toda a amostra, ambas subescalas da IUS-12 foram significativa e positivamente relacionadas às três subescalas da DASS-12. Estes achados são discutidos no contexto de saúde mental durante uma pandemia, e futuras direções de pesquisa também são apresentadas.