Closed Doors: Predictors of Stress, Anxiety, Depression, and PTSD During the Onset of COVID-19 Pandemic in Brazil

Background The rise of mental health problems in the population directly or indirectly by the COVID-19 pandemic is a major concern. The aim of this study was to investigate and compare independent predictors of symptoms of stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in Brazilians, one month after the implementation of measures of social distancing. Methods It was a cross-sectional study, performed through a web-based survey. Depression, Anxiety, and Stress Scale (DASS-21) and PTSD Checklist for DSM-5 (PCL-5) were the outcomes. Data were gathered regarding demographics, social distancing, economic problems, exposure to the news of the pandemic, psychiatric history, sleep disturbances, traumatic situations, and substance use. The Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) was also included. Predictors of symptoms were investigated through hierarchical multiple linear regression. Result Of a sample of 3,587 participants, approximately two-thirds considered that their mental health worsened after the beginning of the social restriction measures. The most important predictors of the symptoms investigated were the intensity of the distress related to pandemic news, younger age, current psychiatric diagnosis, trouble sleeping, emotional abuse or violence, and economic problems. Limitations The convenience sample assessed online may have limited external validity. It does not represent the northern regions of the country and most participants was white wealthier females. Conclusions These results confirm the hypothesis that a pandemic would have important impacts on the mental health of the population and indicate the level of distress related to the media as an important predictor of psychological suffering. Highlights Distress triggered by news was the main predictor of psychological symptoms Sleeping problems were strong indicators of mental health problems People with ongoing psychiatric disorders are especially vulnerable Measures to prevent interpersonal trauma and financial loss are crucial Young people may experience great suffering at the onset of the pandemic