P.0266 The mental health response to the first wave of covid-19 in an international sample

Background: Multinational studies have recently reported significantly higher rates of anxiety and depression seen in the general population, compared to pre-COVID-19-pandemic levels.[1] Younger age cohorts and female sex have emerged as predictors for worse mental health (MH) and there is also evidence to suggest that the MH burden on healthcare practitioners (HCPs) is a significant cost of the pandemic.[2,3] Negative psychological consequences for HCPs have been highlighted in previous epidemics and pandemics including Severe Acute Respiratory Syndrome[SARS], SARS-CoV, SARS-CoV-2, H1N1, Middle East Respiratory Syndrome [MERS] and Ebola. This study aims to examine and compare the impact of COVID-19 on the MH of an international cohort from Canada, the United States of America (US), Brazil and Italy. Given that very few studies have reported this information thus far, we focused our analysis on the MH of HCPs within these countries. Methods: Adults aged 18 and over completed an online survey posted at anxiety treatment centre websites in Canada, USA, Brazil and Italy from April 8th - June 11th, 2020. The survey included questions regarding COVID-19 experience, perceived impact of the pandemic on life domains (e.g., social communication, finances), coping strategies (e.g., online activities, substance use), and MH treatment history. Current psychiatric symptom severity and impairment were evaluated using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, the Perceived Stress Scale, the Obsessive Compulsive Inventory-Revised (OCI-R), the PTSD Checklist (PCL-5) and the Quality of Life Enjoyment and Satisfaction Questionnaire. Results: Overall, 1315 individuals (74% female, mean age:42.9+16.4) in Canada (n=443), the USA (n=203), Brazil (n=517) and Italy (n=152) completed the survey. Nearly 26% met diagnostic thresholds for GAD and MDD. Compared to the other countries, fewer Italians met DSM-5 screening criteria for GAD (<0.001) or depression, (p<0.05). In addition, quality of life satisfaction scores were significantly lower in Italy and Brazil when compared to North America, (p<0.001), indicating lower satisfaction. Non-HCPs (vs. HCPs) reported significantly higher scores (p≤0.005) on all MH scales with the exception of the GAD-7, even after adjusting for age, sex, past MH treatment and country. Non-HCPs also reported lower quality of life. Amongst the HCPs, Canadian HCPs reported the highest rates of anxiety, depression, stress and PTSD compared to Canadian non-HCPs and to HCPs in the other countries. Higher proportions of Canadian HCPs also reported decreases in sleep, increases in eating and more time spent watching the news as well as lower levels of perceived emotional support compared to Canadian non-HCPs Conclusion: Despite key infrastructural and COVID-19 mortality differences between the countries, the MH effects appeared to be quite similar within the general populations. HCP status was associated with lower levels of stress, anxiety, depression and related symptoms, with the exception of Canada. Canadian HCPs reported higher symptom severity scores than HCPs from the remaining countries. Therefore, with the exception of Canada, HCPs reported less impact on their mental health compared to the general population, in response to the COVID-19 pandemic, potentially suggesting resilience in the face of adversity. No conflict of interest