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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Brunoni, Andre Russowsky ; Chian Suen, Paulo Jeng ; Bacchi, Pedro Starzynski ; Razza, Lais Boralli ; Klein, Izio ; dos Santos, Leonardo Afonso ; Santos, Itamar de Souza ; Lane Valiengo, Leandro da Costa ; Gallucci-Neto, Jose ; Moreno, Marina Lopes ; Pinto, Bianca Silva ; Silva Felix, Larissa de Cassia ; 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 ; Silveira Bueno, Priscila Vilela ; Passos, Ives Cavalcante ; Nunes, Maria Angelica ; Salum, Giovanni Abrahao ; Bauermeister, Sarah ; Smoller, Jordan W. ; Lotufo, Paulo Andrade ; Bensenor, Isabela Martins

• Document type: Journal article
• Source: PSYCHOLOGICAL MEDICINE; v. 53, n. 2, p. 12-pg., 2021-04-21.

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) Sao 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 [beta = -0.37, 99.5% confidence interval (CI) -0.50 to -0.23], anxiety (beta = -0.37, 99.5% CI -0.48 to -0.26), and stress (beta = -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. (AU)

• FAPESP's process: 20/05441-9 - Mental health impact on the novel Coronavirus (COVID-19) in São Paulo State participants of the Brazilian longitudinal health study (ELSA-Brasil)
• Grantee: Isabela Judith Martins Bensenor
• Support Opportunities: Regular Research Grants