Factors associated with stress, anxiety, and depression during social distancing in Brazil

Souza, Alex Sandro Rolland; Souza, Gustavo Fonseca Albuquerque; Souza, Gabriela Albuquerque; Cordeiro, Ana Lorena Nascimento; Praciano, Gabriella Almeida Figueredo; Alves, Adricia Cristine de Souza; Santos, Alan Chaves dos; Silva Junior, José Roberto; Souza, Manuela Barbosa Rodrigues

doi:10.11606/s1518-8787.2021055003152

Alex Sandro Rolland Souza

Instituto de Medicina Integral Prof. Fernando Figueira. Centro de Atenção à Mulher. Recife, Pernambuco, PE, Brasil

Universidade Federal de Pernambuco. Departamento Materno Infantil. Recife, Pernambuco, PE, Brasil

Universidade Católica de Pernambuco. Centro de Ciências Biológicas e da Saúde. Recife, Pernambuco, PE, Brasil

http://orcid.org/0000-0001-7039-2052

Gustavo Fonseca Albuquerque Souza

Universidade Católica de Pernambuco. Centro de Ciências Biológicas e da Saúde. Recife, Pernambuco, PE, Brasil

http://orcid.org/0000-0002-1794-701X

Gabriela Albuquerque Souza

Universidade Católica de Pernambuco. Centro de Ciências Biológicas e da Saúde. Recife, Pernambuco, PE, Brasil

http://orcid.org/0000-0002-3631-6782

Ana Lorena Nascimento Cordeiro

Faculdade Pernambucana de Saúde. Recife. Pernambuco, PE, Brasil

http://orcid.org/0000-0001-6227-4937

Gabriella Almeida Figueredo Praciano

Universidade Católica de Pernambuco. Centro de Ciências Biológicas e da Saúde. Recife, Pernambuco, PE, Brasil

http://orcid.org/0000-0002-9746-8536

Adricia Cristine de Souza Alves

Faculdade Pernambucana de Saúde. Recife. Pernambuco, PE, Brasil

http://orcid.org/0000-0001-9043-394X

Alan Chaves dos Santos

Instituto de Medicina Integral Prof. Fernando Figueira. Centro de Atenção à Mulher. Recife, Pernambuco, PE, Brasil

Faculdade Pernambucana de Saúde. Recife. Pernambuco, PE, Brasil

http://orcid.org/0000-0001-8614-4301

José Roberto Silva Junior

Instituto de Medicina Integral Prof. Fernando Figueira. Centro de Atenção à Mulher. Recife, Pernambuco, PE, Brasil

Faculdade Pernambucana de Saúde. Recife. Pernambuco, PE, Brasil

http://orcid.org/0000-0003-3843-005X

Manuela Barbosa Rodrigues Souza

Universidade Católica de Pernambuco. Centro de Ciências Biológicas e da Saúde. Recife, Pernambuco, PE, Brasil

http://orcid.org/0000-0002-7773-100X

Correspondence: Alex Sandro Rolland Souza Rua Le Parc, 100 51.160-035 Recife, PE, Brazil E-mail: alexrolland@uol.com.br

Authors’ Contribution: Conception and planning of the study: ASRS, GFAS, JRSJ e MBRS. Data collection: GFAS, GAS, ALNC, GAFP, ACSA e ACS. Analysis and interpretation of the data: ASRS, GFAS, ACS, JRSJ e MBRS. Drafting and revision of the manuscript: all authors. All authors approved the final version and take public responsibility for the content of this article.

Conflict of Interest: The authors declare no conflict of interest.

	n	%
Age (years)
18–20	569	17.8
21–25	666	20.8
26–33	627	19.6
34–44	681	21.3
45–83	657	20.5
Sex
Male	727	22.7
Female	2,473	77.3
Skin color/ethnicity
White	1,929	60.3
Brown	1,015	31.7
Black	198	6.2
Other	58	1.8
Education level
Postgraduate	1,105	34.5
Undergraduate student	1,759	55.0
Primary/secondary school	336	10.5
Marital status
Married	1,253	39.2
Single	1,688	52.8
Others	259	8.0
Region of the country in which respondent lives
Northeast	2,411	75.3
Southeast	430	13.4
South	158	4.9
North	96	3.0
Midwest	75	2.3
Abroad	30	0.9
Religion
Catholic	1,446	45.2
Evangelical	497	15.5
Not religious	793	24.8
Other	464	14.5
Duration of social distancing (days)
≤ 10	223	7.0
11–30	815	25.5
31–35	290	9.1
36–40	1,022	31.9
41–45	538	16.8
46–122	312	9.7

	Normal		Mild		Moderate		Severe		Extreme
	n	%	n	%	n	%	n	%	n	%
Stress	1,679	52.5	414	12.9	419	13.1	413	12.9	275	8.6
Anxiety	1,774	55.4	252	7.9	552	17.3	203	6.3	419	13.1
Depression	1,496	46.8	414	12.9	602	18.8	252	7.9	436	13.6

Factors	Final Model
Factors	PR (95%CI)	p*
Age (years)		< 0.001
18–20	4.49 (3.31–6.09)	< 0.001
21–25	3.97 (2.93–5.39)	< 0.001
26–33	2.91 (2.13–3.97)	< 0.001
34–44	1.84 (1.32–2.57)	< 0.001
45–83	1.0 (Ref.)
Sex		< 0.001
Male	1.0 (Ref.)
Female	1.67 (1.37–2.02)	< 0.001
Working from home		0.006
Increased	1.0 (Ref.)
Remains the same	0.77 (0.63–0.94)	0.011
Decreased	1.14 (0.98–1.32)	0.090
I do not work from home	1.09 (0.90–1.31)	0.380
Region of the country in which respondent lives		< 0.001
Northeast	1.0 (Ref.)
Southeast	1.52 (1.30–1.78)	< 0.001
South	1.27 (1.03–1.56)	0.025
North	1.28 (0.93–1.77)	0.123
Midwest	1.54 (1.10–2.16)	0.012
Abroad	2.03 (1.31–3.16)	0.002
History of anxiety and depression		< 0.001
No	1.0 (Ref.)
Yes	2.14 (1.84–2.49)	< 0.001
Leisure activities		< 0.001
Increased	1.0 (Ref.)
Reduced	1.71 (1.44–2.02)	< 0.001
Remain the same	1.00 (0.84–1.18)	0.966
I do not perform leisure activities	1.33 (0.83–2.14)	0.241
Internet use		0.005
Increased	1.0 (Ref.)
Remains the same	0.78 (0.65–0.93)	0.005
Reduced/I do not use the Internet	1.23 (0.93–1.63)	0.147
Use of medication		< 0.001
I do not use any medication	1.0 (Ref.)
Use increased	1.97 (1.70–2.27)	< 0.001
Remains the same	1.10 (0.90–1.35)	0.333
Use decreased	0.84 (0.46–1.54)	0.577
Social isolation		< 0.001
No	1.0 (Ref.)
Yes	1.36 (1.14–1.63)	< 0.001

Factors	Final model
Factors	PR (95%CI)	p*
Age (years		< 0.001
18–20	1.0 (Ref.)
21–25	0.89 (0.75–1.05)	0.169
26–33	0.76 (0.63–0.91)	0.003
34–44	0.40 (0.32–0.50)	< 0.001
45–83	0.27 (0.19–0.36)	< 0.001
Sex		< 0.001
Male	1.0 (Ref.)
Female	1.90 (1.54–2.34)	< 0.001
Skin color/ethnicity		< 0.001
White	1.0 (Ref.)
Brown	1.60 (1.31–1.94)	< 0.001
Black	0.80 (0.38–1.66)	0.543
Other	1.19 (1.03–1.38)	0.016
Working from home		< 0.001
Increased	1.0 (Ref.)
Remains the same	0.90 (0.73–1.10)	0.306
Decreased	1.37 (1.17–1.60)	< 0.001
I do not work from home	1.28 (1.05–1.56)	0.014
Region of the country in which respondent lives		0.018
Northeast	1.0 (Ref.)
Southeast	1.29 (1.08–1.54)	0.004
South	1.14 (0.88–1.46)	0.317
North	1.42 (1.07–1.90)	0.017
Midwest	1.14 (0.82–1.59)	0.421
Abroad	1.51 (0.90–2.53)	0.123
Number of rooms in the house		0.002
1–6	1.23 (1.08–1.40)	0.002
7 or more	1.0 (Ref.)
Religion		0.010
Catholic	1.0 (Ref.)
Evangelical	0.85 (0.69–1.04)	0.107
Not religious	1.12 (0.96–1.30)	0.158
Other	0.82 (0.66–1.01)	0.063
History of anxiety and depression		< 0.001
No	1.0 (Ref.)
Yes	2.57 (2.18–3.04)	< 0.001
Chronic diseases		0.002
No	1.0 (Ref.)
Yes	1.24 (1.08–1.41)	0.002
Leisure activities		0.002
Increased	1.0 (Ref.)
Reduced	1.44 (1.20–1.74)	< 0.001
Remain the same	1.02 (0.86–1.22)	0.783
I do not perform leisure activities	1.18 (0.74–1.88)	0.478
Use of medication		< 0.001
I do not use any medication	1.0 (Ref.)
Use increased	1.96 (1.68–2.29)	< 0.001
Remains the same	1.11 (0.90–1.38)	0.324
Use decreased	0.88 (0.48–1.60)	0.670
Quarantine		0.031
No	1.0 (Ref.)
Yes	1.19 (1.02–1.40)	0.031
Social isolation		0.019
No	1.0 (Ref.)
Yes	1.26 (1.04–1.52)	0.019

Factors	Final Model
Factors	PR (95%CI)	p*
Age (years)		< 0.001
18–20	2.67 (1.85–3.84)	< 0.001
21–25	2.77 (1.93–3.97)	< 0.001
26–33	2.50 (1.78–3.50)	< 0.001
34–44	1.66 (1.17–2.36)	0.004
45–83	1.0 (Ref.)
Sex		< 0.001
Male	1.0 (Ref.)
Female	1.44 (1.21–1.71)	< 0.001
Skin color/ethnicity		0.014
White	1.0 (Ref.)
Brown	1.40 (1.13–1.73)	0.002
Black	1.25 (0.76–2.07)	0.383
Other	1.00 (0.87–1.15)	0.980
Marital status		< 0.001
Married	1.0 (Ref.)
Single	1.52 (1.27–1.83)	< 0.001
Other	1.42 (1.07–1.89)	0.016
Family income		0.004
Has not decreased	1.0 (Ref.)
Decreased	1.20 (1.06–1.36)	0.004
Working from home		< 0.001
Increased	1.0 (Ref.)
Remains the same	1.19 (0.99–1.42)	0.068
Decreased	1.50 (1.29–1.75)	< 0.001
I do not work from home	1.34 (1.10–1.63)	0.003
Employment status		0.006
Employed, working on-site	1.0 (Ref.)
Employed, working from home	1.28 (0.96–1.70)	0.091
Employed, furloughed	1.54 (1.09–2.17)	0.013
Student, remote learning	1.57 (1.18–2.11)	0.002
Student, no remote learning	1.26 (0.93–1.71)	0.140
Unemployed	1.60 (1.20–2.13)	0.001
Other	1.50 (1.09–2.05)	0.013
Region of the country in which respondent lives		< 0.001
Northeast	1.0 (Ref.)
Southeast	1.68 (1.44–1.96)	< 0.001
South	1.48 (1.18–1.86)	< 0.001
North	1.13 (0.82–1.55)	0.465
Midwest	1.95 (1.50–2.55)	< 0.001
Abroad	2.48 (1.66–3.69)	< 0.001
Number of rooms in the house		0.002
1–6	1.21 (1.07–1.37)	0.002
7 or more	1.0 (Ref.)
Religion		< 0.001
Catholic	1.0 (Ref.)
Evangelical	0.95 (0.78–1.16)	0.609
Not religious	1.33 (1.14–1.54)	< 0.001
Other	1.00 (0.82–1.21)	0.984
History of anxiety and depression		< 0.001
No	1.0 (Ref.)
Yes	1.68 (1.45–1.93)	< 0.001
Leisure activities		0.001
Increased	1.0 (Ref.)
Reduced	1.45 (1.20–1.74)	< 0.001
Remain the same	1.02 (0.86–1.21)	0.807
I do not perform leisure activities	1.14 (0.72–1.82)	0.574
Physical exercise		0.002
Increased	1.0 (Ref.)
Reduced	1.27 (1.06–1.52)	0.010
Remains the same	0.94 (0.74–1.19)	0.605
I do not practice physical exercise	1.29 (1.07–1.57)	0.008
Internet Use		0.025
Increased	1.0 (Ref.)
Remains the same	1.36 (1.03–1.78)	0.029
Reduced/I do not use the Internet	0.89 (0.76–1.05)	0.163
Use of medication		< 0.001
I do not use any medication	1.0 (Ref.)
Use increased	2.25 (1.94–2.59)	< 0.001
Remains the same	1.42 (1.17–1.73)	< 0.001
Use decreased	1.56 (0.99–2.48)	0.058
Illicit drug use		0.008
No	1.0 (Ref.)
Yes	1.26 (1.06–1.49)	0.008
Social isolation		0.059
No	1.0 (Ref.)
Yes	1.21 (0.99–1.49)	0.059
Symptoms of Covid-19		0.002
Yes	1.37 (1.12–1.68)	0.002
No	1.0 (Ref.)

[1] Correspondence: Alex Sandro Rolland Souza Rua Le Parc, 100 51.160-035 Recife, PE, Brazil E-mail: alexrolland@uol.com.br

Brasil

Brasil

Factors associated with stress, anxiety, and depression during social distancing in Brazil

ABSTRACT

OBJECTIVE

METHODS

RESULTS

CONCLUSION