COVID-19 psychological impact in patients with depressive disorder: Differences based on their age

IntroductionCOVID-19 pandemic and lockdown have provoked a considerable psychological impact in Spain. Some studies have reported greater psychological impact in the younger population. To date, no previous study has focused on depressive disorder (DD) patients based on their age.ObjectivesTo describe the psychological impact on DD according to age.MethodsCross-sectional study of an online survey available from 19 to 26 March 2020. Out of a total of 21207 respondents, 608 (2.9%) reported suffering from DD (mean age ±SD = 41.2 years±14.07 [18-82], 80.6% women). The subsample (608) was divided according to age, “youngsters” <45 (57.4%)/ “elders” ≥45. DASS-21 and IES scales were employed. Statistical analyses: Chi-square, t-Student test.ResultsBoth groups did not differ (p>0.05) in sex, having COVID-19 symptoms, having family/friends infected, or income changes. While youngsters were single more frequently (68.8% vs 14.3%, χ² = 179.7, p<0.001), elders had somatic illness more frequently (64.8% vs 39.7% χ² =30.401, p<0.001). Youngsters obtained higher scores in depression (4.69 vs 4.1, T=5.413, p<0.001), anxiety (2.86 vs 1.97, T=5.249, p<0.001) and stress (4.48 vs 3.17, T=6.355, p<0.001) DASS-21 subscales, as in intrusive (3.42 vs 3.05, T=1.984, p=0.048) and avoidant (4.64 vs 4.11, T=3.056, p=0.002) IES scores.ConclusionsDespite the group of elders with depression being more vulnerable to severe COVID-19 disease and presenting more frequently somatic comorbidities, younger depressive patients suffered more from depressive, anxiety, stress and avoidant symptoms and intrusive thoughts, in line with previous reports in the general population.DisclosureNo significant relationships.

P.859COVID-19 lockdown in people with severe mental disorders in Spain: do they have a specific psychological reaction?

Introduction: After the outbreak of a new coronavirus subtype SARS-CoV-2 in China in late 2019, a global pandemic developed, generating a health, economic, and social emergency [1]. In Spain, the COVID-19 pandemic crisis forced the government to declare a state of emergency on 14 March 2020 and to implement unprecedented lockdown restriction. In this context, patients with severe mental disorders (SMD) may be particularly exposed to stress and social distancing measures [2, 3] and thus disproportionately vulnerable to public health interventions to fight the COVID-19 [4]. However, the early psychological impact of the pandemic and the lockdown in this population is still mostly unknown. Aims of the study: Here, we aim to compare the early psychological impact (depression, anxiety, and stress responses, intrusive and avoidant thoughts, and coping strategies) in a sample of people with SMD compared with two control groups: other mental disorders (OMD) and healthy controls (HC). Methods: An anonymous online questionnaire using a snowball sampling method was conducted from March 19-26, 2020 and included sociodemographic and clinical data along with the Spanish versions of the Depression, Anxiety, and Stress Scale (DASS-21) and the Impact of Event Scale (IES). A total of 21,279 people living in Spain answered the questionnaire, and 125 people with SMD were included in the analysis. Subjects in each of the two control groups (OMD, n = 250;HC, n = 250) were matched (ratio 1:2) for sex and age (± 1 year) with the SMD group. We performed descriptive and bivariate analyses and multinomial and linear regression models. Results: People with SMD [mean age = 43.25 years (SD = 14.41);61.6% females] had statistically significantly higher scores on anxiety, stress, and depression subscales of the DASS-21 compared with the HC group, but lower scores than OMD in all domains (p < 0.05). Most people with SMD (87.2%) were able to enjoy free time, although control groups had higher percentages. After controlling for confounding factors, anxiety was the only significant psychological domain with lower scores in HC than people with SMD (OR = 0.721;95% CI: 0.579 - 0.898). In the SMD group, the multiple linear regression model (R2 = 0.580, F = 41.027, p < 0.001) found that higher anxiety was associated with being single (ẞ = 0.144, t = 2.291, p = 0.024), having COVID-19 symptoms (ẞ = 0.146, t = 2.395, p = 0.018), and a higher score on the stress subscale (ẞ = 0.538, t = 7.635, p < 0.001);whereas being able to enjoy free time was a protective factor (ẞ = -0.244, t = -3.692, p < 0.001). Conclusions: Our results showed that patients with SMD reacted to the pandemic and the lockdown restrictions with higher anxiety levels than the general public, suggesting that this domain could be a criterion for early intervention strategies and closer follow-up. No conflict of interest

P.661 Psychological impact of the COVID-19 outbreak and lockdown in Spanish sample with anxiety disorder: differences according to sex

Introduction: We have experienced the effects of an unprecedented pandemic due to the new coronavirus SARS-CoV-2. This is the causative agent of COVID-19. There are precedents for the imposition of lockdown in previous outbreaks that caused a great psychological impact. Specifically, an increase in the mean post-traumatic stress scores, high depressive symptoms and an increase in completed suicides was reported [1,2]. The severity of the impact on mental health is greater in vulnerable people such as those with a psychiatric history [3,4]. Aims: This study aims 1) to assess the psychological impact on a large sample of participants with an anxiety disorder during the onset of the pandemic and lockdown in Spain;2) to Explore differences in the magnitude of the psychological impact of the people with an anxiety disorder according to the sex. Methods: Secondary analyses of a descriptive and comparative cross-sectional study of the data provided by the participants in an anonymous online survey conducted between March 19 and 26. The ad hoc questionnaire included sociodemographic, clinical data and variables related to COVID-19 as well as questions on coping strategies, and the Spanish versions of the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale (IES). From the entire sample of 21207 participants, we analyzed 1617 (7.6%) people with an anxiety disorder at that time [mean age = 35.6 (SD = 12.47);women = 1347 (83.3%)]. For the statistical analysis, the sample was divided into two groups according to sex. We used a chi-square test and Student's t test to detect differences among groups. Next, we analyzed the associations between sex and scores on psychometric scales using logistic regression to control for potential confounding factors. Results: Of the individuals with an anxiety disorder, 55.7% were single, 10.2% lived alone and only 2.4% live with family members infected by SARS-CoV-2. 72.8% do not have children in charge, and 89.1% do not have elderly people dependent on them. Comparing the psychological impact between groups, we observed that it is greater in women. We found statistically significant differences in every DASS-21 subscale: depression (4.35 ± 1.19 vs 4.10 ± 1.28;T= -3.076, p<0.002), anxiety (3.20 ± 2.14 vs 2.41 ± 2.03;T= -5.625, p< 0.001) and stress (4.60 ± 2.15 vs 3.86 ± 2.49;T= -4.540, p< 0.001);and in intrusive (3.63 ± 2.07 vs 2.83 ± 2.09;T= -5.751, p< 0.001) and avoidance subscales of IES (4.72 ± 1.89 vs 3.80 ± 2.06;T= -6.850, p< 0.001). Multivariate analysis revealed a statistically significant association of intrusive thoughts (OR 1.12;IC 95%:1.05-1.21, p=0.001), avoidant thoughts (OR 1.19;IC 95%:1.01-1.29, p<0.001) and age (OR 0.99;IC 95%:0.98-0.99, p=0.004) with being female. Conclusions: Our data indicated that the COVID-19 outbreak and lockdown harmed the mental health of people with mental disorders such as anxiety disorders. After considering confounding variables, we observed that women with an anxiety disorder suffer greater negative repercussions such as intrusive and avoidant thoughts compared to men. No conflict of interest

P.247 Psychological impact of COVID-19 confinement among people with history of mental disorders (bipolar, anxiety, depression) and general population in Spain

Background: Previous studies have shown that epidemic outbreaks have significant effects on mental health and psychological wellbeing, increasing psychiatric morbidity among population [1]. During the initial phase of the COVID-19 outbreak in China, more than half of the general population reported a strong psychological impact and approximately a third moderate to severe anxiety [2]. Furthermore, there is evidence that the psychological effects of infection outbreaks can affect months or years later [3]. A better understanding of the psychological impact of the COVID-19 outbreak is crucial to design coping programs that may mitigate these responses during such outbreaks. Aim: The objective of this study is to determine the early impact of the COVID-19 on mental health among people with history of mental disorders (anxiety, depression and bipolar disorder) and the General Population and people in Spain. Methods: In this study 252 people were included. Sixty three people with a history of bipolar disorder (hBD) were matched by sex and gender with 63 people with a history of anxiety disorders (hAD), 63 people with a history of depression (hDD) and 63 healthy controls (HC). The assessment was made by an online survey during the first days of the national lockdown due to COVID-19 (from 19 March to 26 March 2020) in Spain. Assessment: ad hoc sociodemographic, physical and clinical data questionnaire and the Spanish versions of the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale (IES). Results: Mean age was 45 (range 19-69, SD 14.8) years;69.8% were females for the total example and the four groups. Regarding clinical symptoms, 61.9%hBD, 54.0% hAD, 54.0% hDD and 28.6% HC reported depressive symptoms (χ² =15.922, p <0.001);19.0% hBD, 12.7% hAD, 20.6% hDD and 1.6% HC reported anxiety symptoms (χ² =12.104, p = 0.007);38.1%hBD, 34.9% hAD, 41.3% hDD and 19.0% HC reported stress symptoms (χ² =8.286, p = 0.040). Regarding psychological impact, 27.0%hBD, 17.5% hAD, 25.4% hDD and 14.3% HC reported intrusion style (χ² =4.277, p =0.273);38.1% hBD, 47.6% hAD, 57.1% hDD and 30.2% HC reported avoidance style (χ² =10.525, p =0.015). There were differences between groups in the three DASS-21 subscales scores: Depression (F=4.599, p= 0.004), Anxiety (F = 5.443, p <0.001) and Stress (F=3.537, p = 0.015) and in the IES total score (F=6.018, p<0.001) and each IES subscale: Intrusion (F=3.030, p = 0.030) and Avoidance (F=6.041, p <0.001). Conclusions: The emergency confinement by COVID-19 has an impact on mental health, but especially among people with history of mental disorders (anxiety, depression and bipolar disorder). Depressive symptoms were the most frequent symptoms in all groups, followed by stress symptoms. People with history of Bipolar Disorder was the group with the highest percentage of depressive symptoms. The most frequent style was avoidance in all groups. People with history of Bipolar Disorder was the group with the highest percentage of people with an intrusion style. People with history of Depression Disorder was the group with the highest percentage of people with an avoidance style. No conflict of interest