{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T03:15:24Z","timestamp":1762053324711,"version":"build-2065373602"},"reference-count":65,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foundation for Science and Technology","award":["619792108, N.\u00ba 062"],"award-info":[{"award-number":["619792108, N.\u00ba 062"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The social conditions created by the COVID-19 pandemic had a great potential to affect the mental health of individuals. Meta-analyses indicate a rise in these problems in these periods among general populations, patients and health professionals, even with substantial heterogeneous results. This paper examines mental health impacts specifically during the first wave of COVID-19. An online survey was conducted with a Portuguese convenience sample (N = 1.062) comprising questions about substance use, perceived stress, post-traumatic stress disorder and self-damage behaviors. The results concerning substance use show an extensive use of medication to sleep or calm down, especially among women and older respondents, a small percentage of alcohol consumers with a high pattern of use and less frequent cannabis consumption, even with a quarter of users who began only in the COVID-19 period. The rates of perceived stress and PTSD were higher compared with international prevalence estimations during the pandemic conditions. Both correlated measures were worse for women and young people. Another problematic issue was the rate of suicidal ideation, with a relevant proportion of starters during this period. These data reinforce the need to promote access to mental health services.<\/jats:p>","DOI":"10.3390\/ijerph19116489","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T07:05:07Z","timestamp":1653635107000},"page":"6489","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Implication of the First Wave of COVID-19 on Mental Health: Results from a Portuguese Sample"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5965-4517","authenticated-orcid":false,"given":"Jorge","family":"Quintas","sequence":"first","affiliation":[{"name":"CJS\u2014Interdisciplinary Research Centre on Crime, Justice and Security, School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal"}]},{"given":"Ana","family":"Guerreiro","sequence":"additional","affiliation":[{"name":"CJS\u2014Interdisciplinary Research Centre on Crime, Justice and Security, School of Criminology, Faculty of Law, University of Porto, 4050-123 Porto, Portugal"},{"name":"Department of Social and Behavioral Sciences, University of Maia (UMAIA), 4475-690 Maia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-1398","authenticated-orcid":false,"given":"Maria Jo\u00e3o Leote","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"NOVA School of Social Sciences and Humanities (NOVA FCSH), 1069-061 Lisbon, Portugal"},{"name":"CICS.NOVA\u2014Interdisciplinary Centre of Social Sciences, 1099-085 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-0026","authenticated-orcid":false,"given":"Vera","family":"Duarte","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, University of Maia (UMAIA), 4475-690 Maia, Portugal"},{"name":"CICS.NOVA\u2014Interdisciplinary Centre of Social Sciences, 1099-085 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-7129","authenticated-orcid":false,"given":"Ana Rita","family":"Pedro","sequence":"additional","affiliation":[{"name":"Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-6159","authenticated-orcid":false,"given":"Ana Filipa","family":"Gama","sequence":"additional","affiliation":[{"name":"Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-0254","authenticated-orcid":false,"given":"In\u00eas","family":"Keygnaert","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium"},{"name":"WHO Collaborating Centre: International Centre for Reproductive Health (ICRH), Centre for Social Studies on Migration and Refugees (CESSMIR), 9000 Ghent, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-0685","authenticated-orcid":false,"given":"S\u00f3nia","family":"Dias","sequence":"additional","affiliation":[{"name":"Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, 1150-082 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Newby, J.M., O\u2019Moore, K., Tang, S., Christensen, H., and Faasse, K. (2020). Acute mental health responses during the COVID-19 pandemic in Australia. PLoS ONE, 15.","DOI":"10.1101\/2020.05.03.20089961"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mousoulidou, M., Siakalli, M., Christodoulou, A., and Argyrides, M. (2021). The Impact of the COVID-19 Pandemic on Mental Health: Evidence from Cyprus. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18083868"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"124","DOI":"10.7861\/clinmed.2019-coron","article-title":"What we know so far: COVID-19 current clinical knowledge and research","volume":"20","author":"Lake","year":"2020","journal-title":"Clin. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S2215-0366(20)30307-2","article-title":"How mental health care should change as a consequence of the COVID-19 pandemic","volume":"7","author":"Moreno","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_5","unstructured":"Organisation for Economic Co-Operation and Development [OECD] (2022, February 21). The Territorial Impact of COVID-19: Managing the Crisis across Levels of Government. Available online: https:\/\/read.oecd-ilibrary.org\/view\/?ref=128_128287-5agkkojaaa&title=The-territorial-impact-of-covid-19-managing-the-crisis-across-levels-of-government."},{"key":"ref_6","unstructured":"World Health Organization [WHO] (2021, January 10). WHO Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19. Available online: https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"356","DOI":"10.20344\/amp.13877","article-title":"O impacto da pandemia COVID-19 na sa\u00fade mental [The impact of the COVID-19 pandemic on mental health]","volume":"33","author":"Afonso","year":"2020","journal-title":"Acta Med Port."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1056\/NEJMp2008017","article-title":"Mental health and the COVID-19 pandemic","volume":"383","author":"Pfefferbaum","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1017\/S0033291721000933","article-title":"Investigating the effect of national government physical distancing measures on depression and anxiety during the COVID-19 pandemic through meta-analysis and meta-regression","volume":"51","author":"Marziali","year":"2021","journal-title":"Psychol. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1016\/S2215-0366(20)30079-1","article-title":"Mental Health Services for Older Adults in China during the COVID-19 Outbreak","volume":"7","author":"Yang","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_11","unstructured":"World Health Organization [WHO] (2021, January 01). Mental Health and Psychosocial Considerations during the COVID-19 Outbreak. Available online: https:\/\/www.who.int\/docs\/default-source\/coronaviruse\/mental-health-considerations.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s10640-020-00466-5","article-title":"Cross-Country Comparisons of COVID-19: Policy, Politics and the Price of Life","volume":"76","author":"Balmford","year":"2020","journal-title":"Environ. Resour. Econ."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"113462","DOI":"10.1016\/j.psychres.2020.113462","article-title":"Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany","volume":"293","author":"Benke","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Knolle, F., Ronan, L., and Murray, G.K. (2021). The impact of the COVID-19 pandemic on mental health in the general population: A comparison between Germany and the UK. BMC Psychol., 9.","DOI":"10.1186\/s40359-021-00565-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1891\/1946-6560.3.2.231","article-title":"A Systematic Review of Risk Factors for Intimate Partner Violence","volume":"3","author":"Capaldi","year":"2012","journal-title":"Partn. Abus."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1159\/000514341","article-title":"Domestic Violence during the COVID-19 Pandemic in Portugal","volume":"38","author":"Gama","year":"2020","journal-title":"Port. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Matias, A., Gon\u00e7alves, M., Soeiro, C., and Matos, M. (2020). Intimate partner homicide: A meta-analysis of risk factors. Aggress. Violent Behav., 50.","DOI":"10.1016\/j.avb.2019.101358"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1192\/bjo.2019.82","article-title":"Interpersonal violence and mental health outcomes following disaster","volume":"6","author":"Molyneaux","year":"2019","journal-title":"BJPsych Open"},{"key":"ref_19","unstructured":"Women UN (2021, November 20). COVID-19 and Ending Violence against Women and Girls. Available online: https:\/\/www.unwomen.org\/sites\/default\/files\/Headquarters\/Attachments\/Sections\/Library\/Publications\/2020\/Issue-brief-COVID-19-and-ending-violence-against-women-and-girls-en.pdf."},{"key":"ref_20","first-page":"5","article-title":"COVID 19: Uma pandemia de sa\u00fade mental","volume":"24","author":"Vieira","year":"2020","journal-title":"Sa\u00fade Tecnol."},{"key":"ref_21","unstructured":"World Health Organization [WHO] (2021, March 07). Psychological First Aid during Ebola Virus Disease Outbreaks. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/131682\/9789241548847_eng.pdf;jsessionid=4F171E61D69792C49C13FA40B33A30A8?sequence=1."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.jad.2020.10.061","article-title":"Self-reported changes in anxiety, depression and suicidality during the COVID-19 lockdown in Greece","volume":"279","author":"Fountoulakis","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/15325024.2020.1763556","article-title":"Coronavirus Disease (COVID-19) and Traumatic Stress: Probable Risk Factors and Correlates of Posttraumatic Stress Disorder","volume":"25","author":"Boyraz","year":"2020","journal-title":"J. Loss Trauma"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Sadovyy, M., S\u00e1nchez-G\u00f3mez, M., and Bres\u00f3, E. (2021). COVID-19: How the stress generated by the pandemic may affect work performance through the moderating role of emotional intelligence. Personal. Individ. Differ., 180.","DOI":"10.1016\/j.paid.2021.110986"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1037\/tra0000914","article-title":"COVID-19: PTSD symptoms in Greek health care professionals","volume":"12","author":"Blekas","year":"2020","journal-title":"Psychol. Trauma"},{"key":"ref_26","first-page":"e59","article-title":"COVID-19 as a Stressor: Pandemic Expectations, Perceived Stress, and Negative Affect in Older Adults","volume":"76","author":"Whitehead","year":"2020","journal-title":"J. Gerontol. Ser. B Psychol. Sci. Soc. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jad.2021.11.031","article-title":"Long-term effects of COVID-19 on mental health: A systematic review","volume":"299","author":"Bourmistrova","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"C\u00e9nat, J.M., Blais-Rochette, C., Kokou-Kpolou, C.K., Noorishad, P.-G., Mukunzi, J.N., McIntee, S.-E., Dalexis, R.D., Goulet, M.-A., and Labelle, P.R. (2021). Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res., 295.","DOI":"10.1016\/j.psychres.2020.113599"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Al Falasi, B., Al Mazrouei, M., Al Ali, M., Al Dhamani, M., Al Ali, A., Al Kindi, M., Dalkilinc, M., Al Qubaisi, M., Campos, L.A., and Al Tunaiji, H. (2021). Prevalence and Determinants of Immediate and Long-Term PTSD Consequences of Coronavirus-Related (CoV-1 and CoV-2) Pandemics among Healthcare Professionals: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042182"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Yunitri, N., Chu, H., Kang, X.L., Jen, H.-J., Pien, L.-C., Tsai, H.-T., Kamil, A.R., and Chou, K.-R. (2021). Global prevalence and associated risk factors of posttraumatic stress disorder during COVID-19 pandemic: A meta-analysis. Int. J. Nurs. Stud., 126.","DOI":"10.1016\/j.ijnurstu.2021.104136"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jad.2021.11.040","article-title":"Prevalence of post-traumatic stress disorder among survivors of severe COVID-19 infections: A systematic review and meta-analysis","volume":"299","author":"Nagarajan","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_32","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_33","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1016\/S2215-0366(20)30090-0","article-title":"Patients with mental health disorders in the COVID-19 epidemic","volume":"7","author":"Yao","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Orgil\u00e9s, M., Morales, A., Delvecchio, E., Mazzeschi, C., and Espada, J.P. (2020). Immediate Psychological Effects of the COVID-19 Quarantine in Youth From Italy and Spain. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.579038"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.3389\/fpsyg.2020.01713","article-title":"Parents\u2019 Stress and Children\u2019s Psychological Problems in Families Facing the COVID-19 Outbreak in Italy","volume":"11","author":"Spinelli","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_36","first-page":"42","article-title":"Psychological effects of the COVID-19 lockdown on children and families in the UK","volume":"7","author":"Kallitsoglou","year":"2020","journal-title":"Rev. Psicol. Cl\u00ednica Con. Ni\u00f1os Adolesc."},{"key":"ref_37","unstructured":"Inter-Agency Standing Committee [IASC] (2021, September 22). Interim Briefing Note Addressing Mental Health and Psychosocial Aspects of COVID-19 Outbreak ASC Reference Group on MHPSS in Emergency Settings. Available online: https:\/\/interagencystandingcommittee.org\/iasc-reference-group-mental-health-and-psychosocial-support-emergency-settings\/interim-briefing-note-addressing-mental-health-and-psychosocial-aspects-covid-19-outbreak."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1037\/amp0000662","article-title":"Effects of the COVID-19 pandemic and nationwide lockdown on trust, attitudes toward government, and well-being","volume":"75","author":"Sibley","year":"2020","journal-title":"Am. Psychol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Adamson, M.M., Phillips, A., Seenivasan, S., Martinez, J., Grewal, H., Kang, X., Coetzee, J., Luttenbacher, I., Jester, A., and Harris, O.A. (2020). International Prevalence and Correlates of Psychological Stress during the Global COVID-19 Pandemic. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17249248"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1192\/bjp.2020.242","article-title":"Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts","volume":"218","author":"Kwong","year":"2021","journal-title":"Br. J. Psychiatry"},{"key":"ref_41","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_42","doi-asserted-by":"crossref","unstructured":"Volk, A.A., Brazil, K.J., Franklin-Luther, P., Dane, A.V., and Vaillancourt, T. (2021). The influence of demographics and personality on COVID-19 coping in young adults. Personal. Individ. Differ., 168.","DOI":"10.1016\/j.paid.2020.110398"},{"key":"ref_43","unstructured":"World Health Organization [WHO] (2021, April 15). The Impact of COVID-19 on Mental, Neurological and Substance Abuse Services: Results of a Rapid Assessment. Available online: https:\/\/apps.who.int\/iris\/rest\/bitstreams\/1310579\/retrieve."},{"key":"ref_44","unstructured":"Conselho Nacional de Sa\u00fade [CNS] (2021, March 25). Sem Mais Tempo a Perder\u2013Sa\u00fade Mental em Portugal: Um Desafio para a Pr\u00f3xima D\u00e9cada, Available online: https:\/\/fronteirasxxi.pt\/wp-content\/uploads\/2020\/02\/%E2%80%9CSem-mais-tempo-a-perder%E2%80%9D-CNS-2019.pdf."},{"key":"ref_45","unstructured":"Sociedade Portuguesa de Psiquiatria e Sa\u00fade Mental [SPPSM] (2022, January 18). Perturba\u00e7\u00e3o Mental em N\u00fameros. Available online: https:\/\/www.sppsm.org\/informemente\/guia-essencial-para-jornalistas\/perturbacao-mental-em-numeros\/."},{"key":"ref_46","unstructured":"Instituto Nacional de Estat\u00edstica [INE] (2022, January 18). \u00d3bitos por Causas de Morte. Available online: https:\/\/www.ine.pt\/xportal\/xmain?xpid=INE&xpgid=ine_indicadores&indOcorrCod=0003736&contexto=bd&selTab=tab2&xlang=PT."},{"key":"ref_47","first-page":"28","article-title":"Seksueel geweld in Belgi\u00eb: Eerste representatieve prevalentiestudie naar de aard, omvang en impact van seksueel geweld in Belgi\u00eb","volume":"59","author":"Keygnaert","year":"2018","journal-title":"Sci. Connect."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Koss, M.P., Abbey, A., Campbell, R., Cook, S., Norris, J., Testa, M., Ullman, S., West, C., and White, J. (2006). The Sexual Experiences Short Form Victimization (SES-LFV), University of Arizona.","DOI":"10.1037\/t09413-000"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Walters, M., Chen, J., and Breiding, M. (2013). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Findings on Victimization by Sexual Orientation.","DOI":"10.1037\/e541272013-001"},{"key":"ref_50","first-page":"682","article-title":"Prevalence and correlates of young people\u2019s sexual aggression perpetration and victimisation in 10 European countries: A multi-level analysis","volume":"17","author":"Berger","year":"2014","journal-title":"Cult. Health Sex."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1093\/eurpub\/cku066","article-title":"Sexual and gender-based violence in the European asylum and reception sector: A perpetuum mobile?","volume":"25","author":"Keygnaert","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_52","unstructured":"Prins, A., Bovin, M.J., Kimerling, R., Kaloupek, D.G., Marx, B., Pless Kaiser, A., and Schnurr, P. (2020, February 27). Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) [Measurement instrument], Available online: https:\/\/www.ptsd.va.gov."},{"key":"ref_53","unstructured":"Spacapan, S., and Oskamp, S. (1988). Perceived Stress in a Probability Sample of the United States. The Social Psychology of Health, Sage."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"353","DOI":"10.14195\/1647-8606_53_17","article-title":"Estudo das propriedades psicom\u00e9tricas da Perceived Stress Scale (PSS) na popula\u00e7\u00e3o portuguesa","volume":"53","author":"Trigo","year":"2010","journal-title":"Psychologica"},{"key":"ref_55","unstructured":"Balsa, C., Vital, C., and Urbano, C. (2018). IV Inqu\u00e9rito Nacional ao Consumo de Subst\u00e2ncias Psicoativas na Popula\u00e7\u00e3o Geral\u2013Portugal 2016\/17, SICAD. Available online: https:\/\/www.sicad.pt\/BK\/EstatisticaInvestigacao\/EstudosConcluidos\/Lists\/SICAD_ESTUDOS\/Attachments\/181\/IV%20INPG%202016_17_PT.pdf."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"45","DOI":"10.5664\/jcsm.8800","article-title":"Escalation of sleep disturbances amid the COVID-19 pandemic: A cross-sectional international study","volume":"17","author":"Mandelkorn","year":"2021","journal-title":"J. Clin. Sleep Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e13052","DOI":"10.1111\/jsr.13052","article-title":"Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy","volume":"29","author":"Altena","year":"2020","journal-title":"J. Sleep Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e13119","DOI":"10.1111\/jsr.13119","article-title":"COVID-19 health crisis and lockdown associated with high level of sleep complaints and hypnotic uptake at the population level","volume":"30","author":"Beck","year":"2021","journal-title":"J. Sleep Res."},{"key":"ref_59","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_60","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.3389\/fpsyt.2021.689634","article-title":"Changes in Cannabis Consumption During the Global COVID-19 Lockdown: The International COVISTRESS Study","volume":"12","author":"Salles","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"601653","DOI":"10.3389\/fpsyt.2020.601653","article-title":"Cannabis and COVID-19: Reasons for Concern","volume":"11","author":"Oomen","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Chong, W.W.-Y., Acar, Z.I., West, M.L., and Wong, F. (2021). A Scoping Review on the Medical and Recreational Use of Cannabis During the COVID-19 Pandemic. Cannabis Cannabinoid Res., 1\u201312.","DOI":"10.1089\/can.2021.0054"},{"key":"ref_63","unstructured":"Organisation for Economic Co-operation and Development [OECD] (2021, November 23). The Effect of COVID-19on Alcohol Consumption, and Policy Responses to Prevent Harmful Alcohol Consumption. Available online: https:\/\/read.oecd-ilibrary.org\/view\/?ref=1094_1094512-803wufqnoe&title=The-effect-of-COVID-19-on-alcohol-consumption-and-policy-responses-to-prevent-harmful-alcohol-consumption."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12937-021-00699-0","article-title":"Altered alcohol consumption during COVID-19 pandemic lockdown","volume":"20","author":"Steffen","year":"2021","journal-title":"Nutr. J."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1590\/0047-2085000000180","article-title":"Suicide in Portugal: Image of the country","volume":"67","author":"Nunes","year":"2018","journal-title":"J. Bras. Psiquiatr."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6489\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:19:17Z","timestamp":1760138357000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,26]]},"references-count":65,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19116489"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19116489","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,5,26]]}}}