Psychological and financial impact of the COVID-19 pandemic during the first stages of the pandemic: Brazilian orthodontists´ perspective

ABSTRACT Introduction: Brazil faced a catastrophic situation in the coronavirus pandemic. Due to the high risk of contamination and spread of COVID-19, dentist have been attending only urgency and emergency services in Brazil at the beginning of the pandemic. Objective: This research aimed to evaluate the psychological and financial impacts caused by the coronavirus pandemic in Brazilian orthodontists. Methods: This population-based cross-sectional study collected demographic data and mental health measurements from 404 orthodontists. Depression, anxiety, insomnia, and distress were evaluated through Brazilian versions of the 9-item Patient Health Questionnaire (9-PHQ), the 7-item Generalized Anxiety Disorder scale and Mini-Tracking (GAD), the 7-item Insomnia Severity Index (ISI), and the 22-item Impact of Event Scale-Revised (IES-R), respectively. The demographic data of the sample was described using descriptive statistics. The data was analyzed according to sex, professional status, and economic income. Comparisons were performed using Chi-square tests, Mann-Whitney U tests, and Kruskal-Wallis followed by post-hoc tests. Results: Females, graduate students, and lower incomes subgroups showed higher levels of depression, anxiety, insomnia, and distress. Most orthodontists showed moderate to extreme financial and professional concerns during the pandemic. Conclusion: The coronavirus pandemic negatively affected the psychological health and increased the financial concerns of the Brazilian orthodontists, mainly female, graduate students, and with income below 10k participants.

[1]  D. Talamonti,et al.  The impact of inequality on mental health outcomes during the COVID-19 pandemic: A systematic review. , 2021 .

[2]  H. N. Yılmaz,et al.  The Assessment of Knowledge, Behaviors, and Anxiety Levels of the Orthodontists about COVID-19 Pandemic. , 2020, Turkish journal of orthodontics.

[3]  E. Ioannidou,et al.  Estimating COVID-19 prevalence and infection control practices among US dentists , 2020, The Journal of the American Dental Association.

[4]  S. Pelloso,et al.  Healthcare Workers in Brazil during the COVID-19 Pandemic: A Cross-Sectional Online Survey , 2020, Inquiry : a journal of medical care organization, provision and financing.

[5]  Prashant Sharma,et al.  Orthodontists' apprehension and viewpoint regarding COVID-19: A survey of Indian orthodontists , 2020 .

[6]  P. Cotrin,et al.  Urgencies and emergencies in orthodontics during the coronavirus disease 2019 pandemic: Brazilian orthodontists' experience , 2020, American Journal of Orthodontics and Dentofacial Orthopedics.

[7]  I. Isiekwe,et al.  Perceived impact of the COVID-19 pandemic on orthodontic practice by orthodontists and orthodontic residents in Nigeria , 2020, Journal of the World Federation of Orthodontists.

[8]  M. Varela Morales,et al.  Changes in orthodontics during the COVID-19 pandemic that have come to stay , 2020, American Journal of Orthodontics and Dentofacial Orthopedics.

[9]  Xin Xiong,et al.  Mental distress in orthodontic patients during the coronavirus disease 2019 pandemic , 2020, American Journal of Orthodontics and Dentofacial Orthopedics.

[10]  P. Cotrin,et al.  COVID-19 and orthodontics in Brazil: What should we do?∗ , 2020, American Journal of Orthodontics and Dentofacial Orthopedics.

[11]  Irene Y. H. Ng,et al.  Economic distress and health: A fixed effects analysis of low-income persons in Singapore , 2020 .

[12]  Y. Maaravi,et al.  Not all worries were created equal: the case of COVID-19 anxiety , 2020, Public Health.

[13]  R. Rongo,et al.  The Perception of COVID-19 among Italian Dentists: An Orthodontic Point of View , 2020, International journal of environmental research and public health.

[14]  P. Cotrin,et al.  Impact of coronavirus pandemic in appointments and anxiety/concerns of patients regarding orthodontic treatment , 2020, Orthodontics & craniofacial research.

[15]  G. Hripcsak,et al.  Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19 , 2020, The New England journal of medicine.

[16]  P. Katsaounou,et al.  Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis , 2020, Brain, Behavior, and Immunity.

[17]  C. Iani,et al.  Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia , 2020, International journal of environmental research and public health.

[18]  L. Sher COVID-19, anxiety, sleep disturbances and suicide , 2020, Sleep Medicine.

[19]  W. Alhazzani,et al.  COVID-19 coronavirus research has overall low methodological quality thus far: case in point for chloroquine/hydroxychloroquine , 2020, Journal of Clinical Epidemiology.

[20]  Vijay K. Sharma,et al.  A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak , 2020, Brain, Behavior, and Immunity.

[21]  Jinrong Yang,et al.  Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China , 2020, Medical science monitor : international medical journal of experimental and clinical research.

[22]  Zhou Aibao,et al.  Epidemic of COVID-19 in China and associated Psychological Problems , 2020, Asian Journal of Psychiatry.

[23]  Bach Tran,et al.  A longitudinal study on the mental health of general population during the COVID-19 epidemic in China , 2020, Brain, Behavior, and Immunity.

[24]  B. Pfefferbaum,et al.  Mental Health and the Covid-19 Pandemic. , 2020, The New England journal of medicine.

[25]  Yeen Huang,et al.  Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey , 2020, Psychiatry Research.

[26]  Kun Wang,et al.  Mental Health and Psychosocial Problems of Medical Health Workers during the COVID-19 Epidemic in China , 2020, Psychotherapy and Psychosomatics.

[27]  E. Ferneini The Financial Impact of COVID-19 on Our Practice , 2020, Journal of Oral and Maxillofacial Surgery.

[28]  I. Farooq,et al.  COVID-19 outbreak and its monetary implications for dental practices, hospitals and healthcare workers , 2020, Postgraduate Medical Journal.

[29]  D. Cucinotta,et al.  WHO Declares COVID-19 a Pandemic , 2020, Acta bio-medica : Atenei Parmensis.

[30]  Jianguo Tan,et al.  The impact of the COVID-19 epidemic on the utilization of emergency dental services , 2020, Journal of Dental Sciences.

[31]  Ningxi Yang,et al.  The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China , 2020, Medical science monitor : international medical journal of experimental and clinical research.

[32]  R. Ho,et al.  Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China , 2020, International journal of environmental research and public health.

[33]  Shao-hua Hu,et al.  Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 , 2020, JAMA network open.

[34]  R. Agha,et al.  World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19) , 2020, International Journal of Surgery.

[35]  W. Siqueira,et al.  Coronavirus COVID-19 impacts to dentistry and potential salivary diagnosis , 2020, Clinical Oral Investigations.

[36]  G. Zhu,et al.  Psychological interventions for people affected by the COVID-19 epidemic , 2020, The Lancet Psychiatry.

[37]  G. Kampf,et al.  Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents , 2020, Journal of Hospital Infection.

[38]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[39]  Jing Zhao,et al.  Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia , 2020, The New England journal of medicine.

[40]  C. Epperson,et al.  Sex Differences in Vulnerability and Resilience to Stress Across the Life Span , 2019, Biological Psychiatry.

[41]  Qing Yang,et al.  Gender differences in the influence of social isolation and loneliness on depressive symptoms in college students: a longitudinal study , 2019, Social Psychiatry and Psychiatric Epidemiology.

[42]  S. Martins,et al.  Generalized anxiety disorder and associated factors in adults in the Amazon, Brazil: A population-based study. , 2018, Journal of affective disorders.

[43]  A. Zuardi,et al.  Integrated mental healthcare: outcomes from Brazilian primary care , 2016 .

[44]  Lindsay Richards,et al.  Social class, employment status and inequality in psychological well-being in the UK: Cross-sectional and fixed effects analyses over two decades. , 2016, Social science & medicine.

[45]  G. Salum,et al.  Factor structure, reliability, and item parameters of the brazilian-portuguese version of the GAD-7 questionnaire , 2016 .

[46]  P. Albert,et al.  Why is depression more prevalent in women? , 2015, Journal of psychiatry & neuroscience : JPN.

[47]  Alícia Matijasevich,et al.  [Sensitivity and specificity of the Patient Health Questionnaire-9 (PHQ-9) among adults from the general population]. , 2013 .

[48]  Andrea Vannini Santesso Caiuby,et al.  Adaptação transcultural da versão brasileira da Escala do Impacto do Evento - Revisada (IES-R) , 2012 .

[49]  Ljiljana Kaliterna Lipovčan,et al.  Monthly income and subjective well-being of Croatian citizens. , 2007, Croatian medical journal.

[50]  R. Spitzer,et al.  The PHQ-9 , 2001, Journal of General Internal Medicine.

[51]  C. Morin,et al.  Validation of the Insomnia Severity Index as an outcome measure for insomnia research. , 2001, Sleep medicine.

[52]  R. Cummins Personal Income and Subjective Well-being: A Review , 2000 .

[53]  G. Simon,et al.  Somatic Symptoms of Distress: An International Primary Care Study , 1996, Psychosomatic medicine.

[54]  S. Dumith,et al.  Suicidal thought in southern Brazil: Who are the most susceptible? , 2019, Journal of affective disorders.

[55]  F. Sjöberg,et al.  Psychometric Properties of the Impact of Event Scale-Revised in Patients One Year After Burn Injury , 2010, Journal of burn care & research : official publication of the American Burn Association.