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Título

COVID-19 PANDEMIC IMPACT ON PSYCHIATRIC SYMPTOMS AND THEIR NETWORK STRUCTURE: ANALYSIS OF THE BRAZILIAN LONGITUDINAL STUDY OF HEALTH (ELSA-BRASIL) COHORT OVER A 12-YEAR TIMESPAN

Introdução

Cohort studies have had mixed findings on changes in mental symptoms severity during the COVID-19 pandemic. Network approaches can provide additional insights by analyzing the connectivity of such symptoms.

Objetivo

We assessed the prevalence rates and network structure of mental symptoms in the Brazilian Longitudinal Study of Health (ELSA-Brasil) in 3 waves: 2008-2010 (baseline), 2017-2019 (pre-pandemic), and 2020 (pandemic), and hypothesized that the pandemic would cause changes in symptom rates and connectivity.

Método

Psychiatric assessments were performed using the Clinical Interview Scheduled-Revised (CIS-R) questionnaire that evaluates the severity of 14 common mental symptoms. Symptom rates were compared between assessments, and networks were graphed using unregularized Gaussian models and compared using centrality and connectivity measures. The predictive power of centrality measures and individual symptoms were also estimated.

Resultados

Among 2,011 participants (mean age: 62.1 years, 58% females), fatigue and obsessive symptoms decreased and phobic symptoms increased when comparing pre-pandemic to the pandemic period; but other individual symptoms did not significantly vary. As predicted, the pandemic symptom network displayed higher overall connectivity, especially among symptoms that were related to general worries, with increased local connectivity between general worries and worries about health, as well as between anxiety and phobia symptoms. There was no difference between baseline and pre-pandemic networks.

Conclusão

Although the prevalence of individual psychiatric symptoms changed only slightly over time, their network structure became more densely connected during the pandemic. Since baseline and pre-pandemic network comparisons revealed no changes, this effect likely occurred due to the COVID-19 pandemic.

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