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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

Published online by Cambridge University Press:  21 April 2021

André Russowsky Brunoni
Affiliation:
Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Paulo Jeng Chian Suen
Affiliation:
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Pedro Starzynski Bacchi
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Lais Boralli Razza
Affiliation:
Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Izio Klein
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Leonardo Afonso dos Santos
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Itamar de Souza Santos
Affiliation:
Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Leandro da Costa Lane Valiengo
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
José Gallucci-Neto
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Marina Lopes Moreno
Affiliation:
Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Bianca Silva Pinto
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Larissa de Cássia Silva Félix
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Juliana Pereira de Sousa
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Maria Carmen Viana
Affiliation:
Department of Social Medicine, Postgraduate Program in Public Health, Center of Psychiatric Epidemiology (CEPEP), Federal University of Espírito Santo, Vitória, Brazil
Pamela Marques Forte
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Marcia Cristina de Altisent Oliveira Cardoso
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Marcio Sommer Bittencourt
Affiliation:
Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Rebeca Pelosof
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Luciana Lima de Siqueira
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Daniel Fatori
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Helena Bellini
Affiliation:
Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Priscila Vilela Silveira Bueno
Affiliation:
Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Ives Cavalcante Passos
Affiliation:
Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Maria Angelica Nunes
Affiliation:
Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Giovanni Abrahão Salum
Affiliation:
Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
Sarah Bauermeister
Affiliation:
Department of Psychiatry, University of Oxford, Oxford, UK
Jordan W. Smoller
Affiliation:
Department of Psychiatry, Harvard Medical School & Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
Paulo Andrade Lotufo
Affiliation:
Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Isabela Martins Benseñor
Affiliation:
Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil Departamento e Instituto de Psiquiatria & Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Corresponding
E-mail address:

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 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.

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.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

The three authors contributed equally to the current study.

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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
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