Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measures
- -
- Sociodemographic and health questionnaire: age; nationality; sex; marital status; residence region; profession; proximity to a family member or friend who has or has had the Coronavirus; confinement duration; presence of chronic disease (these data allowed us to assess whether, before the start of the pandemic, individuals already had some type of chronic pathology, namely mental and/or psychiatric); use of medications; regular physical activity (minimum 3 times a week); health facilities resort; doctor or psychologist appointment; alcoholic habits. How satisfied are you with your health? With the following answer possibilities: Very unsatisfied, Unsatisfied, Neither dissatisfied nor satisfied and Satisfied. How satisfied are you with your family economic income? With the following answer possibilities: Very unsatisfied, Unsatisfied Neither dissatisfied nor satisfied, Satisfied and Very Satisfied. With regard to spirituality, during quarantine a person is considered: Unspiritual, With some spirituality, Not too little, not too spiritual, Spiritual and Very spiritual.
- -
- Patient Health Questionnare-9 (PHQ-9), developed by Kroenke, Spitzer and Williams (2001) [19], validated for the Portuguese population by Monteiro et al. (2013; 2019) [20,21], is a self-report questionnaire asking about the nine items of major depression disorder (Diagnostic and Statistical Manual of Mental Disorders–DSM-IV), during the last two weeks. For each item, responses are rated on a 4-point Likert scale, ranging from 0 (“Not at all”) to 3 (“Almost every day”). Higher scores represent high levels of depressive symptoms, which can vary from 0–27 [22]. We considered the recommendations of Kroenke et al. (2001): minimal 0–4, mild 5–9, moderate 10–14, moderately severe 15–19, and severe 20–27 [19]. Global scale Cronbach’s α is 0.88 [23] and in the present study 0.89.
- -
- General Anxiety Disorder (GAD-7), developed by Spitzer, Kroenke, Williams and Löwe (2006) [22], translated and validated for the Portuguese population by Sousa et al. (2015) [24]. GAD-7 is a one-dimensional instrument, composed by 7 items assessing the presence of anxiety symptoms in the last 14 days. Uses a Likert scale ranging from 0–3 (0 = nothing, 1 = several days, 2 = more than half the days and 3 = almost every day). The sum of the items allows a total anxiety score, ranging from 0–21. Severity is determined by the cutoff scores; 0–4 normal, 5–9 mild symptoms, 10–14 moderate symptoms and 15–21 severe symptoms. The global scale Cronbach’s α is 0.93 [25] and in the present study 0.92.
2.3. Statistical Analysis
3. Results
3.1. Sociodemographic and Health Characteristics
3.2. Depressive Symptoms and Generalized Anxiety Disorder
4. Discussion
4.1. General Anxiety Disorder (GAD-7)
4.2. Depressive Symptoms (PHQ-9)
4.3. Socioeconomic and Health Variables Related to Anxiety and Depression Symptoms
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | n | Mean (Min./Max.) | St. Dev. | Normal (0–4) n % | Mild (5–9) n % | Moderate (10–14) n % | Moderate Severe (15–19) n % | Severe Depression (20–27) n % |
---|---|---|---|---|---|---|---|---|
Depressive Symptoms (PHQ–9) | 920 | 81,283 (0–27) | 589,211 | 293 31.8% | 298 32.4% | 203 22.1% | 82 8.9% | 44 4.8% |
Variable | n | Mean (Min./Max.) | St. Dev. | Normal (0–4) n % | Mild (5–9) n % | Moderate (10–14) n % | Severe (15–21) n % |
---|---|---|---|---|---|---|---|
Generalized Anxiety Disorder (GAD–7) | 920 | 62,435 (0–21) | 495,304 | 364 39.6% | 372 40.4% | 107 11.6% | 77 8.4% |
Variables | Categories | Total n % | Patient Health Questionnaire (PHQ) | Test (p-Value) | Generalized Anxiety Disorder Scale (GAD7) | Test (p-Value) | ||
---|---|---|---|---|---|---|---|---|
Mean | SD | Mean | SD | |||||
Age | <=37 | 334 (36.3%) | 8.8 | 5.4 | * F = 4.265 (p = 0.014) | 6.8 | 4.9 | * F = 9.271 (p < 0.0001) |
38–49 | 294 (32.0%) | 8.1 | 6.3 | 6.5 | 5.4 | |||
>=50 | 292 (31.7%) | 7.4 | 5.9 | 5.2 | 4.4 | |||
Sex | Female | 655 (72.4%) | 8.7 | 5.9 | ** t = 5.276 (p < 0.0001) | 6.7 | 5.0 | ** t = 4.633 (p < 0.0001) |
Male | 253 (27.6%) | 6.5 | 5.4 | 5.0 | 4.4 | |||
Health Professional Type | Nurse | 280 (74.3%) | 8.0 | 5.7 | * F = 3.726 (p = 0.012) | 6.2 | 4.8 | * F = 3.233 (p = 0.022) |
Doctor | 32 (8.5%) | 7.5 | 5.8 | 5.1 | 4.2 | |||
Therapeutic and Diagnosis Technician | 30 (8.0%) | 11.0 | 5.9 | 8.1 | 5.3 | |||
Other | 35 (9.3%) | 6.4 | 5.5 | 4.7 | 5.0 | |||
Chronic Disease | No | 689 (74.9%) | 7.8 | 5.6 | ** t = −2.424 (p = 0.016) | |||
Yes | 231 (25.1%) | 8.9 | 6.5 | |||||
Use of Medicines | No | 569 (61.8%) | 7.4 | 5.3 | ** t = −4.766 (p < 0.0001) | 5.8 | 4.7 | ** t = −3.191 (p = 0.001) |
Yes | 351 (38.2%) | 9.4 | 6.6 | 6.9 | 5.3 | |||
Prescribed Medicines | No | 561 (61.0%) | 7.4 | 5.3 | ** t = −4.802 (p < 0.0001) | 5.8 | 4.6 | ** t = −3.338 (p = 0.001) |
Yes | 359 (39.0%) | 9.3 | 6.6 | 6.9 | 5.4 | |||
Regular Physical Activity | No | 518 (56.3%) | 8.9 | 6.1 | ** t = 4.873 (p < 0.0001) | 6.8 | 5.0 | ** t = 3.699 (p < 0.0001) |
yes | 402 (43.7%) | 7.1 | 5.4 | 5.6 | 4.8 | |||
Resort to Health Unit | No | 786 (85.4%) | 7.9 | 5.8 | ** t = −2.510 (p = 0.012) | 6.1 | 4.9 | ** t = −2.372 (p = 0.018) |
Yes | 134 (14.6%) | 9.3 | 6.4 | 7.1 | 5.4 |
Variables | Categories | Patient Health Questionnaire-9 (PHQ-9) ≥ 10 | General Anxiety Disorder (GAD-7) ≥ 10 |
---|---|---|---|
Odds Ratio (CI95%) | Odds Ratio (CI95%) | ||
Intercept | 0.021 (0.007−0.061) | 0.005 (0.001–0.024) | |
Age | <=37 | 1.397 (0.964–2.024) | 2.040 (1.304–3.190) |
38–49 | 1.011 (0.688–1.486) | 1.544 (0.972–2.454) | |
>=50 | 1 | 1 | |
Sex | Woman | 2.098 (1.461−3.014) | 1.901 (1.223–2.954) |
Man | 1 | 1 | |
How satisfied are you with your health? | Very unsatisfied | 3.828 (1.512–9.692) | 8.009 (2.857–22.457) |
Unsatisfied | 7.015 (3.527–13.951) | 6.800 (3.109–14.872) | |
Neither dissatisfied nor satisfied | 4.318 (2.676–6.968) | 4.347 (2.296–8.231) | |
Satisfied | 1.487 (0.934–2.366) | 2.211 (1.169–4.183) | |
Very Satisfied | 1 | 1 | |
How satisfied are you with your family economic income? | Very unsatisfied | 4.093 (1.685–9.940) | 3.719 (1.254–11.031) |
Unsatisfied | 3.277 (1.424–7.541) | 2.126 (0.741–6.101) | |
Neither dissatisfied nor satisfied | 1.618 (0.745–3.514) | 1.222 (0.445–3.352) | |
Satisfied | 1.122 (0.506–2.486) | 1.199 (0.429–3.350) | |
Very Satisfied | 1 | 1 | |
With regard to spirituality, during quarantine a person is considered: | Unspiritual | 4.445 (1.984–9.962) | 6.578 (2.132–20.290) |
With some spirituality | 3.667 (1.624–8.283) | 4.237 (1.345–13.350) | |
Not too little, not too spiritual | 3.771 (1.802–7.891) | 4.702 (1.603–13.796) | |
Spiritual | 3.809 (1.776–8.167) | 4.237 (1.406—12.763) | |
Very spiritual | 1 | 1 |
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José, H.; Oliveira, C.; Costa, E.; Matos, F.; Pacheco, E.; Nave, F.; Valentim, O.; Sousa, L. Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study. Healthcare 2023, 11, 659. https://doi.org/10.3390/healthcare11050659
José H, Oliveira C, Costa E, Matos F, Pacheco E, Nave F, Valentim O, Sousa L. Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study. Healthcare. 2023; 11(5):659. https://doi.org/10.3390/healthcare11050659
Chicago/Turabian StyleJosé, Helena, Cláudia Oliveira, Emília Costa, Filomena Matos, Eusébio Pacheco, Filipe Nave, Olga Valentim, and Luís Sousa. 2023. "Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study" Healthcare 11, no. 5: 659. https://doi.org/10.3390/healthcare11050659
APA StyleJosé, H., Oliveira, C., Costa, E., Matos, F., Pacheco, E., Nave, F., Valentim, O., & Sousa, L. (2023). Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study. Healthcare, 11(5), 659. https://doi.org/10.3390/healthcare11050659