Abstract
BackgroundEssential workers have been shown to present a higher prevalence of positive screenings for anxiety and depression during the COVID-19 pandemic. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders.ObjectiveWe aimed to assess the prevalence and predictors of depression, anxiety, and their comorbidity among essential workers in Brazil and Spain during the COVID-19 pandemic.MethodsA web survey was conducted between April and May 2020 in both countries. The main outcome was a positive screening for depression only, anxiety only, or both. Lifestyle was measured using a lifestyle multidimensional scale adapted for the COVID-19 pandemic (Short Multidimensional Inventory Lifestyle Evaluation–Confinement). A multinomial logistic regression model was performed to evaluate the factors associated with depression, anxiety, and the presence of both conditions.ResultsFrom the 22,786 individuals included in the web survey, 3745 self-reported to be essential workers. Overall, 8.3% (n=311), 11.6% (n=434), and 27.4% (n=1027) presented positive screenings for depression, anxiety, and both, respectively. After adjusting for confounding factors, the multinomial model showed that an unhealthy lifestyle increased the likelihood of depression (adjusted odds ratio [AOR] 4.00, 95% CI 2.72-5.87), anxiety (AOR 2.39, 95% CI 1.80-3.20), and both anxiety and depression (AOR 8.30, 95% CI 5.90-11.7). Living in Brazil was associated with increased odds of depression (AOR 2.89, 95% CI 2.07-4.06), anxiety (AOR 2.81, 95%CI 2.11-3.74), and both conditions (AOR 5.99, 95% CI 4.53-7.91).ConclusionsInterventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID-19 pandemic. Essential workers who live in middle-income countries with higher rates of inequality may face additional challenges. Ensuring equitable treatment and support may be an important challenge ahead, considering the possible syndemic effect of the social determinants of health.
Highlights
Interventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID-19 pandemic
The prevalence of COVID-19 continues to increase in Brazil [1], and mental health is recognized as an important challenge ahead worldwide [2,3,4]
The first study investigating mental health problems among essential workers during the COVID-19 pandemic was conducted in China and found the prevalence of anxiety and depressive symptoms to be at 20.1% and 12.7%, respectively [19]
Summary
The prevalence of COVID-19 continues to increase in Brazil [1], and mental health is recognized as an important challenge ahead worldwide [2,3,4]. Several studies have used web surveys to screen for common mental health disorders (mainly depressive and anxiety disorders) among the general population [5,6,7,8] Some of these studies, but not all [9,10], have shown that essential workers, such as health care workers (HCWs), had an increased likelihood of anxiety and depression compared to other workers [11,12]. The first study investigating mental health problems among essential workers during the COVID-19 pandemic was conducted in China and found the prevalence of anxiety and depressive symptoms to be at 20.1% and 12.7%, respectively [19]. Individuals from countries with socioeconomic inequalities may be at increased risk for mental health disorders
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