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

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)...

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Published in:	Psychological medicine Vol. 53; no. 2; p. 446
Main Authors:	Brunoni, André Russowsky, Suen, Paulo Jeng Chian, Bacchi, Pedro Starzynski, Razza, Lais Boralli, Klein, Izio, Dos Santos, Leonardo Afonso, de Souza Santos, Itamar, da Costa Lane Valiengo, Leandro, Gallucci-Neto, José, Moreno, Marina Lopes, Pinto, Bianca Silva, de Cássia Silva Félix, Larissa, de Sousa, Juliana Pereira, Viana, Maria Carmen, Forte, Pamela Marques, de Altisent Oliveira Cardoso, Marcia Cristina, Bittencourt, Marcio Sommer, Pelosof, Rebeca, de Siqueira, Luciana Lima, Fatori, Daniel, Bellini, Helena, Bueno, Priscila Vilela Silveira, Passos, Ives Cavalcante, Nunes, Maria Angelica, Salum, Giovanni Abrahão, Bauermeister, Sarah, Smoller, Jordan W, Lotufo, Paulo Andrade, Benseñor, Isabela Martins
Format:	Journal Article
Language:	English
Published:	England 01-01-2023
Subjects:	Anxiety - epidemiology Anxiety - psychology Brazil - epidemiology COVID-19 - epidemiology Depression - epidemiology Depression - psychology Female Humans Longitudinal Studies Male Mental Disorders - epidemiology Mental Disorders - psychology Mental Health Middle Aged Pandemics Prevalence Risk Factors Brazil COVID-19 Anxiety cohort study depression pandemic mental health
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Summary:	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. 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. 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 [ = -0.37, 99.5% confidence interval (CI) -0.50 to -0.23], anxiety ( = -0.37, 99.5% CI -0.48 to -0.26), and stress ( = -0.48, 99.5% CI -0.64 to -0.33) symptoms (all 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. 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.
ISSN:	1469-8978
DOI:	10.1017/S0033291721001719