**3. Results**

A total of 13,584 people completed the questionnaires, but 95 were excluded for not meeting the inclusion criteria (61 were < 18 years of age and 34 were non-Brazilians). 1388 participants did not complete all items of the scales (DASS-21 and IER-S) and were excluded. Thus, the loss rate (considering individuals who did not respond to all the questions) was 10.2%, being below the expected from the sample size of the initial study (25%).

Of the included participants, 8.7% reported having an average monthly family income below 240.00 USD, 11.6% between 240.00 USD and 383.00 USD, 38.0% between 384.00 USD and 1652.00 USD, 16.1% between 1653.00 USD and 2153.00 USD, and 25.0% above 2154.00 USD. Regarding education, 50.1% had completed graduate studies, 20.7% had completed higher education, 28.8% had completed high school, and 0.4% had completed middle school. All Brazilian states were adequately represented (Table 2): 38.3% (*n* = 4677) were from the Southeast, 31.2% (*n* = 3804) from the Northeast, 12.3% (*n* = 1498) from the South, 9.8% (*n* = 1191) from the North, and 8.4% (*n* = 1026) from the Midwest.

There was a greater prevalence of women (69.8%) and younger people (50% < 33 years old and 10% ≥ 55 years) in the sample. The prevalence of previous mental health ranged from 20 to 43.1%. 81.5 to 95.2% of participants reported the appearance of some mental health symptom and 58.1 to 75.0% reported changes in their mental health status after the onset of the pandemic. Among individuals who had no previous medical diagnosis related to mental disorders (*n* = 8178), 85.5% reported the appearance of symptoms of psychological impairment after the start of the pandemic. Among individuals with a medical diagnosis of mental disorder, 96.2% reported new symptoms after the start of the pandemic. Considering the total sample, approximately 88.8% had some new symptoms after the start of the pandemic. A large number of people reported knowing someone who had tested positive for COVID-19 (68.8%) and most believed the coronavirus is a serious condition (97.9%) and felt unsafe about the current pandemic scenario (84.4%). Approximately one-third of participants found the broadcasted news confusing and the average time spent per day with news related to the pandemic was 125.2 (standard deviation = 128.9) min.

A cluster effect by states was not observed in the data, i.e., data variance due to the state of residence was very small (ICC for Depression = 0.050, Anxiety = 0.055, Stress = 0.054, Psychological impact related to the event = 0.025, Avoidance = 0.013, Intrusion = 0.017, Hyperarousal = 0.025). Thus, the subsequent analyzes will be presented for the whole of Brazil (*n* = 12,196).


Population (*N*) according to the State and minimum sample size estimated (*n*), final sample size (*n*'), and demographic characteristics.

> **Table 2.**

Table 3 shows the prevalence of depressive symptoms, anxiety, stress and the psychological impact due to the pandemic according to the level of symptoms.


**Table 3.** Prevalence (%) of symptoms of depression, anxiety and stress and the psychological impact due to the pandemic according to level of symptoms in Brazilian adults (*n* = 12,196).

A high prevalence of depression, anxiety, stress, and psychological impact due to the pandemic was found in the population, especially at moderate and severe levels.

The occurrence of psychological symptoms according to demographic and pandemic-related characteristics is shown in Table 4. Younger people, those feeling unsafe in regards to the pandemic, with a previous mental health problem, who reported a change in their mental state, and who reported following the news to the greatest extent excessively follow the news had a higher risk of developing psychological symptoms. Women were more likely to develop psychological symptoms than men, except for depressive symptoms. The lower the economic level, the higher the chance of symptoms, except for stress. Lower education levels increased the likelihood of depressive and intrusive symptoms. The presence of previous health problems increased the chance of developing symptoms, with the exception of avoidance.


