De Boni Raquel Brandini, Balanzá-Martínez Vicent, Mota Jurema Correa, Cardoso Taiane De Azevedo, Ballester Pedro, Atienza-Carbonell Beatriz, Bastos Francisco I, Kapczinski Flavio
Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain.
J Med Internet Res. 2020 Oct 30;22(10):e22835. doi: 10.2196/22835.
Essential 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.
We 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.
A 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.
From 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).
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. 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.
在新冠疫情期间，一线工作者焦虑和抑郁筛查呈阳性的患病率较高。来自存在社会经济不平等的国家的个人患心理健康障碍的风险可能更高。
我们旨在评估新冠疫情期间巴西和西班牙一线工作者中抑郁症、焦虑症及其共病的患病率和预测因素。
2020年4月至5月在两国进行了一项网络调查。主要结果是仅抑郁症、仅焦虑症或两者的筛查呈阳性。使用针对新冠疫情改编的生活方式多维量表（简短多维生活方式评估 - 禁闭量表）来衡量生活方式。进行多项逻辑回归模型以评估与抑郁症、焦虑症以及两种情况同时存在相关的因素。
在网络调查纳入的22786人中，3745人自述为一线工作者。总体而言，分别有8.3%（n = 311）、11.6%（n = 434）和27.4%（n = 1027）的人抑郁症、焦虑症及两者的筛查呈阳性。在调整混杂因素后，多项模型显示不健康的生活方式会增加患抑郁症（调整优势比[AOR] 4.00，95%置信区间2.72 - 5.87）、焦虑症（AOR 2.39，95%置信区间1.80 - 3.20）以及焦虑症和抑郁症同时患病（AOR 8.30，95%置信区间5.90 - 11.7）的可能性。生活在巴西与患抑郁症（AOR 2.89，95%置信区间2.07 - 4.06）、焦虑症（AOR 2.81，95%置信区间2.11 - 3.74）以及两种情况同时患病（AOR 5.99，95%置信区间4.53 - 7.91）的几率增加相关。
在新冠疫情给一线工作者带来的压力期间，针对生活方式的干预措施可能有助于应对常见精神障碍的症状。生活在不平等率较高的中等收入国家的一线工作者可能面临额外挑战。考虑到健康的社会决定因素可能产生的综合征效应，确保公平的治疗和支持可能是未来一项重要挑战。
