Evaluation of Depression, Anxiety and Sleep Quality in the Brazilian Population During Social Isolation Due to the New Coronavirus (SARS-CoV-2) pandemic: the DEGAS-CoV Study/ Avaliação da Depressão, Ansiedade e Qualidade do Sono na População Brasileira Durante o Isolamento Social Devido à Nova Pandemia do Coronavírus (SARS-CoV-2): o Estudo DEGAS-CoV
Keywords:Anxiety, Brazil, COVID-19, Depression, Sleep Disorders.
Introduction: The new coronavirus infection (COVID-19) has caused distress and repercussions in mental and physical health of individuals. Depression, anxiety and worsening of sleep quality have been reported in several recent articles that surveyed populations all over the globe. Our work meant to access, through a cross-sectional study, these disorders in the Brazilian population, through the application of an online questionnaire conducted on the second trimester of 2020. Materials and Methods: We applied an online questionnaire, filled with questions regarding social, economic, financial, educational and health status, as well as questions from the Hospital Anxiety and Depression Scale (HAD), and from the Pittsburgh Sleep Quality Index (PSQI).Results: We collected 2,695 valid answers, from April 24th to May 31st, 2020. Age ranged from 18 to 79 years, mean of 31.3. Women were 76.3%, men 23.7%. Symptoms of Anxiety were found in 56.5%, of depression in 46.1%, and of bad sleep in 49.2%. Some groups were more prone than others to one or more of those conditions, such as: younger people, women, mestizos, people with lesser years of education, of lower income or whose income dropped significantly during the pandemic, caregivers, students, sedentary or people practicing less physical activity, people who followed more hours of news of COVID-19 and those less engaged in social and instrumental activities.Conclusion: anxiety, depression and bad sleep quality were significantly high in our survey. Mental and sleep health is heterogeneously affected among individuals, depending on social, economic, financial, educational and health status.
Zhu, N. et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N. Engl. J. Med. 382, 727–733 (2020).
Coronavirus disease (COVID-19) – World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
Xu, S. & Li, Y. Beware of the second wave of COVID-19. The Lancet 395, 1321–1322 (2020).
Rubin, G. J. & Wessely, S. The psychological effects of quarantining a city. BMJ 368, (2020).
Coughlin, S. S. Anxiety and Depression: Linkages with Viral Diseases. Public Health Rev. 34, 7 (2012).
Liao, Q., Cowling, B. J., Lam, W. W., Ng, D. M. & Fielding, R. Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys. BMC Infect. Dis. 14, (2014).
Rogers, J. P. et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 7, 611–627 (2020).
Huang, Y. & Zhao, N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 288, 112954 (2020).
Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. Cad Saúde Pública 36, 1–9 (2020).
?ahin, M. K., Aker, S., ?ahin, G. & Karabekiro?lu, A. Prevalence of Depression, Anxiety, Distress and Insomnia and Related Factors in Healthcare Workers During COVID-19 Pandemic in Turkey. J. Community Health 45, 1168–1177 (2020).
Blbas, H. T. A., Aziz, K. F., Nejad, S. H. & Barzinjy, A. A. Phenomenon of depression and anxiety related to precautions for prevention among population during the outbreak of COVID-19 in Kurdistan Region of Iraq: based on questionnaire survey. Z. Gesundheitswissenschaften 1–5 (2020) doi:10.1007/s10389-020-01325-9.
Shevlin, M. et al. COVID-19-related anxiety predicts somatic symptoms in the UK population. Br. J. Health Psychol. 25, 875–882 (2020).
Agberotimi, S. F., Akinsola, O. S., Oguntayo, R. & Olaseni, A. O. Interactions Between Socioeconomic Status and Mental Health Outcomes in the Nigerian Context Amid COVID-19 Pandemic: A Comparative Study. Front. Psychol. 11, (2020).
Public responses to the novel 2019 coronavirus (2019?nCoV) in Japan: Mental health consequences and target populations - Shigemura - 2020 - Psychiatry and Clinical Neurosciences - Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12988.
Qiu, J. et al. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen. Psychiatry 33, e100213 (2020).
Wang, C. et al. The Association Between Physical and Mental Health and Face Mask Use During the COVID-19 Pandemic: A Comparison of Two Countries With Different Views and Practices. Front. Psychiatry 11, 901 (2020).
Jahanshahi, A. A., Dinani, M. M., Madavani, A. N., Li, J. & Zhang, S. X. The distress of Iranian adults during the Covid-19 pandemic - More distressed than the Chinese and with different predictors. Brain. Behav. Immun. 87, 124–125 (2020).
Naderifar, M., Goli, H. & Ghaljaei, F. Snowball Sampling: A Purposeful Method of Sampling in Qualitative Research. Strides Dev. Med. Educ. In Press, (2017).
Google Forms. https://docs.google.com/forms/.
Zigmond, A. S. & Snaith, R. P. The hospital anxiety and depression scale. Acta Psychiatr. Scand. 67, 361–370 (1983).
Botega, N. J., Bio, M. R., Zomignani, M. A., Garcia Jr, C. & Pereira, W. A. B. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Rev. Saúde Pública 29, 359–363 (1995).
Bertolazi, A. N. & Alegre, P. Tradução, Adaptação Cultural e Validação de Dois Instrumentos de Avaliação do Sono: Escala de Sonolência de Epworth e Índice de Qualidade de Sono de Pittsburgh. (Universidade Federal do Rio Grande do Sul, 2008).
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R. & Kupfer, D. J. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 28, 193–213 (1989).
Buysse, D. J. et al. Relationships Between the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Clinical/Polysomnographic Measures in a Community Sample. J. Clin. Sleep Med. JCSM Off. Publ. Am. Acad. Sleep Med. 4, 563–571 (2008).
IBM Corp. SPSS Statistics. (2016).
Beasley, T. & Schumacker, R. Multiple Regression Approach to Analyzing Contingency Tables: Post Hoc and Planned Comparison Procedures. J. Exp. Educ. - J EXP EDUC 64, 79–93 (1995).
Salari, N. et al. Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Glob. Health 16, 57 (2020).
Lovibond, S.H., L., P. F. Manual for the Depression Anxiety Stress Scales. (Sydney: Psychology Foundation, 1995).
Spitzer, R. L., Kroenke, K., Williams, J. B. W. & Löwe, B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch. Intern. Med. 166, 1092–1097 (2006).
Kroenke, K., Spitzer, R. L. & Williams, J. B. The PHQ-9: validity of a brief depression severity measure. J. Gen. Intern. Med. 16, 606–613 (2001).
Barros, M. B. de A. et al. Report on sadness/depression, nervousness/anxiety and sleep problems in the Brazilian adult population during the COVID-19 pandemic. Epidemiol. E Serviços Saúde 29, (2020).
Gonçalves, D. A. et al. Brazilian multicentre study of common mental disorders in primary care: rates and related social and demographic factors. Cad. Saúde Pública 30, 623–632 (2014).
Fujii, R. K., Goren, A., Annunziata, K. & Mould-Quevedo, J. Prevalence, Awareness, Treatment, and Burden of Major Depressive Disorder: Estimates from the National Health and Wellness Survey in Brazil. Value Health Reg. Issues 1, 235–243 (2012).
IBGE. CENSO DEMOGRÁFICO 2010: características da população e dos domicílios: resultados do universo. (2011).
Salata, A. Race, Class and Income Inequality in Brazil: A Social Trajectory Analysis. Dados 63, (2020).
Diagnostic and statistical manual of mental disorders?: DSM-5. (American Psychiatric Association, 2013).
Phillips, B. A. & Danner, F. J. Cigarette smoking and sleep disturbance. Arch. Intern. Med. 155, 734–737 (1995).