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Prevalence and risk factors of psychiatric symptoms and diagnoses before and during the COVID-19 pandemic: findings from the ELSA-Brasil COVID-19 mental health cohort

2021; Cambridge University Press; Linguagem: Inglês

10.1017/s0033291721001719

1469-8978

André R. Brunoni, Paulo Suen, Pedro Starzynski Bacchi, Laís B. Razza, Izio Klein, Leonardo Afonso dos Santos, Itamar S Santos, Leandro Valiengo, José Gallucci Neto, Marina Moreno, Bianca Silva Pinto, Larissa de Cássia Silva Félix, Juliana Pereira de Sousa, María Carmen Viana, Pamela Marques Forte, Marcia Cristina de Altisent Oliveira Cardoso, Márcio Sommer Bittencourt, Rebeca Pelosof, Luciana Lima de Siqueira, Daniel Fatori, Helena Bellini, Priscila Vilela Silveira Bueno, Ives Cavalcante Passos, Maria Angélica Nunes, Giovanni Abrahão Salum, Sarah Bauermeister, Jordan W. Smoller, Paulo A. Lotufo, Isabela M. Benseñor,

Mental Health Research Topics

Abstract Background There is mixed evidence on increasing rates of psychiatric disorders and symptoms during the coronavirus disease 2019 (COVID-19) pandemic in 2020. We evaluated pandemic-related psychopathology and psychiatry diagnoses and their determinants in the Brazilian Longitudinal Study of Health (ELSA-Brasil) São Paulo Research Center. Methods Between pre-pandemic ELSA-Brasil assessments in 2008–2010 (wave-1), 2012–2014 (wave-2), 2016–2018 (wave-3) and three pandemic assessments in 2020 (COVID-19 waves in May–July, July–September, and October–December), rates of common psychiatric symptoms, and depressive, anxiety, and common mental disorders (CMDs) were compared using the Clinical Interview Scheduled-Revised (CIS-R) and the Depression Anxiety Stress Scale-21 (DASS-21). Multivariable generalized linear models, adjusted by age, gender, educational level, and ethnicity identified variables associated with an elevated risk for mental disorders. Results In 2117 participants (mean age 62.3 years, 58.2% females), rates of CMDs and depressive disorders did not significantly change over time, oscillating from 23.5% to 21.1%, and 3.3% to 2.8%, respectively; whereas rate of anxiety disorders significantly decreased (2008–2010: 13.8%; 2016–2018: 9.8%; 2020: 8%). There was a decrease along three wave-COVID assessments for depression [ β = −0.37, 99.5% confidence interval (CI) −0.50 to −0.23], anxiety ( β = −0.37, 99.5% CI −0.48 to −0.26), and stress ( β = −0.48, 99.5% CI −0.64 to −0.33) symptoms (all p s < 0.001). Younger age, female sex, lower educational level, non-white ethnicity, and previous psychiatric disorders were associated with increased odds for psychiatric disorders, whereas self-evaluated good health and good quality of relationships with decreased risk. Conclusion No consistent evidence of pandemic-related worsening psychopathology in our cohort was found. Indeed, psychiatric symptoms slightly decreased along 2020. Risk factors representing socioeconomic disadvantages were associated with increased odds of psychiatric disorders.