Factors associated with comorbidity for depression, anxiety, and stress screening in a sample of a Brazilian university’s community during Covid-19 pandemic
Keywords:Anxiety; Comorbidity; Depression; Covid-19 pandemic; Stress.
Backgrouund: Mental health is a major public health challenge wordwide and affected people may present more than one mental outcomes simultaneosly. Purpose: To describe the prevalence of comorbidity in screening for depression, anxiety, and stress, as well as determinants of these comorbidity in a university’s community in Mid-West Brazil during the Covid-19. Methods: A cross-sectional descriptive/exploratory study used self-report DASS-21 to screen for mental health. Data from a non-probabilistic sample was obtained online between April 10 and May 25, 2020. Multinomial model was used to identify factors associated with comorbidity. Results: The majority of the sample was students (78.84%), women (65.53%), white (54.18%), single (71.33%), aged 18-29 years old (67.26%), with an overall mean age of 28.3 years (sd = 10.1), 85.63% refered household internet access. 14.48%, 12.42%, and 31.12% screened positive for one, two and all the 3 outcomes, respectively. Students, having children, substance use, presenting Covid-19’s symptoms, worsened self-rated emotional state, and previous mental disorders were associated with comorbidity for depression, anxiety, and stress. Conclusions: Individuals from the studied university’s community experienced psychological disorders, as measured by levels of anxiety, depression, and stress and comorbidity for these outcomes, probably as Covid-19’s initial psychological impact.
Ahmed, Z., Ahmed, O., Aibao, Z., Hanbin, S., Siyu, L., & Ahmad, A. (2020). Epidemic of COVID-19 in China and associated Psychological Problems. Asian Journal of Psychiatry, 51, 102092. https://doi.org/10.1016/j.ajp.2020.102092
Alsolais, A., Alquwez, N., Alotaibi, K. A., Alqarni, A. S., Almalki, M., Alsolami, F., Almazan, J., & Cruz, J. P. (2021). Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic. Journal of Mental Health, 30(2), 194–201. https://doi.org/10.1080/09638237.2021.1922636
Anker, J. J., & Kushner, M. G. (2019). Co-occurring alcohol use disorder and anxiety. Alcohol Research: Current Reviews, 40(1), e03. https://doi.org/https://doi.org/10.35946/arcr.v40.1.03
Anthenelli, R. M. (2012). Overview: Stress and alcohol use disorders revisited. Alcohol Research: Current Reviews, 34(4), 386–390.
Brooks, S. K., Webster, R K, Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395, 912–920. https://doi.org/10.1016/ S0140-6736(20)30460-8
Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934. https://doi.org/10.1016/j.psychres.2020.112934
De Boni, R. B., Balanzá-Martínez, V., Mota, J. C., de Azevedo Cardoso, T., Ballester, P., Atienza-Carbonell, B., Bastos, F. I., & Kapczinski, F. (2020). Depression, Anxiety, and Lifestyle among Essential Workers: A Web Survey from Brazil and Spain during the COVID-19 Pandemic. Journal of Medical Internet Research, 22(10), e22835. https://doi.org/10.2196/22835
Du, J., Dong, L., Wang, T., Yuan, C., Fu, R., Zhang, L., Liu, B., Zhang, M., Yin, Y., Qin, J., Bouey, J., Zhao, M., & Li, X. (2020). Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. General Hospital Psychiatry, 67, 144–145. https://doi.org/10.1016/j.genhosppsych.2020.03.011
Elbogen, E. B., Lanier, M., Blakey, S. M., Wagner, H. R., & Tsai, J. (2021). Suicidal ideation and thoughts of self-harm during the COVID-19 pandemic: The role of COVID-19-related stress, social isolation, and financial strain. Depression and Anxiety, 38, 739–748. https://doi.org/10.1002/da.23162
Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., Wang, Y., Fu, H., & Dai, J. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE, 15(4), e0231924. https://doi.org/10.1371/journal.pone.0231924
Gorrochategi, M. P., Munitis, A. E., Santamaria, M. D., & Etxebarria, N. O. (2020). Stress, Anxiety, and Depression in People Aged Over 60 in the COVID-19 Outbreak in a Sample Collected in Northern Spain. American Journal of Geriatric Psychiatry, 28(9), 993–998. https://doi.org/10.1016/j.jagp.2020.05.022
Hyland, P., Shevlin, M., McBride, O., Murphy, J., Karatzias, T., Bentall, R. P., Martinez, A., & Vallières, F. (2020). Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic. Acta Psychiatrica Scandinavica, 142(3), 249–256. https://doi.org/10.1111/acps.13219
Keyes, K. M., Hatzenbuehler, M. L., Grant, B. F., & Hasin, D. S. (2012). Stress and alcohol epidemiologic evidence. Alcohol Research: Current Reviews, 34(4), 391–400.
Kim, H., Rackoff, G. N., Fitzsimmons-Craft, E. E., Shin, K. E., Zainal, N. H., Schwob, J. T., Eisenberg, D., Wilfley, D. E., Taylor, C. B., & Newman, M. G. (2021). College Mental Health Before and During the COVID-19 Pandemic: Results From a Nationwide Survey. Cognitive Therapy and Research, 1-10. https://doi.org/10.1007/s10608-021-10241-5
Kursa, M. B., Jankowski, A., & Rudnicki, W. R. (2010). Boruta - A system for feature selection. Fundamenta Informaticae, 101, 271–285. https://doi.org/10.3233/FI-2010-288
Lees, B., Meredith, L. R., Kirkland, A. E., Bryant, B. E., & Squeglia, L. M. (2020). Effect of alcohol use on the adolescent brain and behavior. Pharmacology Biochemistry and Behavior, 192, 172906. https://doi.org/10.1016/j.pbb.2020.172906
Leong Bin Abdullah, M. F. I., Ahmad Yusof, H., Mohd Shariff, N., Hami, R., Nisman, N. F., & Law, K. S. (2021). Depression and anxiety in the Malaysian urban population and their association with demographic characteristics, quality of life, and the emergence of the COVID-19 pandemic. Current Psychology, 1–12. https://doi.org/10.1007/s12144-021-01492-2
Li, G., Miao, J., Wang, H., Xu, S., Sun, W., Fan, Y., Zhang, C., Zhu, S., Zhu, Z., & Wang, W. (2020). Psychological impact on women health workers involved in COVID-19 outbreak in Wuhan: A cross-sectional study. Journal of Neurology, Neurosurgery and Psychiatry, 91(8), 895–897. https://doi.org/10.1136/jnnp-2020-323134
Ma, Z., Zhao, J., Li, Y., Chen, D., Wang, T., Zhang, Z., Chen, Z., Yu, Q., Jiang, J., Fan, F., & Liu, X. (2020). Mental health problems and correlates among 746 217 college students during the coronavirus disease 2019 outbreak in China. Epidemiology and Psychiatric Sciences, 29, e181. https://doi.org/10.1017/S2045796020000931
Mamun, M. A., Sakib, N., Gozal, D., Bhuiyan, A. I., Hossain, S., Bodrud-Doza, M., Mamun, F. Al, & Hosen, I. (2021). The COVID-19 pandemic and serious psychological consequences in Bangladesh: A population-based nationwide study. Journal of Affective Disorders, 279, 462–472. https://doi.org/10.1016/j.jad.2020.10.036
Marijanović, I., Kraljević, M., Buhovac, T., Cerić, T., Abazović, A. M., Alidžanović, J., Gojković, Z., & Sokolović, E. (2021). Use of the depression, anxiety and stress scale (DASS-21) questionnaire to assess levels of depression, anxiety, and stress in healthcare and administrative staff in 5 oncology institutions in Bosnia and Herzegovina during the 2020 COVID-19 pandemic. Medical Science Monitor, 27, e930812. https://doi.org/10.12659/MSM.930812
Mazza, C., Ricci, E., Biondi, S., Colasanti, M., Ferracuti, S., Napoli, C., & Roma, P. (2020). A nationwide survey of psychological distress among italian people during the covid-19 pandemic: Immediate psychological responses and associated factors. International Journal of Environmental Research and Public Health, 17(9):3165. https://doi.org/10.3390/ijerph17093165
Mishra, J., Samanta, P., Panigrahi, A., Dash, K., Behera, M. R., & Das, R. (2021). Mental Health Status, Coping Strategies During Covid-19 Pandemic Among Undergraduate Students of Healthcare Profession. International Journal of Mental Health and Addiction, 0123456789. https://doi.org/10.1007/s11469-021-00611-1
Moghanibashi-Mansourieh, A. (2020). Assessing the anxiety level of Iranian general population during COVID-19 outbreak. Asian Journal of Psychiatry, 51, 102076. https://doi.org/10.1016/j.ajp.2020.102076
Mosheva, M., Gross, R., Hertz-Palmor, N., Hasson-Ohayon, I., Kaplan, R., Cleper, R., Kreiss, Y., Gothelf, D., & Pessach, I. M. (2021). The association between witnessing patient death and mental health outcomes in frontline COVID-19 healthcare workers. Depression and Anxiety, 38(4), 468–479. https://doi.org/10.1002/da.23140
Natalia, D., & Syakurah, R. A. (2021). Mental health state in medical students during COVID-19 pandemic. Journal of Education and Health Promotion, 10(208). https://doi.org/10.4103/jehp.jehp
Ozamiz-Etxebarria, N., Dosil-Santamaria, M., Picaza-Gorrochategui, M., & Idoiaga-Mondragon, N. (2020). Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cadernos de Saude Publica, 36(4), e00054020. https://doi.org/10.1590/0102-311X00054020
Özdin, S., & Bayrak Özdin, Ş. (2020). Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. International Journal of Social Psychiatry, 66(5), 504–511. https://doi.org/10.1177/0020764020927051
Ruengorn, C., Awiphan, R., Wongpakaran, N., Wongpakaran, T., & Nochaiwong, S. (2021). Association of job loss, income loss, and financial burden with adverse mental health outcomes during coronavirus disease 2019 pandemic in Thailand: A nationwide cross-sectional study. Depression and Anxiety, 38(6), 648–660. https://doi.org/10.1002/da.23155
Shi, L., Lu, Z.-A., Que, J.-Y., Huang, X.-L., Liu, L., Ran, M.-S., Gong, Y.-M., Yuan, K., Yan, W., Sun, Y.-K., Shi, J., Bao, Y.-P., & Lu, L. (2020). Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic. AMA Network Open, 3(7), e2014053. https://doi.org/10.1001/jamanetworkopen.2020.14053
Silva, M., Resurrección, D. M., Antunes, A., Frasquilho, D., & Cardoso, G. (2018). Impact of economic crises on mental health care: A systematic review. Epidemiology and Psychiatric Sciences, 29, e7. https://doi.org/10.1017/S2045796018000641
Sinha, R. (2012). How does stress lead to risk of alcohol relapse? Alcohol Research: Current Reviews, 34(4), 432–440.
Thombs, B. D., Kwakkenbos, L., Levis, A. W., & Benedetti, A. (2018). Addressing overestimation of the prevalence of depression based on self-report screening questionnaires. CMAJ: Canadian Medical Association Journal, 190(2), E44–E49. https://doi.org/10.1503/cmaj.170691
Verma, S., & Mishra, A. (2020). Depression, anxiety, and stress and socio-demographic correlates among general Indian public during COVID-19. International Journal of Social Psychiatry, 66(8), 756–762. https://doi.org/10.1177/0020764020934508
Vignola, R. C. B., & Tucci, A. M. (2014). Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders, 155(1), 104–109. https://doi.org/10.1016/j.jad.2013.10.031
Vindegaard, N., & Benros, M. E. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity, 89, 531–542. https://doi.org/10.1016/j.bbi.2020.05.048
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. https://doi.org/doi:10.3390/ijerph17051729
Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M. W., Gill, H., & Phan, L. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Elsevier Connect, 277, 55–64. https://doi.org/10.1016/j.jad.2020.08.001
Zhao, Y., Jin, Y., Rao, W., Li, W., & Zhao, N. (2021). The prevalence of psychiatric comorbidities during the SARS and COVID-19 epidemics: a systematic review and meta-analysis of observational studies. Journal of Affective Disorders, 287, 145–157. https://doi.org/10.1016/j.jad.2021.03.016
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