COVID-19 pandemic: Prevalence of depression, anxiety, and stress symptoms among Brazilian psychologists.

Introduction: Symptoms related to mental health disorders became the background of the COVID-19 pandemic, and psychologists had to adapt to the demands, while they themselves were exposed to the pandemic and its stressors. Objectives: To identify demographic and professional characteristics of Brazilian psychologists in different phases of pandemic and their reported care practices, concerns, and symptoms. Methods: This was an observational study conducted online in four independent phases with no pairing among the samples (May/June 2020, n = 263; November/December 2020, n = 131; May/June 2021, n = 378; November/December 2021, n = 222). Depression, Anxiety and Stress Scale was used. The validity and reliability of the data obtained with the DASS-21 were attested to by confirmatory factor analysis. Basic lexographic and similarity analysis were conducted to obtain textual information. Prevalence of variables was estimated and compared between phases using the z-test (α = 5%). Similarity analysis was performed to identify the psychologists' concerns. Results: Most of participants were women and were self-employed or employed. There was rapid adjustment to remote work and more than 70% reported changes in their mental health since the onset of pandemic. One in four participants had a previous mental health disorder, and there was a high prevalence of symptoms such as anxiety, fear, and angst. The prevalence of professionals who reported not caring about their own mental health was significant. In 2020, one cluster (health) of concern was identified, while in 2021 there were three clusters (health, family, and COVID-19). The prevalence of depression, anxiety, and stress symptoms was high and did not change during the pandemic. Conclusions: Psychologists adapted to the demands of the population in the face of the pandemic. However, there was a high prevalence of mental health symptoms and a disregard for self-care among these professionals.

Coping Strategies and Their Relationship With Subjective Distress due to the COVID-19 Pandemic in Brazil.

OBJECTIVES: To identify the strategies used by Brazilian adults for coping with the COVID-19 pandemic and to verify the effect of these strategies on subjective distress. METHODS: This was a cross-sectional observational study with online data collection in May/June 2020, November/December 2020, and May/June 2021. The BriefCOPE Inventory and the Impact of Event Scale (IES-R) were used. The prevalence of strategies used at different time points was estimated with a 95% confidence interval and compared with a z-test. A multiple logistic regression model was constructed and the odds ratio (OR, 95%CI) was calculated to verify the probability of subjective distress according to the coping strategy used. RESULTS: Younger individuals had a lower prevalence of adaptive strategies, which increased significantly with age. Participants with higher income levels had a higher prevalence of adaptive strategies, as did those who were never diagnosed with a mental health disorder. The prevalence of using only maladaptive strategies ranged from 6.1% to 5.4% (p > 0.05). The use of problem-centered strategies (Active Coping and Planning), venting of emotions, and substance use increased with time, while acceptance and behavioral disengagement decreased. In general, the population used problem-centered strategies, but the high prevalence of problem avoidance was striking. Positive reinterpretation and acceptance were protective factors for subjective distress, whereas maladaptive strategies increased the chance of distress. The presence of a negative valence component (problem- or emotion-centered) increased the chance of subjective distress, whereas strategies based on Problem Solving acted as a protective factor. CONCLUSION: Coping strategies were significantly associated to subjective distress and have changed since the beginning of the pandemic. Strategies focused on emotion regulation may be relevant to minimize distress.

Depression, Anxiety and Stress in Health Professionals in the COVID-19 Context.

To assess the prevalence of depression, anxiety and stress symptoms in health professionals in the COVID-19 pandemic context. METHOD: Cross-sectional study with non-probabilistic (snow-ball) sampling method. The assessment was performed using the Depression, Anxiety, and Stress Scale (DASS-21) and the prevalence of symptoms severity was calculated by point and 95% confidence interval. The analysis of the psychometric properties of DASS-21 was performed using confirmatory factor analysis (CFA) and the following goodness of fit indices: χ2/df (chi-square ratio by degrees of freedom), Tucker-Lewis index (TLI), comparative fit index (CFI) and root mean square error of approximation (RMSEA) with a 90% confidence interval. RESULTS: The study participants were 529 health professionals (82.4% women and 66.7% nursing professionals). CFA of the DASS-21 structural model presented adequate fit for the sample (χ2/df = 3.530; CFI = 0.979; TLI = 0.976; RMSEA = 0.069). Regarding prevalence, moderate to extremely severe symptoms of depression, anxiety and stress were found in 48.6%, 55.0% and 47.9% of the participants, respectively. CONCLUSION: The use of DASS-21 confirmed the validity and reliability of the data. The prevalence of depression, anxiety and stress symptoms in the participants indicated a high risk of mental illness in health professionals in the COVID-19 pandemic.

The Psychological Impact of COVID-19 on Individuals With and Without Mental Health Disorders.

OBJECTIVE: To identify people with history of mental health disorders before the COVID-19 pandemic in the Brazilian population and estimate the prevalence of mood swings and the subjective distress of the pandemic among individuals with or without mental health disorders. METHODS: Through an online survey, participants were asked about presence or absence of mental health disorders. In addition, they answered the Brunel Mood Scale and the Impact of Event Scale. The mean percentile of mood swing indicators and psychological impact scores were estimated, and data were analyzed by logistic regression. RESULTS: 13,248 people participated (70.5% women, mean age 35.4 years, 31.2% with history of mental health disorder). Women and younger people were more likely to be diagnosed with mental health disorder. All participants had significant changes in mood due to the pandemic. Anger, depressed mood, mental confusion, and fatigue were higher among individuals with bipolar disorder or with combined disorders. Individuals with mental health disorders had a greater subjective distress, especially the group with bipolar disorder (OR = 4.89 [3.64-6.56]) and combined disorders (OR = 6.89 [5.21-9.10]). CONCLUSION: Individuals previously diagnosed with mental health disorders at some point in life are more vulnerable to psychological impact from the pandemic.

Emotions and mood swings of pharmacy students in the context of the coronavirus disease of 2019 pandemic.

INTRODUCTION: The coronavirus disease of 2019 pandemic has changed university routines affecting student mental health. The aims of this study were to survey aspects related to mental health of pharmaceutical course students considering previous and current contexts. METHODS: The Depression, Anxiety, and Stress Scale (DASS-21), Impact of Event Scale-Revised, and Brunel Mood Scale were used. DASS-21 was completed pre- and post-pandemic. The validity and reliability of the data were verified. The prevalence (95% CI) of mental health symptoms was estimated. The relationship between the time spent watching/reading the news and mean scales scores was evaluated (Pearson's correlation coefficient). RESULTS: The prevalence of depression symptoms in students pre-pandemic was 66.7% (95% CI = 65.3-68.1) and during the pandemic was 81% (95% CI = 79.8-82.2). More than 70% (95% CI = 69.8-72.6) of participants had some psychological impact as a result of the pandemic (mild: 16.7% [95% CI = 15.6-17.8]; moderate: 9.1% [95% CI = 8.2-10]; severe: 45.4% [95% CI = 43.9-46.9]). High values of tension, depressed mood, mental confusion, and anger were observed. There was a significant correlation between the time spent following the news of the pandemic and symptoms of anxiety (r = 0.356; P < .001), stress (r = 0.248; P = .014), hyperarousal (r = 0.322; P ≤ 0.001), and intrusion (r = 0.21; P = .039). CONCLUSIONS: Students are highly vulnerable to depressive symptoms and mood swings due to the pandemic. These findings deserve consideration mainly from mental health professionals, but also from managers and educators.

Symptoms related to mental disorder in healthcare workers during the COVID-19 pandemic in Brazil.

BACKGROUND: Studies of previous pandemics indicate that healthcare workers have a high risk of developing symptoms related to mental health, especially depression, anxiety, and stress. OBJECTIVE: To identify mental disorder symptoms among Brazilian healthcare workers during the Sars-Cov-2 pandemic and compare findings in different work categories. METHODS: This was an online cross-sectional study. Information related to the pandemic and mental disorder symptoms was collected. The Depression, Anxiety, and Stress Scale and the Impact of Event Scale-revised were used. Associations were estimated by the chi-square test. The mean scores were compared among work categories with ANOVA (α = 5%) and the prevalence of symptoms was estimated. RESULTS: 1,609 healthcare workers participated in the survey [mean age: 36.9 (SD = 11.6) years, women = 83.6%]. There was no association between work category and changes in mental health during the pandemic (p = 0.288) or prevalence of unsafe feeling (p = 0.218). A significant relationship was observed between maintaining work activities during the pandemic and work category (p < 0.001). Physicians had the lowest out-of-work prevalence (9.5%) while dentists had the highest (32.3%). Physicians and nurses showed the highest prevalence of in-person work routine. Psychologists presented the highest prevalence of remote work (64.0%) while dentists had the lowest (20.2%). A high prevalence of depression (D), anxiety (A), and stress (S) symptoms was observed in all professional categories (D: 57.2, 95% CI 48.3-66.1%; A: 46.20%, 95% CI = 37.2-55.2%; S: 55.80%, 95% CI = 46.8-64.8%), with physicians (D = 38.4%, A = 25.80%, S = 37.90%), psychologists (D = 50.2%, A = 39.0%, S = 43.1%), and nurses (D = 50.0%, A = 40.9%, S = 49.0%) having significantly lower scores. Psychologists had the lowest pandemic-related psychological impact (42.70%, 95% CI 36.8-48.6%). CONCLUSION: Extreme changes in the work routine of dentists and psychologists and an overall high prevalence of mental symptoms due to the pandemic were found. Researchers should focus on gathering information that can identify workers at increased risk of mental illness to guide discussions and develop actions to minimize the harm of the pandemic. In addition, we suggest that healthcare and support systems urgently adopt mental health care measures with specialized professionals to protect the psychological well-being of the healthcare community.

Early Psychological Impact of the COVID-19 Pandemic in Brazil: A National Survey.

BACKGROUND: Isolation measures used to contain epidemics generate social interaction restrictions and impose changes in routines of the public that increase negative psychological outcomes. Anxiety and depression are the most common symptoms. OBJECTIVE: To evaluate the mental health of the Brazilian population during the SARs-CoV-2 pandemic and its relationship with demographic and health characteristics. METHODS: Adults from all Brazilian States participated (n = 12,196; women: 69.8%, mean age = 35.2 years). The Depression, Anxiety and Stress Scale, and the Impact of Event Scale-revised were used (online survey). Data validity and reliability were verified by confirmatory factor analysis and ordinal alpha coefficient. The probability of presenting psychological symptoms was calculated by multiple logistic regression and odds ratio (OR) (0 = without symptoms, 1 = with mild, moderate, and severe levels of symptoms). RESULTS: High prevalence of depression (61.3%), anxiety (44.2%), stress (50.8%), and psychological impact (54.9%) due to the isolation experienced from the pandemic was found. Younger individuals (OR = 1.58-3.58), those that felt unsafe (OR = 1.75-2.92), with a previous diagnosis of mental health (OR = 1.72-2.64) and/or had general health problems before the pandemic (OR = 1.17-1.51), who noticed changes in their mental state due to the pandemic context (OR = 2.53-9.07), and excessively exposed to the news (OR = 1.19-2.18) were at increased risk of developing symptoms. Women (OR = 1.35-1.65) and those with lower economic status (OR = 1.38-2.69) were more likely to develop psychological symptoms. Lower educational levels increased the likelihood of depressive (OR = 1.03-1.34) and intrusive symptoms (OR = 1.09-1.51). Conclusions: The pandemic and related factors can have a high impact on the mental health of the population. Demographic characteristics can influence the occurrence of psychological symptoms.