P.0564 Active suicidal ideation one year after the beginning of COVID-19 pandemic in a large spanish sample: risk and protective factors

Introduction: The influence of coronavirus disease 2019 (COVID-19) pandemic over mental health and suicidal behavior has been described worldwide [1,2]. Active suicidal ideation (ASI) and its associated risk and protective factors after one year of COVID-19 pandemic need to be measured and described in order to easy design effective mental health strategies. Objectives: To assess the prevalence of active suicidal ideation in a sample of the general Spanish population after one year of COVID-19 pandemic and to characterize factors associated with active suicidal ideation. Methods: Cross-sectional study based on an anonymous self-report online survey consisting of sociodemographic and clinical questions. The survey was conducted between March 16 and 31, 2021. It was completed by 5,646 participants, aged 18 and over, from all over Spanish territory. The Spanish versions of Depression, Anxiety and Stress Scale (DASS-21), the Dep5 and Anx5, and the Paykel Suicidal Ideation Scale (PSS) were used to assess psychological impact and suicidal ideation. The sample was divided into two different groups based on PSS responses: “active suicidal ideation” (ASI) (positive answer to questions 3 and/or 4) and "no active suicidal ideation" (NASI) (negative answer to questions 3 and 4). Logistic regression models (forward stepwise selection) were estimated to determine the independent factors associated with having ASI. Cohen's d equivalence for Odds Ratios (OR) has been included. Due to multiple comparisons and to avoid inflation in Type I error, the level of statistical significance was set at α ≤ 0.001 (two-tailed). Results: The total sample included 5,654 respondents [mean age (SD) = 39.65 (12.65);females: n = 4,575 (80.9%)]. From the total sample, 415 participants (7.3%: IC 95% [6.7-8.0]) presented ASI during the last month. A logistic regression model, including all significant variables from bivariate analyses, was run to assess variables associated with ASI. Risk factors for ASI were: income reduction > 50% [OR (IC 95) = 1.994 (1.317-3.020), p = 0.001], history of past or current mental disorder [OR (IC 95%) = 1.469 (1.067-2.023), p = 0.018;OR (IC 95%) = 3.161 (2.468-4.048), p < 0.001, respectively], insomnia [OR (IC 95%) = 1.850 (1.404-2.437), p < 0.001] and personal history of suicide attempt [OR (IC 95) = 3.779 (2.681-5.327), p < 0.001]. Protective factors against ASI were: older age [OR (IC 95%) = 0.968 (0.958-0.978), p < 0.001), living with one or more than one other person [OR (IC 95%) = 0.537 (0.385-0.747), p < 0.001;OR (IC 95%) = 0.634 (0.466-0.863), p = 0.004, respectively] and neutral or sleep satisfaction [OR (IC 95%) = 0.672 (0.510-0.886), p = 0.005;OR (IC 95%) = 0.472 (0.349-0.638), p < 0.001, respectively]. Conclusion: The estimated prevalence of ASI in this large sample of Spanish general population was significantly high. In addition, significant income reduction, history of past or current mental disorder, insomnia or history of suicide attempt have been described as risk factors associated with ASI, whereas older age, neutral or sleep satisfaction act as protective factors. The results from this study provide useful information which may help to identify vulnerable population characteristics. No conflict of interest

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