Mental disorder symptoms during the COVID-19 pandemic in Latin America – a systematic review and meta-analysis

  1. Stephen X. Zhang
  2. Kavita Batra
  3. Wen Xu
  4. Tao Liu
  5. Rebecca Kechen Dong
  6. Allen Yin
  7. Andrew Yilong Delios
  8. Bryan Z. Chen
  9. Richard Z. Chen
  10. Saylor Miller
  11. Xue Wan
  12. Wenping Ye
  13. Jiyao Chen

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Abstract

Aims

There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America.

Methods

Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv , were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. Studies were assigned quality scores using the Mixed Methods Appraisal Tool. The double data extraction method was used to minimise data entry errors.

Results

A total of 62 studies with 196 950 participants in Latin America were identified. The pooled prevalence of anxiety, depression, distress and insomnia was 35%, 35%, 32% and 35%, respectively. There was a higher prevalence of mental health symptoms in South America compared to Central America (36% v . 28%, p < 0.001), in countries speaking Portuguese (40%) v. Spanish (30%). The pooled prevalence of mental health symptoms in the general population, general healthcare workers, frontline healthcare workers and students in Latin America was 37%, 34%, 33% and 45%, respectively.

Conclusions

The high yet heterogenous level of prevalence of mental health symptoms emphasises the need for appropriate identification of psychological interventions in Latin America.

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  1. Version published to 10.1017/s2045796021000767
  2. ScreenIT

    SciScore for 10.1101/2021.06.21.21259299: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variableStudies which targeted other populations, including children, adolescents, and certain subgroups (e.g. pregnant women), were excluded.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Bibliographic databases, such as PubMed, Embase, PsycINFO, and Web of Sciences, were searched on February 6, 2021.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    PsycINFO
    suggested: (PsycINFO, RRID:SCR_014799)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Study Limitations: There are a few limitations that merit discussion. First our analysis reveals substantial heterogeneities across studies in the type of survey instruments used and the cut-off scores, both of which may affect the interpretation of the findings. Second, not all Latin American countries have been well-studied, therefore our results may have limited generalizability for the less studied nations. Third, a majority of the included studies were cross-sectional, which provides no information on the prevalence over time during the pandemic. In addition, studies included in this meta-analysis relied on self-reported data of psychological symptoms by the participants and hence do not constitute mental health diagnosis from clinicians. Fourth, other outcomes, such as Post-traumatic Stress Syndrome (PTSD), suicidal ideation, and burnout, were not studied in this meta-analysis, leaving opportunities for prospective studies. Last, a language bias is expected in the study because of the language restriction (only English) applied in this study. Practical Implications: First, our systematic review and meta-analysis supports evidence-based medicine by revealing a high proportion of mental health symptoms among the general population and healthcare workers during the COVID-19 pandemic in Latin America. However, our systematic review also reveals there is a lack of evidence in many Latin American countries to guide relevant practice of evidence-based medicine on this topic. O...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.06.21.21259299v1 on medRxiv