Mental health during the first wave of COVID-19 in Canada, the USA, Brazil and Italy

Abstract

Background

The mental health (MH) burden on healthcare practitioners (HCPs) is emerging as a significant cost of the pandemic, although few studies have compared the MH of HCPs in different countries.

Methods

A link to an online survey was posted in the Spring of 2020 which included questions regarding perceived impact of the pandemic; current MH symptom severity and impairment was evaluated using validated scales.

Results

Overall, 1315 individuals (74% female, mean age: 42.9 + 16.4) in Canada, the United States, Brazil and Italy completed the survey. Nearly 26% met diagnostic thresholds for GAD and MDD; Italian respondents reported the lowest rates of disorder. Except for Canada, non-HCPs in each country reported higher symptom severity than HCPs. Amongst the HCPs, Canadian HCPs reported the highest rates of anxiety and depression as well as increases in alcohol and cannabis use, lower levels of perceived emotional support and more worry about themselves or their loved ones contracting COVID-19.

Conclusion

Despite key infrastructural and COVID-19 mortality differences between the countries, the MH effects appeared to be quite similar. HCPs, with the exception of Canada, reported less impact on their mental health compared to the general population, suggesting resilience in the face of adversity.

Key points

• Rates of current mental health disorders were similar across Canada, the USA and Brazil but lower in Italy, yet much higher than pre-pandemic rates

• Non-Healthcare Practitioners (HCPs) reported significantly higher severity on all MH scales in the overall sample. This was consistent within the USA, Brazil and Italy, however in Canada, HCPs reported higher anxiety, depression and stress symptom severity compared to Canadian non-HCPs.

• Canadian HCPs reported significantly higher anxiety and depression symptom severity than all other countries

• Canadian HCPs also reported significantly greater increases in alcohol and cannabis use, lower levels of perceived emotional support and more worry about themselves or their loved ones contracting COVID-19 compared to HCPs in the other countries.

Keywords:

• Mental health
• anxiety
• depression
• stress
• COVID-19
• healthcare workers

Disclosure statement

Dr. Turna has nothing to disclose. Ms. Patterson has nothing to disclose. Dr. Goldman Bergmann reports grants from Coordenação de Aperfeiçoamento de Pessoal de Nivel Superior – Brasil (CAPES), outside the submitted work. Ms. Lamberti has nothing to disclose. Ms. Rahat has nothing to disclose. Ms. Dwyer has nothing to disclose. Ms. Sideris has nothing to disclose. Dr. Francisco has nothing to disclose. Dr. Vismara has nothing to disclose. Dr. Dell’Osso has received Grant/Research Support from LivaNova, Inc., Angelini and Lundbeck and Lecture Honoraria from Angelini, FB Health and Lundbeck. Dr. Van Ameringen reports personal fees from Allergan, personal fees from Almatica, personal fees from Brainsway, personal fees from Lundbeck, personal fees from Myriad Neuroscience, personal fees from Otsuka, grants and personal fees from Purdue Pharma (Canada), other from Janssen-Ortho Inc, personal fees from Pfizer, grants from Hamilton Academic Health Sciences Organisation, Innovation Grant, outside the submitted work.

Data availability statement

The data may be accessed upon request to Dr. Van Ameringen.