COVID-19 and Mental Health-What Do We Know So Far?

The coronavirus disease 2019 pandemic brought several worldwide health, social, and economic disturbances-particularly associated with the imposed confinement measures-that raised concerns about an emerging public mental health crisis. Studies investigating the early mental health impact of the pandemic on general population and vulnerable groups, such as healthcare workers, revealed a high prevalence of stress, anxiety, and depression symptoms, among others, and found several risk and protective factors. Along with these findings, the risk of substance use, suicide, domestic violence, and complicated grief may increase. We further discuss interventions that can be applied at a governmental, institutional, and individual level to minimize the mental health consequences of the pandemic, such as using telehealth to provide remote support or practicing self-care. These interventions should be maintained after the initial outbreak, as current disturbances may impact long-term well-being. We encourage the development of longitudinal studies to assess long-term adaptive responses.

A Wake-up Call for Burnout in Portuguese Physicians During the COVID-19 Outbreak: National Survey Study.

BACKGROUND: The COVID-19 outbreak has imposed physical and psychological pressure on health care professionals, including frontline physicians. Hence, evaluating the mental health status of physicians during the current pandemic is important to define future preventive guidelines among health care stakeholders. OBJECTIVE: In this study, we intended to study alterations in the mental health status of Portuguese physicians working at the frontline during the COVID-19 pandemic and potential sociodemographic factors influencing their mental health status. METHODS: A nationwide survey was conducted during May 4-25, 2020, to infer differences in mental health status (depression, anxiety, stress, and obsessive compulsive symptoms) between Portuguese physicians working at the frontline during the COVID-19 pandemic and other nonfrontline physicians. A representative sample of 420 participants stratified by age, sex, and the geographic region was analyzed (200 frontline and 220 nonfrontline participants). Moreover, we explored the influence of several sociodemographic factors on mental health variables including age, sex, living conditions, and household composition. RESULTS: Our results show that being female (ß=1.1; t=2.5; P=.01) and working at the frontline (ß=1.4; t=2.9; P=.004) are potential risk factors for stress. In contrast, having a house with green space was a potentially beneficial factor for stress (ß=-1.5; t=-2.5; P=.01) and anxiety (ß=-1.1; t=-2.4; P=.02). CONCLUSIONS: It is important to apply protective mental health measures for physicians to avoid the long-term effects of stress, such as burnout.

How Long Does Adaption Last for? An Update on the Psychological Impact of the Confinement in Portugal.

During the first COVID-19 related confinement in Portugal, there was a decrease in the levels of psychological symptoms measured by the Depression, Anxiety and Stress Scale 21 (March to April 2020). Upon experiencing a new period of restraints in 2021, the psychological impact of this sample was assessed again (N = 322, two more time points). It was expected that the psychological symptoms evidenced in February 2021 would be at similar levels to those found in April 2020, leading to a transfer of adaptation. Contrary to our hypothesis, in the second confinement in Portugal there were higher levels of depression and stress symptoms than at the beginning of the pandemic. On the other hand, the maximum level of anxiety was observed in March 2020. It seems that our perception of the threats in 2021 was not the same as at the onset of COVID-19, or that knowledge was not disseminated to the general population to increase their mental health literacy and help them cope with the imposed challenges.

Sociodemographic and lifestyle predictors of mental health adaptability during COVID-19 compulsory confinement: A longitudinal study in the Portuguese population.

BACKGROUND: The outbreak of COVID-19 and the physical isolation measures taken by the governments to reduce its propagation might have negative psychological consequences on the population. In this study, we aimed to explore, for the first time, how mental health status fluctuated along the weeks of the emergency state in Portugal, and to identify which factors may shape these changes in mental health outcomes. METHODS: To this end, we conducted an online survey to evaluate demographic, lifestyle and mental health variables (DASS-21 and quality of life) in the Portuguese population at three different time-points. 748 participants (mean age = 39.52, % females = 79.95) provided data at all time-points. RESULTS: We observed that depression, anxiety and stress symptoms seemed to improve as the weeks passed during the state of emergency, while the perception of quality of life and sleep got worse. In particular, being female, younger, actively working, and extroverted appear to be protective factors of mental health adaptability during this particular period. On the contrary, having a psychiatric diagnosis or physical illness, and higher neuroticism seem to be risk factors for mental health worsening. LIMITATIONS: The lack of a more diverse sample could limit the generalizability of our results, and other factors that were not considered in our analysis might also have a significant impact on mental health. CONCLUSIONS: Our results provide relevant and novel insights about the course of mental health changes and its predictors during the outbreak of COVID-19, which may help identify potential vulnerability groups.

Protective Elements of Mental Health Status during the COVID-19 Outbreak in the Portuguese Population.

The outbreak of COVID-19 might produce dramatic psychological effects on individuals' lives. In this study, we aimed to explore the elements that may reduce the negative effects on mental health of the quarantine period imposed by most governments during this worldwide crisis. We conducted an online survey to evaluate demographic, lifestyle and mental health variables in a sample of 1280 Portuguese individuals (79.8% females) with an average age of 37 years. We observed that factors related to living conditions, maintaining work either online or in the workplace, frequency of exercise and absence of previous psychological or physic disorders are protective features of psychological well-being (anxiety, depression, stress and obsessive-compulsive symptoms). Finally, the individuals previously receiving psychotherapeutic support exhibited better psychological indicators if they did not interrupt the process as a consequence of the outbreak. Our results indicate that the practice of physical exercise, reduced consumption of COVID-19 information and the implementation of remote mental healthcare measures might prevent larger impacts on mental health during the COVID-19 outbreak.