Factors related to depression, distress, and self-reported changes in anxiety, depression, and suicidal thoughts during the COVID-19 state of emergency in Latvia

Abstract

Purpose

Evidence suggests that the 2020 COVID-19 pandemic might have deleterious effects on the population’s mental health and psychiatric outcomes. We examined the prevalence of depression, distress, and suicidal thoughts and their association with social and economic factors during the state of emergency in a nationwide representative sample of the general population in Latvia.

Materials and method

An online survey was conducted using a randomized stratified sample of the general adult population in July 2020 for 3 weeks. Distress, depression, suicidal thoughts, and self-reported changes in mental health were identified using a structured questionnaire. The statistical analysis included chi-square tests, analyses of variance, and multivariate forward-stepwise linear regressions.

Results

The study sample included 2608 respondents. Clinical depression was present in 5.75% and distress in 7.82%. Suicidal thoughts increased in 13.30% of those with a history of clinical depression, and 27.05% of those with a history of suicidal attempts. The variables that were associated with increases in self-reported anxiety, depressive thoughts, suicidal ideation, and being currently depressed/distressed included lower general health, increased fears of contracting COVID-19 or having family members contract it and die, history of suicidality, increased family conflicts, decreased religiosity, caring for a vulnerable person. Protective factors included positive changes in family relationships and economic situation, maintaining one’s basic routine, and having more people living in the household.

Conclusions

Further research and interventions should focus specifically on these factors. The study’s findings can help to develop future strategies for management of psychological support for different groups in general population.

Keywords:

• COVID-19
• pandemic
• depression
• distress
• suicidality
• mental health
• Latvia

Disclosure statement

The authors do not have any interests related to this research.

Data availability statement

Rancans E, Vrublevska J, Aleskere I, Rezgale B, Sibalova A. Mental health and associated factors in the general population of Latvia during the COVID-19 pandemic. https://doi.org/10.25143/FK2/0MQSI9. Dataverse; 2021.

Notes on contributors

Jelena Vrublevska, MD, PhD – leading researcher; holds doctoral degree in psychiatry (Riga Stradins University, Latvia). Currently she is Assistant Professor of Psychiatry at the Department of Psychiatry and Narcology and as a leading researcher at the Institute of Public Health at Riga Stradins University. Dr. Vrublevska works as a consultant psychiatrist in the Outpatient Consultative Department in Riga Psychiatry and Narcology Centre. Jelena Vrublevska serves as a secretary of the Section of the Evidence Based Psychiatry of the World Psychiatric Association. Dr. Vrublevska is a national expert in psychiatry at Latvian Council of Science. Since 2014 she is involved in the national level projects led by governmental organizations. She is lecturing at the university since 2011.

Anna Sibalova, MD, is currently working as a lecturer in Riga Stradins University Department of Clinical skills and Medical Technology and Department of Obstetrics and Gynecology. She is resident in obstetrics and gyneacology. She has also been involved in several national projects within the Department of Public Health and Epidemiology.

Ilana Aleskere is a resident doctor in psychiatry at Riga Stradins University, currently working in Riga Psychiatry and Narcology Centre. In 2020, she graduated from Riga Stradins University Medicine faculty. During her studies in medical school was working on researches on the topics like depression, anxiety, distress, cognitive functions, has participated in several international conferences. In 2020 was working in Riga Stradins University Public health department as a research assistant. Since 2021 is working as a tutor at the Department of Psychiatry and Narcology.

Baiba Rezgale, MD - assistant researcher; holds a medical degree and is currently a resident doctor in psychiatry working in Riga Psychiatry and Addiction Disorders Centre. Dr. Rezgale works as a consultant psychiatrist at ''Health Centre 4’’ in Riga, Latvia. She is a member of Latvian Psychiatric Association and the Young Psychiatrist Section and is involved with its activities concerning exchanging knowledge among residents and medical students.

Dr. Daria Smirnova currently acts as a Director of the International Centre for Education and Research in Neuropsychiatry and an Associate Professor of the Department of Psychiatry, Samara State Medical University (Russia). Dr. Smirnova has been a lecturer for undergraduate and postgraduate students in the field of psychiatry since 2006. Her career background includes basic training in General Medicine (MD) with postgraduate course in Psychiatry (Samara State Medical University) and research experience (PhD, Medical Sciences, Psychiatry, Moscow Research Institute of Psychiatry). Dr. Smirnova also works as a consultant in psychiatry and psychotherapy. Dr. Smirnova participated in several international collaborative projects. In 2014 she was awarded GoEight European fellowship to continue her research on thought, language and communication dysfunction in English-speaking patients using the dataset of Western Australian Family Study Schizophrenia. Dr. Smirnova is also working on collaborative projects about the Schizophrenia staging using PANSS, since 2020 as a project coordinator for the studies on "Estimating COVID-19 outbreak on mental health in general population and students across 40 countries", "COVID-19 associated mental and neurological disturbances". She published 100+ papers, including 32+ WoS peer-review articles, as well as several textbook chapters.

Konstantinos N. Fountoulakis, MD, is Professor of Psychiatry at Aristotle University of Thessaloniki, AHEPA University Hospital, in Thessaloniki, Greece and Director of Cochrane Greece. He is zonal 8 representative (South Europe) in the Board of the World Psychiatric Association and National Representative for Mental Health in the World Health Organization. General background Dr. Fountoulakis received his medical degree (1989), performed his residency in psychiatry (1998), and earned his doctorate in psychiatry (1999) at the Aristotle University of Thessaloniki. He received a 3-year fellowship in psychosomatic medicine and a 1-year postdoctoral fellowship for research from the State Scholarships Foundation of Greece. Until 2003 he served as a medical officer in the Greek Armed forces retired with the rank of major. In 2005, Dr. Fountoulakis was a Research Fellow in the Department of Psychiatry, Division of Neuropsychiatry, at the University of Geneva in Switzerland. Research and teaching topics Dr. Fountoulakis’ areas of clinical and research interest are reflected in the topics that he teaches: general psychiatry, biological psychiatry, psychopharmacology, mood disorders, schizophrenia and personality disorders. He has coauthored more than 400 papers and more than 250 of them are published in international journals such as the LANCET, BMJ, Am J Psychiatry, British Journal of Psychiatry, Biological Psychiatry, International Journal of Neuropsychopharmacology, Journal of Affective Disorders, Schizophrenia Research, Psychiatry Research, Bipolar Disorders, and the Annals of General Psychiatry among others, with approx. 10,000 citations and h=55 (Publish or Perish). During the years 2016-8 he was ranked by expertscape.com within the top 25 world experts concerning Bipolar disorder (0.068%) and among the top 50 concerning suicidality (0.097%). Books: He authored or co-authored a number of chapters in books including the Mood disorders chapter for the Wiki project of the World Psychiatric Association (WPA). He has authored the book ‘Bipolar disorders: An Evidence-Based Guide to Manic Depression’ (Springer-Verlag 2015), co-edited the WPA book ‘Advances in Psychiatry vol 3’ (Springer-Verlag 2018), and the book ‘Psychobiology of behavior’ (Springer-Verlag 2019) Membership in scientific associations. He chairs the ISNP and since 2006, he served as Secretary, since 2008 as co-chair, and currently as Chair of the Private Practice Section and also currently is chair of the section of Evidence Based Psychiatry, of the World Psychiatric Association. He served as Chair of the CINP Credentials and Membership Committee (2010-2) and the Neuropsychological and Psychometric Instruments Section, of the Greek Psychiatric Association. He is an active member of a number of national and international professional organizations, including the EPA, APA, WPA, CINP, ECNP, ISAD, ISBD, EBF and others, peer referee for the Cochrane Collaboration and member of the International College of Neuropsychopharmacology (CINP) Advisory Board to the Task Force on the Usefulness of Antidepressants and the Mental Health Economics Task Force of the International Psychogeriatric Association (IPA). Publications and related issues Dr. Fountoulakis serves for 20 years as Editor of Annals of General Psychiatry (IF=2.5). He also serves as field editor of CNS Spectrums (IF=3.9) and Frontiers in Psychiatry (IF=3.5). In the past he also served as Section Editor of Current Opinion in Psychiatry as well as guest editor in other international journals. Administration experience In 2009 was appointed member and in 2012-4 chair of the Greek Ministry of Health Committee for the Administrative, Economic and Scientific Supervision of the Mental Health Units of the deinstitutionalization project. In 2013 was appointed chair of the Independent Committee of Experts for the Assessment of Mental Health Services of the Greek Ministry of Health. Since 2019 he is head of the Mental Health Section, Research Institute, Greek Medical Association. In 2020 he was appointed first director of the newly established Cochrane Greece Events organized Was secretary of CME of the International Congress on Brain and Behaviour (2003-2007). Organized and chaired the series of International Congress on Neurobiology and Psychopharmacology (2009- ), the International Congress on Evidence Based Mental Health (2016- ) and a series of certified by the WPA educational Workshops. For details on the significant number of meetings, congresses and workshops organized please see www.psychiatry.gr International awards. He has received a number of national and international research awards, including the 2012 Kraepelin-Alzheimer medal of the University of Munich and the 2015 Excellence in Education Award of the WFSBP. Since 2014 he is honorary member of the WPA.

Elmars Rancans MD, PhD, leading researcher is Professor of Psychiatry and Chair of the Department of Psychiatry and Narcology (Addiction) at Riga Stradins University (RSU). Prof. Rancans is expert in the field of Medicine for the Latvian Council of Science. His program of research has been continuously funded since 1998, and he has over 40 peer-reviewed publications, book chapters, textbooks and manuals, Hirsh index 13. Dr. Rancans led or co-led international, national and local projects and initiatives on psychiatry issues of depression, suicide, early psychosis in Latvia and Europe. Our research team published the first epidemiological studies first episode Acute and Transient Psychosis, on suicidal behaviours, prevalence of depression in the general population and different mental disorders in the primary care in Latvia. As a Member of the Board of Nordic Psychiatric Associations, an umbrella organization for psychiatric associations of the Nordic and Baltic countries, he has extended professional and liaison network in the region for establishment of future research and policy development collaboration.

Additional information

Funding

The study is a part of a National Research Programme to mitigate consequences of COVID-19 approved by the Latvian Council of Science [VPP COVID_2020/1-0011].