{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:37:41Z","timestamp":1774611461739,"version":"3.50.1"},"reference-count":69,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"This article was supported by National Funds through FCT - Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia,I.P., within CINTESIS, R&amp;D Unit","award":["(reference UIDB\/4255\/2020)."],"award-info":[{"award-number":["(reference UIDB\/4255\/2020)."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Mental health effects secondary to the COVID-19 pandemic were till recently considered less important or were neglected. Portugal and Brazil are facing the pandemic in quite different ways. This study aimed to describe the mental health status of the general adult population in Portugal and Brazil during the COVID-19 pandemic and analyze the differences between the two countries. A cross-sectional quantitative study was based on an online questionnaire. Socio-demographic data were collected in addition to four validated scales: CAGE (acronym cut-annoyed-guilty-eye) Questionnaire, Satisfaction with Life Scale, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-2. For each outcome, a multiple linear regression was performed. Five hundred and fifty people answered the questionnaire (435 women). The median age was 38 (Q1, Q3: 30, 47) years, 52.5% resided in Brazil and 47.5% in Portugal. The prevalence of anxiety was 71.3% (mild anxiety was present in 43.1%), the prevalence of depression was 24.7% and 23.8% of the sample had both depression and anxiety. Isolation was a significant factor for depression but not for anxiety. Well-being was below average. Mental illness was considerably higher than pre-COVID-19 levels. Portugal and Brazil will have to be prepared for future consequences of poor mental health and contribute immediate psychological support to their adult populations.<\/jats:p>","DOI":"10.3390\/ijerph17186794","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T20:47:48Z","timestamp":1600375668000},"page":"6794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":107,"title":["Impact on Mental Health Due to COVID-19 Pandemic: Cross-Sectional Study in Portugal and Brazil"],"prefix":"10.3390","volume":"17","author":[{"given":"L\u00edgia","family":"Passos","sequence":"first","affiliation":[{"name":"Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2849-5194","authenticated-orcid":false,"given":"Filipe","family":"Prazeres","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, University of Beira interior, 6200-506 Covilh\u00e3, Portugal"},{"name":"Family Health Unit Beira Ria, 3830-596 Gafanha da Nazar\u00e9, Portugal"},{"name":"Centre for Health Technology and Services Research (CINTESIS), University of Porto, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1199-2220","authenticated-orcid":false,"given":"Andreia","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Centre for Health Technology and Services Research (CINTESIS), University of Porto, 4200-450 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-5167","authenticated-orcid":false,"given":"Carlos","family":"Martins","sequence":"additional","affiliation":[{"name":"Centre for Health Technology and Services Research (CINTESIS), University of Porto, 4200-450 Porto, Portugal"},{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"ref_1","unstructured":"(2020, August 03). WHO Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19\u201411 March 2020. Available online: https:\/\/www.who.int\/dg\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020."},{"key":"ref_2","unstructured":"Minist\u00e9rio da Sa\u00fade Brasil (2020, August 03). Brasil Confirma Primeiro Caso da Doen\u00e7a, Available online: https:\/\/www.saude.gov.br\/noticias\/agencia-saude\/46435-brasil-confirma-primeiro-caso-de-novo-coronavirus."},{"key":"ref_3","unstructured":"Expresso (2020, August 17). Ministra Confirma Primeiro Caso Positivo de Coronav\u00edrus em Portugal. Available online: https:\/\/expresso.pt\/sociedade\/2020-03-02-Ministra-confirma-primeiro-caso-positivo-de-coronavirus-em-Portugal."},{"key":"ref_4","unstructured":"G1 (2020, August 17). Primeira Morte por Coronav\u00edrus no Brasil Aconteceu em 12 de Mar\u00e7o, diz Minist\u00e9rio da Sa\u00fade. Available online: https:\/\/g1.globo.com\/bemestar\/coronavirus\/noticia\/2020\/06\/27\/primeira-morte-por-coronavirus-no-brasil-aconteceu-em-12-de-marco-diz-ministerio-da-saude.ghtml."},{"key":"ref_5","unstructured":"S\u00e1bado (2020, August 17). Registada Primeira Morte por Novo Coronav\u00edrus em Portugal. Available online: https:\/\/www.sabado.pt\/portugal\/detalhe\/confirmada-a-primeira-morte-por-novo-coronavirus-em-portugal."},{"key":"ref_6","unstructured":"Peixoto, V.R., Vieira, A., Aguiar, P., Carvalho, C., Thomas, D., and Abrantes, A. (2020). Rapid assessment of the impact of lockdown on the COVID-19 epidemic in Portugal. medRxiv."},{"key":"ref_7","unstructured":"Correio da Manh\u00e3 (2020, August 17). Ant\u00f3nio Costa Anuncia fim do Estado de Emerg\u00eancia e Declara Estado de Calamidade. Available online: https:\/\/www.cmjornal.pt\/politica\/detalhe\/antonio-costa-anuncia-fim-do-estado-de-emergencia-e-declara-estado-de-calamidade."},{"key":"ref_8","unstructured":"Worldometer (2020, September 12). Coronavirus Cases. Available online: https:\/\/www.worldometers.info\/coronavirus\/?."},{"key":"ref_9","unstructured":"Reuters (2020, September 12). Major Brazilian Cities set Lockdowns as Virus Spreads. Available online: https:\/\/www.reuters.com\/article\/us-health-coronavirus-brazil-lockdown\/major-brazilian-cities-set-lockdowns-as-virus-spreads-idUSKBN22H2V3."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Pancani, L., Marinucci, M., Aureli, N., and Riva, P. (2020). Forced social isolation and mental health: A study on 1006 Italians under COVID-19 lockdown. PsyArXiv.","DOI":"10.31234\/osf.io\/uacfj"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100216","DOI":"10.1136\/gpsych-2020-100216","article-title":"Mental healthcare for psychiatric inpatients during the COVID-19 epidemic","volume":"33","author":"Li","year":"2020","journal-title":"Gen. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/S2215-0366(20)30046-8","article-title":"Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed","volume":"7","author":"Xiang","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/0020764020915212","article-title":"The outbreak of COVID-19 coronavirus and its impact on global mental health","volume":"66","author":"Torales","year":"2020","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"156","DOI":"10.4103\/jgid.jgid_66_17","article-title":"The forgotten plague: Psychiatric manifestations of ebola, zika, and emerging infectious diseases","volume":"9","author":"Tucci","year":"2017","journal-title":"J. Glob. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_16","first-page":"137","article-title":"Mental health outcomes of the CoViD-19 pandemic","volume":"55","author":"Talevi","year":"2020","journal-title":"Riv. Psichiatr."},{"key":"ref_17","unstructured":"The Academy of Medical Sciences (2020, August 23). Survey Results: Understanding People\u2019s Concerns about the Mental Health Impacts of the COVID-19 Pandemic. Available online: https:\/\/acmedsci.ac.uk\/file-download\/99436893."},{"key":"ref_18","unstructured":"Berg, R.L., and Cassells, J.S. (1992). Social Isolation Among Older Individuals: The Relationship to Mortality and Morbidity. The Second Fifty Years: Promoting Health and Preventing Disability, National Academies Press (US)."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"356","DOI":"10.20344\/amp.13877","article-title":"The Impact of the COVID-19 Pandemic on Mental Health","volume":"33","author":"Afonso","year":"2020","journal-title":"Acta Med. Port."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_21","first-page":"2","article-title":"Pandemia COVID-19: Quais s\u00e3o os Riscos para a Sa\u00fade Mental?","volume":"6","author":"Afonso","year":"2020","journal-title":"Rev. Port. Psiquiatr. e Sa\u00fade Ment."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e2020038","DOI":"10.4178\/epih.e2020038","article-title":"Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence","volume":"42","author":"Hossain","year":"2020","journal-title":"Epidemiol. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1017\/S0950268807009156","article-title":"Understanding, compliance and psychological impact of the SARS quarantine experience","volume":"136","author":"Reynolds","year":"2008","journal-title":"Epidemiol. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/alcalc\/agn073","article-title":"Alcohol Abuse\/Dependence Symptoms Among Hospital Employees Exposed to a SARS Outbreak","volume":"43","author":"Wu","year":"2008","journal-title":"Alcohol Alcohol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/inm.12735","article-title":"Family violence and COVID-19: Increased vulnerability and reduced options for support","volume":"29","author":"Usher","year":"2020","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Salgado, J., Andr\u00e9s-Villas, M., Dom\u00ednguez-Salas, S., D\u00edaz-Milan\u00e9s, D., and Ruiz-Frutos, C. (2020). Related Health Factors of Psychological Distress During the COVID-19 Pandemic in Spain. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17113947"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Choi, E.P.H., Hui, B.P.H., and Wan, E.Y.F. (2020). Depression and Anxiety in Hong Kong during COVID-19. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17103740"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Gualano, M.R., Lo Moro, G., Voglino, G., Bert, F., and Siliquini, R. (2020). Effects of Covid-19 Lockdown on Mental Health and Sleep Disturbances in Italy. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17134779"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Nwachukwu, I., Nkire, N., Shalaby, R., Hrabok, M., Vuong, W., Gusnowski, A., Surood, S., Urichuk, L., Greenshaw, A.J., and Agyapong, V.I.O. (2020). COVID-19 Pandemic: Age-Related Differences in Measures of Stress, Anxiety and Depression in Canada. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17176366"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Twenge, J.M., and Joiner, T.E. (2020). U.S. Census Bureau-assessed prevalence of anxiety and depressive symptoms in 2019 and during the 2020 COVID-19 pandemic. Depress. Anxiety, da.23077.","DOI":"10.1002\/da.23077"},{"key":"ref_31","unstructured":"Mundo ao Minuto (2020, August 17). Europa Endurece Medidas Face a Amea\u00e7a de Segunda Vaga da Covid-19. Available online: https:\/\/www.noticiasaominuto.com\/mundo\/1532689\/europa-endurece-medidas-face-a-ameaca-de-segunda-vaga-da-covid-19."},{"key":"ref_32","unstructured":"SAPO (2020, August 18). Das M\u00e1scaras Obrigat\u00f3rias aos Casamentos com 10 Pessoas, pa\u00edses Voltam a Apertar Regras Contra a Covid-19. Available online: https:\/\/eco.sapo.pt\/2020\/08\/18\/das-mascaras-obrigatorias-aos-casamentos-com-10-pessoas-paises-voltam-a-apertar-regras-contra-a-covid-19\/."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1001\/jama.1984.03350140051025","article-title":"Detecting alcoholism. The CAGE questionnaire","volume":"252","author":"Ewing","year":"1984","journal-title":"JAMA"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1176\/ajp.131.10.1121","article-title":"The CAGE questionnaire: Validation of a new alcoholism screening instrument","volume":"131","author":"Mayfield","year":"1974","journal-title":"Am. J. Psychiatry"},{"key":"ref_35","first-page":"215","article-title":"Validation of the \u201cCAGE\u201d alcoholism screening test in a Brazilian psychiatric inpatient hospital setting","volume":"16","author":"Masur","year":"1983","journal-title":"Braz. J. Med. Biol. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/978-90-481-2354-4_5","article-title":"Review of the Satisfaction with Life Scale","volume":"Volume 39","author":"Diener","year":"2009","journal-title":"Assessing Well-Being. Social Indicators Research Series"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1207\/s15327752jpa4901_13","article-title":"The Satisfaction with Life Scale","volume":"49","author":"Diener","year":"1985","journal-title":"J. Pers. Assess."},{"key":"ref_38","first-page":"503","article-title":"Ulterior valida\u00e7\u00e3o de uma escala de satisfa\u00e7\u00e3o com a vida (SWLS)","volume":"26","year":"1992","journal-title":"Rev. Port. Pedagog."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"317","DOI":"10.7326\/0003-4819-146-5-200703060-00004","article-title":"Anxiety disorders in primary care: Prevalence, Impairment, Comorbidity, and Detection","volume":"146","author":"Kroenke","year":"2007","journal-title":"Ann. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population","volume":"46","author":"Decker","year":"2008","journal-title":"Med. Care"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12955-015-0244-2","article-title":"Reliability and validity of the Portuguese version of the Generalized Anxiety Disorder (GAD-7) scale","volume":"13","author":"Sousa","year":"2015","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: A new depression diagnostic and severity measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatr. Ann."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jad.2009.07.004","article-title":"Screening for depression: Rasch analysis of the dimensional structure of the PHQ-9 and the HADS-D","volume":"122","author":"Kendel","year":"2010","journal-title":"J. Affect. Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1744-6163.2009.00224.x","article-title":"Study of the Discriminative Validity of the PHQ-9 and PHQ-2 in a Sample of Brazilian Women in the Context of Primary Health Care","volume":"45","author":"Mendes","year":"2009","journal-title":"Perspect. Psychiatr. Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1097\/01.MLR.0000093487.78664.3C","article-title":"The patient health questionnaire-2: Validity of a two-item depression screener","volume":"41","author":"Kroenke","year":"2003","journal-title":"Med. Care"},{"key":"ref_48","unstructured":"Myers, R.H. (1986). Classical and Modern Regression with Applications, Duxbury Press."},{"key":"ref_49","unstructured":"PORDATA (2020, August 17). Popula\u00e7\u00e3o Residente: Total e por Grandes Grupos et\u00e1rios. Available online: https:\/\/www.pordata.pt\/Portugal\/Popula\u00e7\u00e3o+residente+total+e+por+grandes+grupos+et\u00e1rios-513."},{"key":"ref_50","unstructured":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE) (2020, August 17). Popula\u00e7\u00e3o, por Grupos de Idade, Available online: https:\/\/sidra.ibge.gov.br\/tabela\/5918#resultado."},{"key":"ref_51","unstructured":"SIC Not\u00edcias (2020, August 17). Baston\u00e1rio dos M\u00e9dicos: \u201cA sa\u00fade Mental vai ser a Grande Pandemia Deste s\u00e9culo\u201d. Available online: https:\/\/sicnoticias.pt\/saude-e-bem-estar\/2020-08-08-Bastonario-dos-Medicos-A-saude-mental-vai-ser-a-grande-pandemia-deste-seculo."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.genhosppsych.2009.03.001","article-title":"Long-term psychiatric morbidities among SARS survivors","volume":"31","author":"Mak","year":"2009","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1001\/jama.2014.17934","article-title":"The 2014 Ebola outbreak and mental health: Current status and recommended response","volume":"313","author":"Shultz","year":"2015","journal-title":"JAMA"},{"key":"ref_54","unstructured":"World Health Organization (2017). Depression and Other Common Mental Disorders: Global Health Estimates, World Health Organization. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/254610\/WHO-MSD-MER-2017.2-eng.pdf."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1016\/S2215-0366(20)30077-8","article-title":"Online mental health services in China during the COVID-19 outbreak","volume":"7","author":"Liu","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1080\/07481187.2020.1748481","article-title":"Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety","volume":"44","author":"Lee","year":"2020","journal-title":"Death Stud."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1034\/j.1600-0447.2003.00204.x","article-title":"Gender differences in unipolar depression: An update of epidemiological findings and possible explanations","volume":"108","author":"Kuehner","year":"2003","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1038\/s41598-018-21243-x","article-title":"Prevalence of Depression in the Community from 30 Countries between 1994 and 2014\/692\/699\/476\/1414\/692\/499 article","volume":"8","author":"Lim","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1002\/da.20341","article-title":"Sex differences in the use of coping strategies: Predictors of anxiety and depressive symptoms","volume":"25","author":"Kelly","year":"2008","journal-title":"Depress. Anxiety"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.puhe.2017.07.035","article-title":"An overview of systematic reviews on the public health consequences of social isolation and loneliness","volume":"152","author":"Bagguley","year":"2017","journal-title":"Public Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"20140114","DOI":"10.1098\/rstb.2014.0114","article-title":"Perceived social isolation, evolutionary fitness and health outcomes: A lifespan approach","volume":"370","author":"Hawkley","year":"2015","journal-title":"Philos. Trans. R. Soc. B Biol. Sci."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Ge, L., Yap, C.W., Ong, R., and Heng, B.H. (2017). Social isolation, loneliness and their relationships with depressive symptoms: A population-based study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0182145"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1176\/appi.ajp.2020.20030305","article-title":"The Critical Relationship Between Anxiety and Depression","volume":"177","author":"Kalin","year":"2020","journal-title":"Am. J. Psychiatry"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1017\/S2045796015000189","article-title":"Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys","volume":"24","author":"Kessler","year":"2015","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1176\/ajp.150.8.1216","article-title":"Psychiatric comorbidity in patients with generalized anxiety disorder","volume":"150","author":"Emmanuel","year":"1993","journal-title":"Am. J. Psychiatry"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpsychires.2017.02.020","article-title":"Clinical characteristics and treatment outcomes of patients with major depressive disorder and comorbid anxiety disorders - results from a European multicenter study","volume":"91","author":"Dold","year":"2017","journal-title":"J. Psychiatr. Res."},{"key":"ref_67","unstructured":"Diener, E. (2020, August 19). Understanding Scores on the Satisfaction with Life Scale. Available online: http:\/\/labs.psychology.illinois.edu\/~ediener\/Documents\/UnderstandingSWLSScores.pdf."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jcbs.2020.07.010","article-title":"COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic","volume":"17","author":"Dawson","year":"2020","journal-title":"J. Context. Behav. Sci."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Dey, M., Frazis, H., Loewenstein, M.A., and Sun, H. (2020). Ability to work from home: Evidence from two surveys and implications for the labor market in the COVID-19 pandemic. U.S. Bureau of Labor Statistics. Mon. Labor. 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