Sharp increase in depression and anxiety among Brazilian adults during the COVID-19 pandemic: findings from the PAMPA cohort

Objectives: We aimed to compare the prevalence of depression and anxiety symptoms before and during the pandemic and identify factors associated with aggravated mental health symptoms. Study design: Retrospective cohort study. Methods: We identified the proportion of normal, mild, moderate, and severe symptoms of depression and anxiety before and during the social distancing restrictions in adults from southern Brazil. An online, self-administered questionnaire was delivered for residents within the state of Rio Grande do Sul. Depressive and anxiety symptoms were examined by the Hospital Anxiety and Depression Scale. Results: Most of the participants (n = 2314) aged between 31 and 59 years (54.2%), were women (76.6%), White (90.6%) with a university degree (66.6%). Moderate-to-severe symptoms of depression and anxiety were reported in 3.9% and 4.5% of participants, respectively, before COVID-19. During the pandemic (June -July, 2020), these proportions increased to 29.1% (6.6-fold increase) and 37.8% (7.4-fold increase), respectively. Higher rates of depressive and anxiety symptoms were observed among women, those aged 18-30 years, diagnosed with chronic disease and participants who had their income negatively affected by social restrictions. Remaining active or becoming physically active during social distancing restrictions reduced the probability of aggravated mental health disorders. Conclusions: Depressive and anxiety symptoms had a 6.6- and 7.4-fold increase since the COVID-19 pandemic. Public policies such as physical activity promotion and strategies to reduce the economic strain caused by this pandemic are urgently needed to mitigate the impact of the pandemic on mental health. (C) 2020 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.