Abstract
To assess the association between household food insecurity (FI) and major depressive episodes (MDE) amid Covid-19 pandemic in Brazil. Cross-sectional study carried out with data from four consecutive population-based studies. The study was conducted between May and June 2020, in Bagé, a Brazilian southern city. Household FI was measured using the short-form version of the Brazilian Food Insecurity Scale. Utilising the Patient Health Questionnaire-9, we used two different approaches to define MDE: the cut-off point of ≥ 9 and the diagnostic criteria proposed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Association between FI and MDE was analysed using crude and adjusted Poisson regression models. 1550 adults (≥ 20 years old). The prevalence of household FI was 29·4 % (95 % CI 25·0, 34·4). MDE prevalence varied from 4·4 % (95 % CI 3·1, 6·0), when we used the DSM-IV-TR criteria to define this condition, to 9·6 % (95 % CI 7·3, 12·5) of the sample, when we used the cut-off point of ≥ 9 as definition. The prevalence of MDE was more than two times higher in those individuals living with FI, independent of the criteria adopted to define the outcome. Adjustment for potential confounders did not change the association's magnitude. Household FI has been positively associated with MDE amid Covid-19 pandemic, independent of socio-demographic characteristics of participants. Actions are needed to warrant basic living conditions to avoid FI and hunger and its consequences for the Brazilian population, especially those consequences linked to mental health disorders.
Highlights
Our study showed an association between food insecurity (FI) status and major depressive episodes (MDE) amid the Covid-19 pandemic using a populationbased sample from a city located in southern Brazil
Using two different approaches to define MDE, we observed that FI increased the likelihood of depressive episodes, with those individuals who experienced this situation presenting a prevalence of MDE more than 2-fold higher than the food secure ones, independent of the socio-demographic characteristics included in the adjusted models
According to a recently published meta-analysis, among the most common mental health disorders, depression is the one strongest associated with FI
Summary
Investigators have demonstrated increases in the prevalence of mental health disorders amid Covid-19 pandemic in different countries[14,15,16]. Population-based studies are important to better understand the association between FI and mental health amid Covid-19 pandemic, especially in low- and middle-income countries like Brazil, where social disparities were already large even before this public health issue.
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