class: center, middle, inverse, title-slide # International symposium ## COVID-19<br/>Longitudinal analysis ### Luis Anunciação, Lucas Barrozo, Fabiana Ribeiro, Anja Leist, Landeira-Fernandez ### PUC-Rio, UFRJ, Universidade de Luxemburgo ### 2020/27/03 (updated: 2021-03-31) --- class: center, middle, inverse <style> .remark-slide-number { position: inherit; } .remark-slide-number .progress-bar-container { position: absolute; bottom: 0; height: 4px; display: block; left: 0; right: 0; } .remark-slide-number .progress-bar { height: 100%; background-color: gray; } </style> <div> <style type="text/css">.xaringan-extra-logo { width: 50px; height: 128px; z-index: 0; background-image: url(http://www.deqm.puc-rio.br/wp-content/uploads/2020/08/logo-puc-pequena-pb.png); background-size: contain; background-repeat: no-repeat; position: absolute; top:1em;right:1em; } </style> <script>(function () { let tries = 0 function addLogo () { if (typeof slideshow === 'undefined') { tries += 1 if (tries < 10) { setTimeout(addLogo, 100) } } else { document.querySelectorAll('.remark-slide-content:not(.title-slide):not(.inverse):not(.hide_logo)') .forEach(function (slide) { const logo = document.createElement('div') logo.classList = 'xaringan-extra-logo' logo.href = null slide.appendChild(logo) }) } } document.addEventListener('DOMContentLoaded', addLogo) })()</script> </div> # Background & Motivation --- # Background & Motivation .pull-left[ 1. On 11 Mar 2020, the World Health Organization (WHO) declared the outbreak a global pandemic; 1. Brazil is fighting a terrible COVID-19 waves exacerbated by multiple inadequate responses; 1. The rapidly evolving situation has drastically altered people's lives; 1. Health also includes from the neck up diseases; ] .pull-right[ 1. The uncertainties and fears associated with the outbreak, along with mass lockdowns and economic recession are predicted negatively impact the mental health; 1. increase the psychological distress in the general population, as well as in persons with pre-existing mental disorders; 1. Lack of interpersonal attachments is linked to poor physical, emotional, and mental health (Baumeister & Leary, 1995); 1. There is a lot of forecasts related to economic aspects, but just a few related to mental health; 1. Understand the consequences of the social distance in mental health; ] --- class: center, middle, inverse # The current study --- # Objectives & Methodology .pull-left[ 1. This is an exploratory survey; 1. Web-based data collection; 1. A convenience-sampling plan was the main strategy; 1. Participants were recruited at two times (the first current moment and 6 months later; ] .pull-right[ 1. To explore the impacts of social distancing and quarantine in two waves in aspects related to mental health, especially in depression and anxiety among Brazilian participants; 1. To check for differences in anxiety and depression trajectories including time and quarantine-related variables as predictors (if you stay at home, how many hours you stay at home, how often you leave home). ] --- # Demographic aspects <div id="htmlwidget-3b0317d107d70dcc50e3" style="width:100%;height:auto;" class="datatables html-widget"></div> <script type="application/json" data-for="htmlwidget-3b0317d107d70dcc50e3">{"x":{"filter":"none","extensions":["FixedColumns","FixedHeader"],"data":[["1","2","3","4","5","6","7","8","9","10","11","12","13","14","15","16","17","18","19","20","21","22","23","24","25","26","27","28","29","30","31","32","33","34","35","36","37","38","39","40","41","42","43","44","45","46","47","48","49","50","51","52","53","54","55","56","57","58","59","60","61","62","63","64","65","66","67","68","69","70","71","72","73","74","75","76","77","78","79","80","81","82","83","84","85","86","87","88","89","90","91","92","93","94","95","96","97","98","99","100","101","102","103","104","105","106","107","108","109","110","111","112","113","114","115","116","117","118","119","120","121","122","123","124","125","126","127","128","129","130","131","132","133","134","135","136","137","138","139","140","141","142","143","144","145","146","147","148","149","150","151","152","153","154","155","156","157","158","159","160","161","162","163","164","165","166","167","168","169","170","171","172","173","174","175","176","177","178","179","180","181","182","183","184","185","186","187","188","189","190","191","192","193","194","195","196","197","198","199","200","201","202","203","204","205","206","207","208","209","210","211","212","213","214","215","216","217","218","219","220","221","222","223","224","225","226","227","228","229","230","231","232","233","234","235","236","237","238","239","240","241","242","243","244","245","246","247","248","249","250","251","252","253","254","255","256","257","258","259","260","261","262"],["sexo","- 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(vendedor, barbeiro, etc)","- Construção (pedreiro, etc)","- Educação (professor, etc)","- Indústria (operador de máquina, etc)","- Outros","- Saúde (médicos, fisioterapeutas, etc)","- Serviço público","- Turismo e hotelaria","preocupacao_pagar_conta","- N-Miss","- Não","- Sim","pensa_em_adiar_pagamento","- N-Miss","- Não","- Sim","preocupacao_economia_geral","- N-Miss","- Nenhuma","- Pouca","- Bastante","- Extrema","preocupacao_situacao_financeira","- N-Miss","- Nenhuma","- Pouca","- Bastante","- Extrema","preocupacao_sua_saude","- N-Miss","- Nenhuma","- Pouca","- Bastante","- Extrema","preocupacao_saude_amigos_familia","- N-Miss","- Nenhuma","- Pouca","- Bastante","- Extrema","preocupacao_coesao_social","- N-Miss","- Nenhuma","- Pouca","- Bastante","- Extrema","preocupacao_produtos_alimentacao_higiene_medicamentos","- N-Miss","- Nenhuma","- Pouca","- Bastante","- Extrema","preocupacao_preco_produtos","- N-Miss","- Nenhuma","- Pouca","- Bastante","- 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(92.3%)","16 (3.2%)","18 (3.6%)","5 (1.0%)","","28","362 (71.7%)","118 (23.4%)","15 (3.0%)","10 (2.0%)","","28","383 (75.8%)","82 (16.2%)","27 (5.3%)","13 (2.6%)","","28","169 (33.5%)","116 (23.0%)","140 (27.7%)","80 (15.8%)","","28","260 (51.5%)","104 (20.6%)","97 (19.2%)","44 (8.7%)","","28","215 (42.6%)","120 (23.8%)","170 (33.7%)","","30","177 (35.2%)","90 (17.9%)","188 (37.4%)","48 (9.5%)"]],"container":"<table class=\"display\">\n <thead>\n <tr>\n <th> <\/th>\n <th>Var.1<\/th>\n <th>Overall..N.533.<\/th>\n <\/tr>\n <\/thead>\n<\/table>","options":{"scrollX":true,"dom":"tp","fixedHeader":true,"order":[],"autoWidth":false,"orderClasses":false,"columnDefs":[{"orderable":false,"targets":0}]}},"evals":[],"jsHooks":[]}</script> --- class: center, middle, inverse # Descriptives --- class: middle, center # First wave ## Contextual variables <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-7-1.png" width="504" /> --- class: middle, center # First wave ## Contextual variables <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-9-1.png" width="504" /> --- class: center, middle, inverse # Results --- class: middle, center # First wave ## I'm worried about (...) <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-10-1.png" width="65%" /> --- class: middle, center # First wave ## Depression <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-11-1.png" width="504" /> .footnote[[*] Overall mean = 23.21 (SD: 12.86).] --- class: middle, center # First wave ## Anxiety <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-12-1.png" width="504" /> .footnote[[*] Overall mean = 9.54 (SD: 5.75).] --- class: middle, center # First wave ## Depression & Anxiety <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-13-1.png" width="504" /> --- class: center, middle, inverse # Follow up --- class: middle, center # Longitudinal analysis <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-16-1.png" width="65%" /> --- class: inverse, middle, center # Hypothesis ## Mental health (Time evolution and group condition) -- Depression (CES) --- # Table & Graph .pull-left[ | | Leave from home (N=45) | Stay at home (N=73) | |:---------------------------|:----------------------:|:-------------------:| |**total_ces_t1** | | | | Mean (SD) | 20.156 (13.047) | 22.973 (12.794) | | Range | 0.000 - 53.000 | 1.000 - 54.000 | |**total_ces_t2** | | | | Mean (SD) | 20.222 (13.623) | 24.205 (13.809) | | Range | 0.000 - 52.000 | 2.000 - 60.000 | ] .pull-right[ <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-18-1.png" width="504" /> ] --- # Overall results ----------------------------------------------------------------------------------- Test statistic df P value Alternative hypothesis mean of the differences ---------------- ----- --------- ------------------------ ------------------------- -0.723 117 0.4711 two.sided -0.7881 ----------------------------------------------------------------------------------- Table: Paired t-test: `ds_t1_t2$total_ces_t1` and `ds_t1_t2$total_ces_t2` --- # Interaction <table> <thead> <tr> <th style="text-align:left;"> </th> <th style="text-align:right;"> Sum Sq </th> <th style="text-align:right;"> Mean Sq </th> <th style="text-align:right;"> NumDF </th> <th style="text-align:right;"> DenDF </th> <th style="text-align:right;"> F value </th> <th style="text-align:right;"> Pr(>F) </th> </tr> </thead> <tbody> <tr> <td style="text-align:left;"> factor(group) </td> <td style="text-align:right;"> 159.67 </td> <td style="text-align:right;"> 159.67 </td> <td style="text-align:right;"> 1 </td> <td style="text-align:right;"> 116 </td> <td style="text-align:right;"> 2.26 </td> <td style="text-align:right;"> 0.14 </td> </tr> <tr> <td style="text-align:left;"> factor(time) </td> <td style="text-align:right;"> 23.51 </td> <td style="text-align:right;"> 23.51 </td> <td style="text-align:right;"> 1 </td> <td style="text-align:right;"> 116 </td> <td style="text-align:right;"> 0.33 </td> <td style="text-align:right;"> 0.56 </td> </tr> <tr> <td style="text-align:left;"> factor(group):factor(time) </td> <td style="text-align:right;"> 18.93 </td> <td style="text-align:right;"> 18.93 </td> <td style="text-align:right;"> 1 </td> <td style="text-align:right;"> 116 </td> <td style="text-align:right;"> 0.27 </td> <td style="text-align:right;"> 0.61 </td> </tr> </tbody> </table> --- class: inverse, middle, center # Hypothesis ## Mental health (Time evolution and group condition) -- Depression (CES) -- Anxiety (GAD) --- # Overall results .pull-left[ | | Leave from home (N=45) | Stay at home (N=73) | |:---------------------------|:----------------------:|:-------------------:| |**total_gad_t1** | | | | Mean (SD) | 8.956 (5.174) | 9.548 (5.706) | | Range | 0.000 - 21.000 | 0.000 - 21.000 | |**total_gad_t2** | | | | Mean (SD) | 9.422 (6.013) | 9.904 (5.991) | | Range | 0.000 - 20.000 | 1.000 - 21.000 | ] .pull-right[ <img src="R-Markdown---covid-19-data-analysis_files/figure-html/unnamed-chunk-22-1.png" width="504" /> ] --- # Overall results ----------------------------------------------------------------------------------- Test statistic df P value Alternative hypothesis mean of the differences ---------------- ----- --------- ------------------------ ------------------------- -0.7757 117 0.4395 two.sided -0.3983 ----------------------------------------------------------------------------------- Table: Paired t-test: `ds_t1_t2$total_gad_t1` and `ds_t1_t2$total_gad_t2` --- # Interaction <table> <thead> <tr> <th style="text-align:left;"> </th> <th style="text-align:right;"> Sum Sq </th> <th style="text-align:right;"> Mean Sq </th> <th style="text-align:right;"> NumDF </th> <th style="text-align:right;"> DenDF </th> <th style="text-align:right;"> F value </th> <th style="text-align:right;"> Pr(>F) </th> </tr> </thead> <tbody> <tr> <td style="text-align:left;"> factor(group) </td> <td style="text-align:right;"> 4.97 </td> <td style="text-align:right;"> 4.97 </td> <td style="text-align:right;"> 1 </td> <td style="text-align:right;"> 116 </td> <td style="text-align:right;"> 0.32 </td> <td style="text-align:right;"> 0.57 </td> </tr> <tr> <td style="text-align:left;"> factor(time) </td> <td style="text-align:right;"> 9.42 </td> <td style="text-align:right;"> 9.42 </td> <td style="text-align:right;"> 1 </td> <td style="text-align:right;"> 116 </td> <td style="text-align:right;"> 0.60 </td> <td style="text-align:right;"> 0.44 </td> </tr> <tr> <td style="text-align:left;"> factor(group):factor(time) </td> <td style="text-align:right;"> 0.17 </td> <td style="text-align:right;"> 0.17 </td> <td style="text-align:right;"> 1 </td> <td style="text-align:right;"> 116 </td> <td style="text-align:right;"> 0.01 </td> <td style="text-align:right;"> 0.92 </td> </tr> </tbody> </table> --- # Conclusions .pull-left[ 1. The depression levels were above the recommended cutoff score at both times; 1. The anxiety levels were only close to cutoff, suggesting that these participants were not experiencing high anxiety during both times (however, subclinical symptoms are not desconsidered); 1. Compared to men, Women presented significantly higher results for depression and anxiety, as observed in the literature, in both times; 1. Social distancing, lockdowns, and quarantine are supposed to partially explain these outcomes; ] .pull-right[ 1. No significant differences were found in depression and anxiety among the groups (stay x leave) 1. Regardless the passage of time or being able to chose between stay of leave from home, they remained with high results 1. Non-significant results <b>are results</b> and we are still discussing our findings ] .footnote[[*] Not really. See next page.] --- # Thank you This research was supported by PUC-Rio, UFRJ, and University of Luxembourg Public note: 4.125.060 emails: luisfca@puc-rio.br