Fear of Covid-19, anxiety, and depression during the pandemic: A network analysis

ABSTRACT

Introduction: Covid-19 has generated several psychological impacts on people's lives and brought new challenges for dealing with the pandemic's repercussions. Objective: The objective was to analyse the relationship between the symptoms of fear of Covid-19, anxiety, and depression using different samples extracted at three distinct time-points. This study performed a network analysis of the fear of Covid-19 and anxiety- and depression -related symptoms based on data collected during the Covid-19 pandemic. Method: Three yearly cross-sectional surveys were conducted based on independent samples (2020-2022) of Brazilian adults (Time-point 1, Time-point 2, and Time-point 3 with 1,520, 1,523, and 1,517 participants, respectively). The Fear of Covid-19 Scale, the Generalised Anxiety Disorder Scale (7 items), and the Patient Health Questionnaire (9 items) were applied. The network structure invariance, the global strength invariance, and the strength of centrality index between the samples were compared. Results: Items from the three instruments had high values (>70%) in all samples (excluding the fear of Covid-19 at Time-point 3). Depression and anxiety symptoms increased, while fear-related behaviours decreased. Network analysis indicates that networks became progressively more parsimonious, and few edges connected different scales. Network comparisons revealed similar structures, but key differences were found Time-point 1 showed significantly higher global connectivity, and changes in edge weights were observed only within the scales. Conclusions: Our findings suggest that the pandemic had a greater disorganising impact at its beginning, with a continuous increase in the mental health symptomatology and a reduction in the ratio between fear and anxiety and/or depression.

RESUMEN

Introducción: El COVID-19 generó varios impactos psicológicos en la vida de las personas imponiendo nuevos desafíos para confrontar la pandemia. Objetivo: Analizar la relación entre los síntomas de miedo al COVID-19, ansiedad y depresión utilizando diferentes muestras extraídas durante tres períodos de tiempo distintos. Fueron analizadas redes del miedo y los síntomas de ansiedad y depresión usando datos recolectados durante la pandemia de COVID-19. Método: Tres encuestas transversales anuales basadas en muestras independientes (2020-2022) de adultos brasileños (punto temporal 1, punto temporal 2 y punto temporal 3 con 1520, 1523 y 1517 participantes, respectivamente). Se aplicaron la Escala de Miedo al COVID-19, la Escala de Trastorno de Ansiedad Generalizada (7 ítems) y el Cuestionario de Salud del Paciente (9 ítems). Se compararon la invariancia de la estructura de la red, la invariancia de la fuerza global y la fuerza del índice de centralidad entre los tres puntos temporales. Resultados: Los ítems de los tres instrumentos tuvieron valores altos (> 70 %) en todos los puntos temporales (excluyendo el miedo al COVID-19 en el punto temporal 3). A lo largo de los tres puntos temporales, los síntomas de depresión y ansiedad aumentaron, mientras que el miedo disminuyó. Las redes se volvieron progresivamente más parsimoniosas y pocas aristas conectaron diferentes escalas, con estructuras similares. Conclusiones: La pandemia tuvo un mayor impacto desorganizador en su inicio, con un aumento continuo de la sintomatología de salud mental y una disminución de la relación entre miedo y ansiedad o depresión.