Valeria S. Claudio-Rivera, BS, Priscila M. Pérez-Mercado, BA, & Eduardo Cumba-Avilés, PhD
Institute for Psychological Research, College of Social Sciences, University of Puerto Rico, Río Piedras Campus, San Juan, Puerto Rico

INTRODUCTION: Chronic physical illnesses (CPIs) pose a higher risk of severe coronavirus-related symptoms, hospitalizations, and mortality. Risk awareness and difficulties accessing services during the outbreak may have made adults with CPIs more likely to experience psychopathological symptoms (PS) than healthy adults. We examined the severity and rates of PS among healthy adults and those with higher physical morbidity levels during the pandemic.

METHOD: Participants aged 21–79 (N=1736) completed an online survey. They had to be Puerto Rico residents for ≥3 months before enrollment, have access to the internet and understand Spanish. We administered measures of anxiety, depression, posttraumatic stress, loneliness, fear of COVID-19 infection (FOCI), and death/self-harm thoughts (DSHT). We defined groups based on morbidity levels: zero (G1), 1–2 (G2), 3–4 (G3), or ≥5 (G4) illnesses. We used Chi-square and ANCOVAs (adjusting for age, education, income, and household size) to compare groups in rates and severity of PS, respectively. We used the Bonferroni adjustment for multiple comparisons.

RESULTS: Rates of PS were statistically similar between G1 and G2, but higher in G3 and G4. G3 and G4 members reported more severe depression, anxiety, posttraumatic stress and loneliness than G2 members, who showed higher scores than G1 (p≤.05). The severity of obsessive/agoraphobic FOCI and DSHT was similar in G3 and G4 but higher than in G1. G4 adults showed higher rates and severity of depression and higher rates of DSHT than G3 members.

CONCLUSION: Our results concur with pre-pandemic studies that showed that increasing levels of physical morbidity result into increasing levels of PS. Because of their double vulnerability and the unique mental health challenges of adults with physical multimorbidity, our findings underscore the need for tailored interventions, continuous health-related education and affordable mental health services for this population, particularly during public health emergencies like the COVID-19 pandemic.

ACKNOLEDGEMENTS: This study was personally funded by the investigators.

IRB APPROVAL NUMBER: 1920-194 (UPR-Río Piedras)

KEYWORDS: Chronic physical illness, COVID-19 pandemic, Hispanics, mental health, multimorbidity