{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T21:56:21Z","timestamp":1768082181931,"version":"3.49.0"},"reference-count":36,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Isolation measures used to contain epidemics generate social interaction restrictions and impose changes in routines of the public that increase negative psychological outcomes. Anxiety and depression are the most common symptoms. Objective: To evaluate the mental health of the Brazilian population during the SARs-CoV-2 pandemic and its relationship with demographic and health characteristics. Methods: Adults from all Brazilian States participated (n = 12,196; women: 69.8%, mean age = 35.2 years). The Depression, Anxiety and Stress Scale, and the Impact of Event Scale\u2013revised were used (online survey). Data validity and reliability were verified by confirmatory factor analysis and ordinal alpha coefficient. The probability of presenting psychological symptoms was calculated by multiple logistic regression and odds ratio (OR) (0 = without symptoms, 1 = with mild, moderate, and severe levels of symptoms). Results: High prevalence of depression (61.3%), anxiety (44.2%), stress (50.8%), and psychological impact (54.9%) due to the isolation experienced from the pandemic was found. Younger individuals (OR = 1.58\u20133.58), those that felt unsafe (OR = 1.75\u20132.92), with a previous diagnosis of mental health (OR = 1.72\u20132.64) and\/or had general health problems before the pandemic (OR = 1.17\u20131.51), who noticed changes in their mental state due to the pandemic context (OR = 2.53\u20139.07), and excessively exposed to the news (OR = 1.19\u20132.18) were at increased risk of developing symptoms. Women (OR = 1.35\u20131.65) and those with lower economic status (OR = 1.38\u20132.69) were more likely to develop psychological symptoms. Lower educational levels increased the likelihood of depressive (OR = 1.03\u20131.34) and intrusive symptoms (OR = 1.09\u20131.51). Conclusions: The pandemic and related factors can have a high impact on the mental health of the population. Demographic characteristics can influence the occurrence of psychological symptoms.<\/jats:p>","DOI":"10.3390\/jcm9092976","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T10:24:09Z","timestamp":1600165449000},"page":"2976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Early Psychological Impact of the COVID-19 Pandemic in Brazil: A National Survey"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7123-5585","authenticated-orcid":false,"given":"Juliana Alvares Duarte Bonini","family":"Campos","sequence":"first","affiliation":[{"name":"School of Pharmaceutical Sciences, S\u00e3o Paulo State University (UNESP), Campus Araraquara, S\u00e3o Paulo 14800-903, Brazil"}]},{"given":"Bianca Gonzalez","family":"Martins","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Sciences, S\u00e3o Paulo State University (UNESP), Campus Araraquara, S\u00e3o Paulo 14800-903, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1514-5758","authenticated-orcid":false,"given":"Lucas Arrais","family":"Campos","sequence":"additional","affiliation":[{"name":"School of Dentistry, S\u00e3o Paulo State University (UNESP), Campus Araraquara, S\u00e3o Paulo 14801-903, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-5378","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Mar\u00f4co","sequence":"additional","affiliation":[{"name":"William James Center for Research (WJCR), University Institute of Psychological, Social, and Life Sciences (ISPA), 1100-304 Lisbon, Portugal"}]},{"given":"Rayya Ahmed","family":"Saadiq","sequence":"additional","affiliation":[{"name":"Mayo Clinic College of Medicine General Interne Medicine and International Medicine, Mayo Clinic, Rochester, MN 55905, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3642-5858","authenticated-orcid":false,"given":"Rodrigo","family":"Ruano","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"ref_1","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_2","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_3","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_4","first-page":"1","article-title":"COVID-19 and mental health: A review of the existing literature","volume":"52","author":"Rajkumar","year":"2020","journal-title":"Asian J. Psychatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"m313","DOI":"10.1136\/bmj.m313","article-title":"The psychological effects of quarantining a city","volume":"368","author":"Rubin","year":"2020","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/inm.12726","article-title":"The COVID-19 pandemic and mental health impacts","volume":"29","author":"Usher","year":"2020","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_7","first-page":"1","article-title":"Isolation, quarantine, social distancing and community containment: Pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak","volume":"27","author":"Freedman","year":"2020","journal-title":"J. Travel Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1176\/appi.ps.55.9.1055","article-title":"Survey of stress reactions among health care workers involved with the SARS outbreak","volume":"55","author":"Bai","year":"2004","journal-title":"Psychiatr. Serv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1086\/382355","article-title":"The public\u2019s response to severe acute respiratory syndrome in Toronto and the United States","volume":"38","author":"Blendon","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/j.0737-1209.2005.220504.x","article-title":"The experience of quarantine for individuals affected by SARS in Toronto","volume":"22","author":"Cava","year":"2005","journal-title":"Public Health Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1016\/j.socscimed.2005.04.010","article-title":"The experience of SARS-related stigma at Amoy Gardens","volume":"61","author":"Lee","year":"2005","journal-title":"Soc. Sci. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1017\/S1049023X17006720","article-title":"Knowledge, attitudes, and practices among members of households actively monitored or quarantined to prevent transmission of Ebola virus disease-Margibi County, Liberia: February\u2013March 2015","volume":"32","author":"Wilken","year":"2017","journal-title":"Prehosp. Disaster Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1186\/s12889-018-5158-6","article-title":"The factors affecting household transmission dynamics and community compliance with Ebola control measures: A mixed-methods study in a rural village in Sierra Leone","volume":"18","author":"Caleo","year":"2018","journal-title":"BMC Public Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.genhosppsych.2010.11.001","article-title":"Is quarantine related to immediate negative psychological consequences during the 2009 H1N1 epidemic?","volume":"33","author":"Wang","year":"2011","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1186\/1471-2458-13-344","article-title":"Understanding the school community\u2019s response to school closures during the H1N1 2009 influenza pandemic","volume":"13","author":"Tooher","year":"2013","journal-title":"BMC Public Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1111\/pcn.13004","article-title":"Mental health during and after the COVID-19 emergency in Italy","volume":"74","author":"Sani","year":"2020","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol."},{"key":"ref_18","first-page":"3404","article-title":"Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha","volume":"24","author":"Zheng","year":"2020","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S2215-0366(20)30078-X","article-title":"Mental health care for medical staff in China during COVID-19 outbreak","volume":"7","author":"Chen","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1159\/000507639","article-title":"Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China","volume":"89","author":"Zhang","year":"2020","journal-title":"Psychother. Psychosom."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., Wang, Y., Fu, H., and Dai, J. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE, 15.","DOI":"10.2139\/ssrn.3541120"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., and Ho, R.C. (2020). Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051729"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Figueiras, A., and Stults-Kolehmainen, M. (2020). The relationship between behavioural and psychosocial factors among brazilians in quarantine due to COVID-19. Lancet Psychiatry.","DOI":"10.2139\/ssrn.3566245"},{"key":"ref_24","first-page":"1","article-title":"A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations","volume":"33","author":"Qiu","year":"2020","journal-title":"BMJ Gen. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.bbi.2020.04.048","article-title":"Affective treatment, attachment style, and the psychological impact of the COVID-19 outbreak: An early report on the Italian general population","volume":"87","author":"Moccia","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jad.2020.06.036","article-title":"The loneliness pandemic: Loneliness anther concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak","volume":"275","author":"Palgi","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_27","unstructured":"Bruin, W.B. (2020). Age Differences in COVID-19 Risk Perceptions and Mental Health: Evidence From a National U.S. Survey Conducted in March 2020. J. Gerontol. Psychol. Sci., 1\u20136."},{"key":"ref_28","first-page":"1","article-title":"Mental health before and during the COVID-19 pandemic: A longitudinal probability sample survey of the UK population","volume":"21","author":"Pierce","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s12992-020-00589-w","article-title":"Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: A systematic review and meta-analysis","volume":"16","author":"Salari","year":"2020","journal-title":"Glob. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.jad.2013.10.031","article-title":"Adaptation and validation of the Depression, Anxiety and Stress Scale (DASS) to Brazilian Portuguese","volume":"155","author":"Vignola","year":"2014","journal-title":"J. Affect. Disord."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1590\/0047-2085000000222","article-title":"Escala de Depress\u00e3o, Ansiedade e Estresse: Propriedades psicom\u00e9tricas e preval\u00eancia das afetividades","volume":"68","author":"Martins","year":"2019","journal-title":"J. Bras. Psiquiatr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1590\/S0102-311X2012000300019","article-title":"Adapta\u00e7\u00e3o transcultural da vers\u00e3o brasileira da Escala do Impacto do Evento\u2014Revisada (IES-R)","volume":"28","author":"Caiuby","year":"2012","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_33","unstructured":"Lovibond, S.H., and Lovibond, P.F. (2020, July 28). Manual for the Depression, Anxiety, Stress Scales. Available online: http:\/\/www2.psy.unsw.edu.au\/dass\/."},{"key":"ref_34","unstructured":"Kline, R.B. (1998). Principles and Practice of Structural Equation Modeling, The Guilford Press."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1093\/qjmed\/hcaa110","article-title":"Mental health in the Covid-19 pandemic","volume":"113","author":"Cullen","year":"2020","journal-title":"QJM Int. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1037\/0022-3514.75.3.670","article-title":"Everyday stressors and gender differences in daily distress","volume":"75","author":"Almeida","year":"1998","journal-title":"J. Personal. Soc. Psychol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/9\/2976\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:10:11Z","timestamp":1760177411000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/9\/2976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,15]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["jcm9092976"],"URL":"https:\/\/doi.org\/10.3390\/jcm9092976","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,15]]}}}