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BACKGROUND: Essential workers have been show to present higher prevalences of anxiety and depression positive screenings during the COVID-19 pandemic Individuals from countries presenting socioeconomic inequalities may be at increased risk to mental health disorders OBJECTIVE: Herein we aimed to assess the prevalence and predictors of depression, anxiety, and their comorbidity among essential workers from Brazil and Spain during the COVID-19 pandemic METHODS: A web survey was conducted during April-May, 2020 in both countries The main outcome was positive screening for depression only, anxiety only and both Lifestyle was measured using a lifestyle multidimensional scale adapted to the COVID-19 pandemic (SMILE-C) A multinomial logistic regression model was performed to evaluate the factors associated with depression, anxiety, and both RESULTS: From the 22,786 individuals included in the websurvey, 3745 self-reported to be essential workers Overall, 8·3%, 11·6% and 27·4% presented positive screenings for depression, anxiety, and both, respectively After adjusting for confounding factors, the multinomial model showed that an unhealthy lifestyle increased the likelihood of depression (Adjusted Odds Ratio- AOR 4·00 (95%CI:2·72-5·87), anxiety (AOR 2·39 (95%CI:1·80-3·20), and both anxiety and depression (AOR 8·30 (95%CI:5·90-11·7);while living in Brazil was associated with increased AOR 2·89 (95%CI:2·07-4·06) for depression, anxiety AOR 2·81 (95%CI:2·11-3·74), and both depression and anxiety AOR 5·99 (95%CI:4·53-7·91) CONCLUSIONS: Interventions addressing lifestyle may be useful in dealing with symptoms of common mental disorders during the strain imposed among essential workers by the COVID 19 pandemic Essential workers that live in midle income countries with higher rates of inequality may face additional challenges Ensuring equitable treatment and support may be an important challenge ahead, considering the possible syndemic effect of social determinants of health
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