Associação entre histórico de transtorno mental e ideação e comportamento suicida em profissionais da saúde brasileiros durante a pandemia de COVID-19 e o potencial efeito mediador do distresse psicológico

Abstract

A history of mental disorders has been consistently associated with an increased risk of suicidal ideation and suicidal behavior. The present study aimed to investigate the mediating role of psychological distress in the relationship between a history of mental disorder and suicidal ideation and behavior among Brazilian healthcare professionals during the COVID-19 pandemic. This is a longitudinal study based on data from 916 Brazilian healthcare professionals, drawn from four waves of an online survey conducted between May 2020 and January 2022. History of mental disorder was assessed at baseline, whereas psychological distress (GSI), suicidal ideation, and suicidal behavior were assessed repeatedly over time. Longitudinal mediation models were estimated using the Weighted Least Squares Mean and Variance adjusted (WLSMV) estimator, with ordinal outcomes modeled on a latent scale and incorporating autoregressive and cross-lagged effects. For suicidal ideation, significant mediation by psychological distress was observed only in the initial transition (W1→W2; indirect effect = 0.413; p < 0.001), with a significant global indirect effect (0.349; p < 0.001). For suicidal behavior, significant indirect effects were found across all temporal windows (2.472; p < 0.001), indicating a consistent pattern of mediation by psychological distress over time. The findings indicate that psychological distress plays a central mediating role in the association between a history of mental disorder and suicidal outcomes, with distinct temporal patterns for ideation and behavior. These results reinforce the relevance of early intervention strategies aimed at identifying and reducing psychological distress among healthcare professionals, particularly in contexts of prolonged crisis, such as the COVID-19 pandemic.