ABSTRACT
Background and Objectives: Italy was the first country in Europe to face the coronavirus 2019 (COVID-19) pandemic and its consequences, which led to two phases of severe restrictions for its population. This study aims to estimate the connections between the trauma of the COVID-19 emergency and the clinical features of a sample of outpatients in a Milan Community Mental Health setting, comparing the first (April 2020) and second lockdowns (November 2020). Materials and Methods: The sample included 116 consecutive outpatients recruited in April 2020 and 116 in November 2020. The subjects were evaluated with Clinical Global Impression Severity (CGI-S), Brief Psychiatric Rating Scale (BPRS-18), and Impact of Event Scale-Revised (IES-R). Results: The IES-R identified 47.4% participants in April and 50% in November with clinical scores over the cut-off. The network analysis of BPRS-18 and IES-R depicted the connection among different symptoms; in April, Unusual Thought Content, Anxiety, and Somatic Concern represented the most central items, and the strongest connections were found between Uncooperativeness and Hostility, Blunted Affect and Emotional Withdrawal, and IES-Intrusion and IES-Arousal. In the November group, the most central items were represented by Conceptual Disorganization and Emotional Withdrawal, whereas the strongest connections were found between IES-Arousal and IES-Intrusion, Excitement and Grandiosity, and Unusual Thought Content and Conceptual Disorganization. Conclusions: Our findings show continued high distress levels and increased psychological burdens during the second phase of restrictions; this could be described as "pandemic fatigue", a general psychological weariness due to pandemic-related restrictions, as well as a lack of motivation to comply with them. As mental health professionals, our mission during these difficult times has been to keep community psychiatry services accessible, with particular regard to vulnerable and marginalized populations.
Subject(s)
COVID-19 , Mental Health , Communicable Disease Control , Hospitals, Urban , Humans , OutpatientsABSTRACT
Objectives: To evaluate the relationship between traumatic aspects of the COVID-19 emergency and clinical correlates in a sample of consecutive outpatients in a Community Mental Health setting in Milan, Italy. Methods: One hundred and forty subjects aged between 18 and 75 years were assessed with the Clinical Global Impression-Severity (CGI-S), Brief Psychiatric Rating Scale (BPRS-18), the 22-item Impact of Event Scale-Revised (IES-R) and the Self Report Questionnaire (SRQ-20). Data analysis were performed using SPSS version 16.0. Basic statistics were used to describe the demographic and clinical characteristics of the participants. The associations between sociodemographic and clinical variables were explored first by performing Pearson's correlation analysis followed by multivariate regression. IES-R total score was used as the dependent variable while sociodemographic variables, SRQ-20, CGI-S and BPRS total score were used as independent variables. Results: A considerable proportion of participants reported symptoms of distress measured by IES-R: 47 (33.6%) mild, 45 (32.1%) moderate and 37 (26.4%) severe. SRQ-20 total score was positive in 82 (58.6%) patients, particularly in the female population (p = 0.009) with an age between 45-65 years (p = 0.020). In multiple regression analysis, being actively working (Beta = 0.15, p = 0.03) and SRQ-20 (Beta = 0.56, p = 0.00) significantly predicted IES-R total score. Conclusions: Our data evidenced high level of distress among patients in contact with mental health services during Covid-19 emergency period suggesting the importance of maintaining continuous monitoring for a careful assessment of their condition from both a psychopathological and medical point of view. (PsycInfo Database Record (c) 2021 APA, all rights reserved)