Trends in the incidence of hospital-treated suicide attempts during the COVID-19 pandemic in Oviedo, Spain.

BACKGROUND: The potential impact of the COVID-19 pandemic on suicidal behavior has generated predictions anticipating an increase in suicidal tendencies. The aim of this research is to study its influence on the incidence of hospital-treated suicide attempts throughout the year 2020 in Oviedo, Spain. METHODS: Data were collected on all patients admitted to the emergency department of Central University Hospital of Asturias in Oviedo for attempted suicide during 2020. Incidence rates were calculated for three lockdown periods. Suicide attempt trends in 2020 were compared with a non-COVID-19 year (2009) to avoid seasonal variations bias. Chi-square and Fisher's exact tests were performed. The influence of COVID-19 incidence in Oviedo was analyzed using Spearman's correlation coefficient. RESULTS: The cumulative incidence rate of attempted suicide per 100,000 person-years was 136.33 (pre-lockdown), 115.15 (lockdown), and 90.25 (post-lockdown) in adults (over 19 years old), and 43.63 (pre-lockdown), 32.72 (lockdown), and 72.72 (post-lockdown) in adolescents (10-19 years old). No association was found with COVID-19 incidence rates (Spearman's rho -0.222; p = 0.113). Comparing the years 2020 and 2009, statistically significant differences were observed in adolescents (Fisher's exact test; p = 0.024), but no differences were observed in adults (chi-square test = 3.0401; p = 0.218). CONCLUSIONS: Hospital-treated suicide rates attempted during the COVID-19 outbreak in Oviedo, Spain showed a similar trend compared with a non-COVID-19 year. In contrast, the number of adolescents hospital-treated for attempted suicide increased during lockdown, suggesting more vulnerability to COVID-19 restrictions after the initial lockdown period in this age group.

The impact of maternal SARS-COV-2 infection in early stages of newborn neurodevelopment: preliminary results in a multicenter Spanish study

Introduction: The consequences for the COVID-19 pandemic in the newborns of affected mothers remains unknown. Previous clinical experiences with other infections during pregnancy lead to considered pregnant women and their offspring especially vulnerable for SARS-COV-2. That is, the underlying physiopathological changes caused by the infection (e.g. storm of cytokines, micro-coagulation in placenta or vertical transmission) could clearly compromise fetal neurodevelopment. Objective(s): To analyze the impact of maternal SARS-COV-2 infection during pregnancy in early neurodevelopment of infants gestated during the COVID-19 pandemic period compared to those gestated immediately prior (2017-2021). Method(s): 212 pregnant women (14% infected) were followed throughout their pregnancy and postpartum, including newborn development. SARS-COV-2 infection was serologically confirmed during pregnancy. The Brazelton Neonatal Assessment Scale (NBAS) was administered at 6 weeks old by a trained neonatologist to evaluate neurological, social and behavioral aspects of newborn's functioning. Differences in NBAS scores between cases and controls were tested by ANOVAs. All the analysis were adjusted for maternal age, sociodemographic status, anxious-depressive symptomatology, infant's sex and gestational age at birth and NBAS, and for the period of gestation (previous or during COVID-19 pandemic). Result(s): NBAS social interactive dimension was significantly decreased in those infants exposed to prenatal SARS-COV-2 (F= 4.248, p=.043), particularly when the infection occurred before the week 20 of gestation. Gestation during COVID-19 pandemic did not alter NBAS subscales. Conclusion(s): SARS-COV-2 infection during pregnancy seems to be associated with lower NBAS scores on social dimension in 6 weeks old exposed newborns.

P.0647 Psychological impact in patients with common mental disorders after six months of COVID-19 outbreak

Introduction: Studies focused on the impact of the COVID-19 pandemic in patients with psychiatric disorders have reported a deterioration of their mental health due to this situation [1]. A study focused on the early COVID-19 pandemic consequences on mental health found that participants reporting a current mental disorder were experiencing the greatest psychological impact, followed by those reporting a past mental disorder [2]. We hypothesize that having suffered or suffering from a depressive or anxiety disorder at that time can lead to maladaptive responses during the pandemic and social restrictions. Aims of the study: To describe the psychological impact among patients with a current or past diagnosis of Common Mental Disorders (CMD;anxiety and depressive disorders) after six months of the beginning of the COVID-19 pandemic. 1. To explore risk and protective factors associated with a Severe Psychological Impact (SPI). Methods: Cross-sectional survey. A self-reported online test was completed by the participants during the pandemic from October 14th to November 8th, 2020, from all over the Spanish territory. From the sample (N=5900), 1122 (19.02%) reported suffering from CMD in the past or at the moment the study was conducted (mean age±SD=46.01 ±14.12 years) The Spanish version of the Depression, Anxiety and Stress Scale (DASS-21) was used to evaluate the maladaptive psychological responses. Psychological impact in CMD was classified according to the number of maladaptive responses in the DASS-21 scale, considering: mild (1 response), moderate (2 responses) and severe (3 responses). Statistical analyses: Chi-square, t-student test (IBM SPSS version 24 was used for data analyses). The p-value was set at <0.05. Results: Women represented 70.1% of the sample. Approximately half of the participants were married or were living with a cohabiting partner (55.8%). Most of the responders had completed university studies (69.6%). From the sample, 1240 participants (21%) had a somatic disease (12% hypertension and 10.8% chronic respiratory disease). 16.1% increased their alcohol consumption and 14.1% increased their tobacco consumption. CMD reported the highest psychological impact on Depressive DASS-21 subscale (59.5% χ²=206.6, p<0.001), followed by Stress subscale (38.6, χ²= 482.2, p<0.001) and Anxiety subscale (31.3, χ²= 204.7, p<0.001). According to copying strategies, a high percentage of patients with CMD reported being able to enjoy leisure time (88.1%). Reading or listening to music were the most frequent activities (87.8%). 20.7% of the sample showed a SPI. Considering the statistically significant variables, a logistic regression analysis was obtained. On the one hand, older age (B=-0.03, OR=0.972, p<0.001), male sex (B=-0.6, OR=0.55, p=0.008), university studies (B=-0.43, OR=0.652, p=0.008) and being able to enjoy leisure time (B=-1.1, OR=0.341, p<0.001) were protective factors of SPI. On the other hand, having a somatic illness (B=0.59, OR=1.797, p<0.001) and the increase in tobacco use (B=0.58, OR=1.778, p=0.005) were factors associated with SPI. Conclusions: This study illustrates the psychological impact in CMD after half-year of the COVID-19 outbreak. Being young, a woman, suffering from somatic illness, and not having a university education are risk factors for SPI. However, being able to enjoy leisure time is the main protective factor against a SPI in CMD. No conflict of interest

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.690 Post-traumatic stress symptoms during the COVID-19 in different regions of Spain

Background: COVID-19 is the pandemic most affected since the 1918 influenza. In order to control its effects, the governments of different countries, including Spain, adopted exceptional measures such as lockdown and the suspension of non-essential economic activity. Studies carried out in China, where the population was also confined, have found an increase in the prevalence of post-traumatic stress symptom among the most affected regions compared to other less affected [1] Aim: To describe the presence of post-traumatic symptom among a large sample from the general population in the different regions of Spain after two weeks from the declaration of the state of alarm in Spain. Methods. The data was obtained through an online questionnaire two weeks after the declaration of the state of alarm in Spain (performed between 19 and 26 March, 2020) addressed to general population over eighteen years old [2]. It was spread using an online “snowball” method. Assessment sociodemographic, clinical variables and psychometric scales. Post-traumatic stress symptoms were measured by the Stressful Impact Scale (EIE), which consists of 15 items, divided into two subscales related to symtoms of intrusion and avoidance. The SPSS v24.0 program was used in the statistical analysis. Results: The sample consists of 21,153 individuals [30.3% men] with an average age of 39.75 ± 14.04 (18 to 100 years). A) Intrusive response: regions with the highest prevalence of intrusive response are Castilla La Mancha (31.2%), Andalusia (30.7%) and Extremadura (26.2%);regions with the lowest prevalence of intrusive response are Aragon (18.9%), Navarra (16.0%) and La Rioja (21.4%). B)Avoidance response: regions with the highest prevalence of avoidance response are Andalusia (55.7%), Extremadura (53.7%) and Castilla La Mancha (51.3%);regions with the lowest prevalence of avoidance response are Galicia (39%), Aragon (37.6%) and Navarra (32.7%). In Madrid, the prevalence of avoidant and intrusive symptoms was 43.1% and 26.0%, respectively. Conclussions: Avoidance symptoms were more frequent than intrusion symptoms in all regions. Andalusia, Extremadura and Castilla La Mancha are the regions with the highest prevalence of post-traumatic stress symptoms, both intrusive and avoidant. In addition, Aragon and Navarra presented low post-traumatic symptoms prevalence. The situation in the Community of Madrid is particularly garish. Despite being the region most affected by the COVID-19 pandemic in Spain, the prevalence of post-traumatic stress symptoms, both intrusive and avoidant, is close to average. The representativeness of the regions in the sample is a limitation of our study. However, the Madrid region is well represented in terms of the percentage share of the total sample. The results obtained do not seem consistent with the epidemiological situation of these regions at that time. It neither are according to the findings of other studies, so it would be necessary to investigate the existence of other factors that contribute to explaining these results. No conflict of interest