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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
- André Russowsky Brunoni, Paulo Jeng Chian Suen, Pedro Starzynski Bacchi, Lais Boralli Razza, Izio Klein, Leonardo Afonso dos Santos, Itamar de Souza Santos, Leandro da Costa Lane Valiengo, José Gallucci-Neto, Marina Lopes Moreno, Bianca Silva Pinto, Larissa de Cássia Silva Félix, Juliana Pereira de Sousa, Maria Carmen Viana, Pamela Marques Forte, Marcia Cristina de Altisent Oliveira Cardoso, Marcio Sommer Bittencourt, Rebeca Pelosof, Luciana Lima de Siqueira, Daniel Fatori, Helena Bellini, Priscila Vilela Silveira Bueno, Ives Cavalcante Passos, Maria Angelica Nunes, Giovanni Abrahão Salum, Sarah Bauermeister, Jordan W. Smoller, Paulo Andrade Lotufo, Isabela Martins Benseñor
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- Journal:
- Psychological Medicine / Volume 53 / Issue 2 / January 2023
- Published online by Cambridge University Press:
- 21 April 2021, pp. 446-457
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- Article
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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.
MethodsBetween 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.
ResultsIn 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 ps < 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.
ConclusionNo 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.