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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 32 (1) • 2023 • https://doi.org/10.1590/S2237-96222023000100012 copy

Common mental disorders in Primary Health Care professionals during the COVID-19 pandemic period: a cross-sectional study in the Northern health macro-region of Minas Gerais state, Brazil, 2021

Transtornos mentales comunes en profesionales de atención primaria de salud durante el período de pandemia de covid-19: un estudio transversal de la macrorregión norte de Minas Gerais, Brasil, 2021

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the prevalence of symptoms of common mental disorders (CMDs) in Primary Health Care professionals between August-October/2021.

Methods:

this was a cross-sectional study conducted with health professionals in the Northern health macro-region of Minas Gerais state; snowball sampling was used; the dependent variable, CMDs, was evaluated using the Self-Reporting Questionnaire (SRQ-20); Poisson regression was used to perform the statistical analysis.

Results:

a total of 702 health professionals took part in the study; the prevalence of CDMs was 43.2%. It was higher in those with previous [prevalence ratios (PR) = 2.42; 95%CI 1.43;4.08] and current (PR = 1.54; 95%CI 1.25;1.89) symptoms of mental disorders, overwork during the pandemic (PR = 1.42; 95%CI 1.16;1.73), previous symptoms of anxiety (PR = 1.27; 95%CI 1.01;1.61), depression (PR = 1.27; 95%CI 1.06;1.52) and other mental disorders (PR = 1.20; 95%CI 1.01;1.43).

Conclusion:

there was an association between CDMs and presenting previous and current symptoms of mental disorders and work overload during the covid-19 pandemic.

Keywords:
Mental Disorders; Health Personnel; Primary Health Care; Covid-19; Cross-sectional studies.

Variables	Total	Absence of CMDs^b	Presence of CMDs^b	PR^c (95%CI)^a	p-value
Variables	% (95%CI)^a	% (95%CI)^a	% (95%CI)^a	PR^c (95%CI)^a	p-value
Sex
Male	15.4 (12.9;18.2)	72.2 (63.1;79.8)	27.8 (20.2;36.9)	1.00
Female	84.6 (81.7;87.1)	54.0 (50.0;58.0)	46.0 (41.2;50.0)	1.63 (1.13;2.36)	0.008
Age (in full years)
≥ 35	49.6 (45.9;53.2)	58.0 (52.8;63.1)	42.0 (36.9;47.2)	1.00
≤ 34	50.4 (46.7;54.1)	55.4 (50.1;60.4)	44.6 (39.5;49.8)	1.06 (0.87;1.28)	0.533
Marital status
Single/widowed/divorced	44.7 (41.0;48.4)	56.4 (50.8;61.8)	43.6 (38.2;49.1)	1.03 (0.85;1.25)
Married	55.3 (51.6;58.9)	57.8 (52.8;62.6)	42.2 (37.4;47.2)	1.00	0.729
Performance level
Middle/technical level	59.3 (55.5;62.8)	60.6 (55.8;65.1)	39.4 (34.8;44.2)	1.00
Higher level	40.7 (37.1;44.4)	51.4 (45.6;57.1)	48.6 (42.8;54.3)	1.23 (1.01;1.48)	0.031
Region
Januária GRS^d/Pirapora GRS^d	36.7 (33.2;40.3)	61.3 (55.2;67.1)	38.7 (32.9;44.7)	1.00
Montes Claros SRS^e	63.3 (59.6;66.7)	54.2 (49.5;58.8)	45.8 (41.2;50.4)	1.18 (0.95;1.46)	0.118
Overall prevalence	-	56.8 (53.1;60.4)	43.2 (39.5;46.8)	-	-

Variables	Total	Absence of CMDs^b	Presence of CMDs^b	PR^c (95%CI)^a	p-value
Variables	% (95%CI)^a	% (95%CI)^a	% (95%CI)^a	PR^c (95%CI)^a	p-value
Working on the front line in the fight against covid-19
No	25.6 (22.5;29.0)	64.6 (57.2;71.2)	35.4 (28.7;42.7)	1.00
Yes	74.4 (70.9;77.5)	53.3 (49.0;57.6)	46.7 (42.3;51.0)	1.31 (1.01;1.69)	0.035
Previous diagnosis of covid-19
No	77.1 (73.8;80.0)	59.3 (55.1;63.4)	40.7 (36.6;44.8)	1.00
Yes	22.9 (19.9;26.2)	48.4 (40.8;56.1)	51.6 (43.9;59.1)	1.27 (1.03;1.55)	0.019
Presence of previous mental disorder symptoms
No	32.7 (29.2;36.2)	88.9 (84.1;92.4)	11.1 (7.6;15.8)	1.00
Yes	67.3 (63.7;70.7)	40.8 (36.4;45.3)	59.2 (54.7;63.6)	5.33 (3.48;8.14)	< 0.001
Presence of current mental disorder symptoms
No	64.4 (60.7;67.8)	74.3 (70.0;78.1)	25.7 (21.8;30.0)	1.00
Yes	35.6 (32.1;39.2)	25.7 (20.6;31.5)	74.3 (68.4;79.3)	2.88 (2.36;3.52)	< 0.001
Previous psychological or psychiatric follow-up
No	64.3 (60.6;67.7)	64.3 (59.7;68.5)	35.7 (31.4;40.2)	1.00
Yes	35.7 (32.2;39.3)	43.0 (36.7;49.1)	57.0 (50.8;63.0)	1.59 (1.32;1.91)	< 0.001
Current psychological or psychiatric follow-up
No	86.6 (83.9;88.9)	59.8 (55.8;63.6)	40.2 (36.3;44.1)
Yes	13.4 (11.0;16.1)	36.6 (27.5;46.7)	63.4 (53.3;72.5)	1.57 (1.28;1.93)	< 0.001
Previous psychotropic medication use
No	62.7 (59.0;66.1)	69.6 (65.1;73.7)	30.4 (26.2;34.8)	1.00
Yes	37.3 (33.8;40.9)	34.9 (29.3;40.8)	65.1 (59.1;70.6)	2.14 (1.77;2.59)	< 0.001
Current psychotropic medication use
No	77.6 (74.3;80.5)	64.3 (60.1;68.3)	35.7 (31.7;39.8)	1.00
Yes	22.4 (19.4;25.6)	30.7 (23.9;38.4)	69.3 (61.5;76.0)	1.94 (1.62;2.32)	< 0.001
Work during the pandemic
I worked the same way or less than usual	48.2 (44.4;51.9)	67.9 (62.6;72.7)	32.1 (27.2;37.4)	1.00
I worked more than usual and I felt overwhelmed	51.8 (48.0;55.5)	43.8 (38.6;49.0)	56.2 (50.9;61.3)	1.75 (1.42;2.16)	< 0.001
Previous self-reported anxiety symptoms
No	44.1 (40.4;47.8)	79.7 (74.8;83.8)	20.3 (16.2;25.2)	1.00
Yes	55.9 (52.1;59.5)	38.3 (33.6;43.3)	61.7 (56.7;66.3)	3.02 (2.33;3.92)	< 0.001
Previous self-reported insomnia symptoms
No	77.3 (74.0;80.2)	62.7 (58.5;66.7)	37.3 (33.2;41.4)	1.00
Yes	22.7 (19.7;26.0)	35.7 (28.6;43.4)	64.3 (56.5;71.4)	1.72 (1.44;2.06)	< 0.001
Previous self-reported depressive symptoms
No	87.8 (85.2;90.0)	61.6 (57.7;65.4)	38.4 (34.6;42.3)	1.00
Yes	12.2 (9.9;14.8)	20.2 (13.0;30.0)	79.8 (69.9;86.7)	2.07 (1.74;2.45)	< 0.001
Other previous self-reported symptoms
No	90.4 (88.0;92.4)	60.6 (56.7;64.4)	39.4 (35.6;43.2)	1.00
Yes	9.6 (7.5;11.9)	18.2 (10.7;29.1)	81.8 (70.8;89.2)	2.09 (1.78;2.45)	< 0.001
Previous self-reported antidepressant medication use
No	78.3 (75.1;81.2)	63.3 (59.1;67.2)	36.7 (32.8;40.8)	1.00
Yes	21.7 (18.7;24.8)	33.6 (26.5;41.3)	66.4 (58.6;73.4)	1.80 (1.51;2.16)	< 0.001
Previous self-reported anxiolytic medication use
No	79.2 (76.0;82.0)	63.4 (59.3;67.3)	36.6 (32.6;40.6)	1.00
Yes	20.8 (17.9;24.0)	31.5 (24.5;39.4)	68.5 (60.5;75.4)	1.87 (1.56;2.23)	< 0.001
Previous self-reported use of another psychotropic medication
No	92.0 (88.7;93.8)	59.1 (55.2;62.8)	40.9 (37.2;44.7)	1.00
Yes	8.0 (6.2;10.2)	30.4 (19.9;43.3)	69.6 (56.6;80.1)	1.69 (1.35;2.12)	< 0.001

Variables	N	% (95%CI)^a
Community Health Agent (CHA)	222	31.6 (28.3;35.1)
Oral health technician and dental assistant	14	2.0 (1.2;3.3)
Dentist	91	13.0 (10.6;15.6)
Nurse	168	23.9 (20.9;27.2)
Physiotherapist	27	3.8 (2.6;5.5)
Physician	19	2.7 (1.7;4.1)
Nutritionist	11	1.6 (0.8;2.7)
Psychologist	36	5.1 (3.7;7.0)
Nursing Technician	77	11.0 (8.8;13.5)
Others	37	5.3 (3.8;7.1)

Groups of symptoms	Yes % (95%CI)^a	No % (95%CI)^a
Somatic symptoms
Do you get frequent headaches?	46.3 (42.7;50.0)	53.7 (49.9;57.3)
Do you have a poor appetite?	17.2 (14.5;20.1)	82.8 (79.9;85.4)
Do you get poor sleep quality?	45.7 (42.2;49.5)	53.9 (50.4;57.8)
Do you experience tremors in your hands?	15.1 (12.5;17.9)	84.9 (82.1;87.4)
Do you have poor digestion?	31.3 (28.1;34.9)	68.6 (65.0;71.9)
Do you have unpleasant sensations in your stomach?	30.1 (26.8;33.6)	69.9 (66.4;73.2)
Depressive/anxious mood
Do you get scared easily?	45.4 (41.7;49.0)	54.6 (50.9;58.3)
Do you feel nervous, tense or worried?	65.8 (62.2;69.2)	34.2 (30.7;37.8)
Have you been feeling sad lately?	41.5 (37.8;4.1)	58.5 (54.8;62.1)
Have you been crying more than usual?	23.2 (20.1;26.4)	76.8 (73.5;79.8)
Decreased vital energy
Do you find it difficult to think clearly?	31.1 (27.7;34.6)	68.9 (65.3;72.2)
Do you find it difficult to perform your daily activities with satisfaction?	35.0 (31.8;38.9)	64.7 (61.0;68.1)
Do you find it difficult to make decisions?	36.4 (32.9;40.0)	63.6 (60.0;67.1)
Do you have difficulties at work (is your work hard, does it make you suffer?)	18.4 (15.6;21.5)	81.6 (78.5;84.3)
Do you feel tired all the time?	37.7 (34.1;41.3)	62.3 (58.7;65.9)
Do you get tired easily?	45.4 (41.7;49.0)	54.6 (50.9;58.3)
Depressive Thoughts
Do you feel unable to play a useful role in your life?	15.1 (12.6;17.7)	84.9 (82.0;87.3)
Have you lost interest in things?	28.7 (25.4;32.1)	71.3 (67.9;74.6)
Do you feel useless, worthless?	9.4 (7.4;11.8)	90.6 (88.2;92.5)
Do you have thoughts about ending your life?	3.6 (2.5;5.3)	96.4 (94.6;97.5)

Variable^a	PR (95%CI)^b	p-value
Have you ever had symptoms of mental disorders
No	1.00
Yes	2.42 (1.43;4.08)	0.001
Are you currently experiencing symptoms of mental disorders
No	1.00
Yes	1.54 (1.25;1.89)	< 0.001
Work during the pandemic
I worked the same way or less than usual	1.00
I worked more than usual and I felt overwhelmed	1.42 (1.16;1.73)	< 0.001
Previous self-reported anxiety symptoms
No	1.00
Yes	1.27 (1.01;1.61)	0.049
Previous self-reported depressive symptoms
No	1.00
Yes	1.27 (1.06;1.52)	0.007
Other previous self-reported symptoms
No	1.00
Yes	1.20 (1.01;1.43)	0.031

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