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Introduction: The mental health of the population has been affected by COVID, reporting in many populations higher levels of depressive, anxious and stress symptoms, however, in Honduras there are no studies showing the impact of COVID on the mental health of the population. Methods: Cross-sectional analytical study. Three scales were used, Beck for hopelessness, Hamilton for depression and anxiety, through interviews with the population attending different levels of health care throughout the country. Descriptive and analytical statistics were obtained. For hopelessness, the Beck Hopelessness Scale was used; for depression and anxiety, the Hamilton Scale was used. Results: Of the 8, participants, the population in general showed results of hopelessness Discussion: The Honduran population presented important differences in the socio-pathological, according to the loss of family members or having previous illnesses, this according to the presentation of problems in the mental sphere. Conclusion: We found factors associated with hopelessness, we found factors associated with hopelessness, depression and anxiety in times of COVID in the Honduran population. It is known that before the pandemic, depressive and anxiety mental disorders were the leading cause of the global health-related burden 4. A systematic review and a meta-analysis at this time the highest levels of depression and anxiety were reported in Africa and the Americas region, respectively 6. But then came the issues of confinement, economic problems, disruption of social, academic and routine activities, which together increased psychological disorders 7. And these symptoms increased in some specific populations, such as those working in the health sector, where multiple reports show increased problems of depressive symptoms, anxiety, insomnia and stress For this reason, the objective was to determine the factors associated with hopelessness, depression and anxiety in times of COVID in the population of Honduras. After training, the surveyors were distributed throughout the country; this distribution was carried out in hospitals and primary care units during the period from September—October to March—April Therefore, the population that was accessed was the one that went to these public health institutions, being mainly populations of the middle and lower social classes and in urban and semi-urban areas. For the survey process, verbal consent was obtained from each participant, which was recorded in the electronic survey designed and uploaded to the Microsoft Forms platform. This form of survey was chosen due to multiple factors: In the period of patient enrollment, there were still a regular number of positive cases, so the virtual survey system helped to have less contact between the respondent and the surveyor. In addition, this system allowed respondents to feel more at ease knowing that they could not be identified, which helped them to give more reliable answers. Finally, this generated a better way of storing the surveys, centralizing the information, debugging and quality control from a single central location and saving physical material, the latter to achieve a smaller carbon footprint. The most appropriate cut-off point is 8 positive responses, so that a score equal to or higher than 8 indicates a high degree of hopelessness The German psychiatrist Max Hamilton in described for the first time the depression scale 18 , which in its original version consisted of 21 items with 3 and 5 ordinal response options, later a reduced version was made with 17 items, which is the one recommended by the National Institute of Mental Health of the United States The scale assesses the severity of depressive symptoms during the week prior to the interview. The total scale score ranges from 0 points no depressive symptoms to 66 severe depressive symptoms. In our study we used the scale validated for Spain It is applied in a semi-structured form, where the severity of the symptoms is evaluated using 5 ordinal response options 0: absence of the symptom, up to 4: very severe or disabling symptom. The total score of the instrument, which is obtained by the sum of the partial scores of the 14 items, can range from 0 points absence of anxiety to 56 maximum degree of anxiety In a study in Mexico, using the Beck II scale for depression and the Hamilton anxiety scale in high school students during the pandemic, showed the presence of depression indicators After the data collection process was completed, the variables were cleaned and coded, with this the database was generated. The data were analyzed with Stata V First a table was generated with the description of the variables, where frequencies and percentages were used for the categorical variables, then measures of central tendency and dispersion were obtained for age. In all cases, p -values greater than 0. Of the 8, respondents, Table 1. In the first multivariate model, there was less hopelessness among women aPR: 0. Table 2. Table 3. Table 4. This being important because Honduras does not have national studies on the mental health situation of the general population, there are specific studies that establish prevalence in certain communities, Paz-Fonseca et al. Women in the family were the most affected and the prevalence of alcoholism was 6. Robinson 29 reported that there was a small increase in mental health symptoms shortly after the outbreak of the COVID pandemic that declined and was comparable to pre-pandemic levels in mid among most population subgroups and symptom types, mental health symptoms during March—April Compared with measures of anxiety and general mental health, increases in symptoms of depression and mood disorders tended to be greater and remained significantly elevated in May—July According to the sex variable, women were more affected than men in their mental health, different from what was reported in our study, men were more affected in the three pathologies, although it does coincide with the literature where women were more affected than men for major depressive disorder, anxiety disorders and younger age groups were more affected than older groups 4. There are more vulnerable groups in case of extreme situations such as catastrophes, pandemics, health workers are a group highly exposed to anxiety, depression, stress and other mental health problems 8 , the recent pandemic by COVID, has had adverse effects on mental health 4 in the general population and in specific populations: women and health workers, who are at particular risk of suffering a deterioration in mental wellbeing In a study in Turkey, levels of hopelessness and anxiety were higher in health professionals than in non-health workers. Levels of hopelessness in nurses were higher than in physicians, and levels of anxiety were higher than in physicians and other health care workers. Levels of anxiety and hopelessness were higher in women who lived with a high-risk person in the household during the pandemic, who had difficulty caring for their children, and who had decreased income. Anxiety levels are an important predictor of hopelessness. Increased levels of anxiety explained Several socioeconomic and lifestyle factors were found to be associated, marital status, household income, smoking, alcohol consumption and existing chronic conditions of the participants, The percentage of all three indicators was higher among women than among men, being married was associated with lower odds of loneliness among men. Loneliness was negatively associated with smoking and positively associated with alcohol consumption Rodriguez et al. The prevalence of depressive disorders in diabetics ranges from Vai and Col, found greater hopelessness, being the antecedent to have a mental illness, according to the literature people with any mental disorder had a higher probability of being hospitalized because of COVID Vai in , describes that the main factors associated with depression were sex, previous psychiatric history, psychopathology at 1-month follow-up, and systemic inflammation during the acute phase, whereas age was only a potential factor and severity of acute COVID was not. In fact, female sex, a previous psychiatric diagnosis, and psychopathology at 1-month follow-up were moderators of depression in the post-COVID syndrome A systematic review and meta-analysis, from January to August , included 44 studies. The prevalence of depression was significantly higher in people with type 1 diabetes or type 2 diabetes compared with those without diabetes. There was no association between study effect size and mean age or sex. The findings did not differ significantly between methods of depression assessment. Depression was higher in patients with diabetes in studies conducted in specialty care compared with those in community or primary care and in low- and middle-income countries compared with countries with high-income economies Anxiety and depression are as strongly predictive of future poor physical health as obesity and smoking People with obesity and diabetes are at increased risk for significant symptoms of depression 47 , physical activity, nutrition, and eating behaviors are associated with physical and mental health, hence the importance of establishing and strengthening healthy lifestyle habits in this target population depression and obesity are complex and chronic We found in our study that there was more anxiety among those who were infected with COVID, in those who had a family member who died from COVID, and in those who had a history of mental illness. Fear of the unknown increases anxiety levels in healthy individuals as well as in those with preexisting mental health conditions In a meta-analysis including studies, the overall prevalence of anxiety was The prevalence in low- and middle-income countries was similar compared with high-income countries. In the case of DM, in Pakistan, In Latin America, 1, patients were evaluated in Mexico, of which Neuropsychiatric symptoms were evaluated with a meta-analysis after COVID, the most prevalent neuropsychiatric symptom was sleep disturbance followed by fatigue, objective cognitive impairment, anxiety, and post-traumatic stress. The uncertainties associated with a new virus, the risk of staff becoming infected, a changing and challenging work environment, the potential personal impact of the virus, and the concerns associated with caring for patients and their families put additional pressure on staff Studies examining the mental health impact of providing front-line medical care during viral outbreaks showed that healthcare workers often have high levels of anxiety, depression, and post-traumatic stress disorder, both during and after outbreaks We identified a wide number of risk factors such as younger age and female gender, and social factors such as lack of social support, social rejection, or isolation and stigmatization. Occupational factors involved working in a high-risk environment frontline staff , specific occupational roles e. A meta-analysis has identified, on a large scale and worldwide, the prevalence of mental health symptoms, it was found that healthcare workers exposed to COVID had a significant prevalence rate of anxiety, depression, acute stress, insomnia, post-traumatic symptoms, and burnout, are a vulnerable population during the COVID pandemic, being more prone to mental health impairment than the general population. These findings suggest that the mental health impairment of healthcare workers is not due to measures of general confinement, social distance, and pandemic preoccupation, but to the particularities of the healthcare professions and their conditions during the pandemic Data suggest that the pandemic and associated public health and social measures PHSM have led to a global increase in mental health problems, including, across the board, depression and anxiety. Persons with pre-existing mental disorders are also at increased risk of severe illness and death from COVID and should be considered an at-risk group when diagnosed with the infection 58 Yuan K, reported that participants with a history of mental disorders displayed over three times higher risk for depression and anxiety In the year in Latin America and the Caribbean, the SARS-COV pandemic has led to increases in unemployment, poverty, food insecurity, domestic violence, and child abuse at the same time that worsening mental health conditions were reported in the same area 58 , in the Human Development Report , Honduras presented an HDI of 0. The COVID pandemic negatively affects mental health in a unique way across all population subgroups. Our results inform tailored preventive strategies and interventions to mitigate current, future, and transgenerational adverse mental health from the COVID pandemic Our database is predominantly composed of individuals of the female gender. Another limitation was that some of the crosstabs did not have adequate statistical power, so these crosstabs should be considered purely exploratory. The approach was carried out in primary health care PHC , and for this reason the diagnoses were not confirmed by a physician specializing in psychiatry. For all these reasons, it should be remembered that extrapolations to other populations should be made with caution in the descriptive results, but the associations are important because they come from a large group of citizens attending public health facilities. Our study shows that the most reported variable was hopelessness, followed by depression and very low anxiety. Men in Honduras had the highest levels of hopelessness, depression and anxiety, and by the end of the pandemic a high percentage of the general population had not yet been infected by COVID A considerable percentage of the participants had suffered the loss of a family member, which negatively influences the deplorable mental health of the population in times of COVID Chronic non-communicable diseases such as HTN, obesity and DM were the most prevalent for all three pathologies, as was the history of mental illness. It is important for countries to be concerned about the mental health of the population, which prior to the pandemic was already a major public health problem worldwide and which was exacerbated as a result of COVID The pandemic came to change our way of living, to change our habits and, faced with the uncertainty of the unknown, made us vulnerable at the expense of finding the solution in a vaccine that would stop the virus and mitigate the panic generated worldwide. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. The ethics committee waived the requirement of written informed consent for participation. All authors contributed to the article and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Google Scholar. Propozycja nowej definicji zdrowia psychicznego. Psychiatr Pol. The mental health of medical workers in Wuhan, China dealing with the novel coronavirus. Lancet Psychiatry. Global prevalence and burden of depressive and anxiety disorders in countries and territories in due to the COVID pandemic. The prevalence of psychological consequences of COVID a systematic review and meta-analysis of observational studies. J Health Psychol. Depression, anxiety, and the COVID pandemic: severity of symptoms and associated factors among university students after the end of the movement lockdown. PLoS One. Lozano-Vargas, A. Rev Neuropsiquiatr. Zhang, SX, and Chen, J. Eur J Psychotraumatol. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease Portal Ciencia. Eur Neuropsychopharmacol. Cien Tecnol. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol. Anu Investig. Standardization of the beck hopelessness scale in the general population. J Ment Health. Rev Psicopatol Psicol Clin. Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry. National Institute of Mental Health. A new validation of the Hamilton rating scale for depression. J Psychiatr Res. Worboys, M. The Hamilton rating scale for depression: the making of a 'gold standard' and the unmaking of a chronic illness, Chronic Illn. The assessment of anxiety states by rating. Br J Med Psychol. Med Clin Barc. Cien Latin. Mental disorders prevalence at Villanueva Comunity, metropolitan region. Prevalence of mental disorders in population of 18 years or older in 29 urban Honduran communities. Epidemiol Psychiatr Sci. A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID pandemic in J Affect Disord. Coronavirus awareness, confinement stress, and mental health: evidence from Honduras, Chile, Costa Rica. Mexico Spain Soc Sci Med. A large-scale meta-analytic atlas of mental health problems prevalence during the COVID early pandemic. J Med Virol. Anxiety and hopelessness levels in COVID pandemic: a comparative study of healthcare professionals and other community sample in Turkey. Perceived psychosocial health and its sociodemographic correlates in times of the COVID pandemic: a community-based online study in China. Infect Dis Poverty. J Am Health. Fam Process. Comput Biol Med. Epidemiological and clinical characteristics of 99 cases of novel coronavirus pneumonia in Wuhan, China: a descriptive study. Cortisol dysregulation: the bidirectional link between stress, depression, and type 2 diabetes mellitus. Ann N Y Acad Sci. Sartorius, N. Depression and diabetes. Dialogues Clin Neurosci. Eur J Psychiatry. Mental disorders and risk of COVIDrelated mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis. World Health Organization. Obesity and Overweight. Geneva: World Health Organization. A systematic review and meta-analysis to compare the prevalence of depression between people with and without type 1 and type 2 diabetes. Prim Care Diabetes. Comparing anxiety and depression to obesity and smoking as predictors of major medical illnesses and somatic symptoms. Health Psychol. Higher risk of depression in individuals with type 2 diabetes and obesity: results of a meta-analysis. Pilot trial of a group cognitive behavioural therapy program for comorbid depression and obesity. BMC Psychol. Association of the COVID lockdown with smoking, drinking and attempts to quit in England: an analysis of data. The prevalence of mental health conditions in healthcare workers during and after a pandemic: systematic review and meta-analysis. J Adv Nurs. Public responses to the novel coronavirus nCoV in Japan: mental health consequences and target populations. Psychiatry Clin Neurosci. Prevalence of anxiety during the COVID pandemic: a systematic review and meta-analysis of over 2 million people. Gac Med Mex. Pak Diabetes Metab Syndr. Brain Commun. Impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review and meta-analysis. COVID pandemic effects on health worker's mental health: systematic review and meta-analysis. Eur Psychiatry. A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID a call to action. Mol Psychiatry. Informe de Desarrollo Humano Keywords: anxiety, depression, hopelessness, Honduras, mental health, Central America. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. Top bar navigation. About us About us. Sections Sections. About journal About journal. Article types Author guidelines Editor guidelines Publishing fees Submission checklist Contact editorial office. Psychiatry , 01 March Statistical analysis After the data collection process was completed, the variables were cleaned and coded, with this the database was generated. Results Of the 8, respondents,

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