Dramatic increase of suicidality in children and adolescents after COVID-19 pandemic start: A two-year longitudinal study

The COVID-19 pandemic has impacted the mental health of the youngest, worsening their emotional well-being. The demand for care in psychiatric emergencies may indirectly reflect the mental health state of children and adolescents and the emotional consequences of the pandemic. Moreover, suicidality can be considered a marker of severity in this population group. Therefore, we have aimed to longitudinally describe the number of children and adolescents attended in the psychiatry emergency department due to suicidal ideation or attempts and, to explore differences in suicidality according to gender and age. A retrospective study was carried out in the University Hospital of San Juan, Alicante, Spain, from 01.01.2018 to 31.12.2021. A total of 138 participants under 18 years requesting psychiatric care due to suicidal ideation or attempts were included. The sample was composed by 35% of males and the mean age was 14.8 years old (SD = 2.2). The number of cases per year range from 10 in 2018 to 88 in 2021. Attendances were significantly higher between 2021 and the three previous years. Besides, the number of attentions registered in the last 9 months of 2021 equals those that occurred in the entire previous period. Most of the cases were girls and middle adolescents. Suicide ideation or attempts have skyrocketed in children and adolescents. This alarming increase presents a one-year lag peak from the COVID-19 outbreak and continues until the end of 2021. Girls and those over 12 years have been identified as risk groups to present suicidal ideation or attempts.

What about mental health after one year of COVID-19 pandemic? A comparison with the initial peak.

A psychiatric epidemic has accompanied the COVID-19 pandemic and specific vulnerable populations have been identified. We aimed to explore the presence of anxiety, acute stress and depression among these vulnerable groups after a year of pandemic and relate them to our previous results obtained with the same methodology during the initial peak of the pandemic in Spain. A total of 2182 participants conducted a national survey, starting on March 2021. Sociodemographic information and clinical symptoms were assessed. The sample was divided into four groups in order to develop four substudies with these results: 1) Healthcare workers presented lower anxiety, acute stress, and depression than non-Healthcare workers (p < 0.001), being nurses the most affected. 2) People with mental disorders experienced higher anxiety, acute stress, and depression than people without (p < 0.001), as well as a higher rate of COVID cases (14% vs. 9.3%, p = 0.041). 3) People ≥60 years old presented lower anxiety and acute stress than people <60, (p < 0.05) and a weaker depressive syndrome (p = 0.003). 4) Males presented lower anxiety, acute stress and depression than females (p < 0.001). According to the results obtained during the initial peak, Healthcare workers have developed efficient coping strategies, while elders have managed to maintain their previously emotional balance. Notwithstanding, women and people with mental disorders continue to be vulnerable to emotional distress after a year of pandemic. Women and people with mental disorders continue to be especially vulnerable to emotional distress after a year of pandemic.

Mental health in elderly Spanish people in times of COVID-19 outbreak

Background: We aim to assess COVID-19 outbreak-related emotional symptoms, identify gender differences, and study the relationship between the emotional state and environmental features in the elderly. Methods: We conducted a cross-sectional study starting on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory) and acute stress (Acute Stress Disorder Inventory) were compared between people over and under 60 years old. Gender differences and the relationship of loneliness, regular exercise, economic losses and use of anxiolytics on the mental state were evaluated. Results: One thousand six hundred thirty-nine (150 [9.2%] aged >= 60) participants completed the survey. The greater than or equal to 60 group showed lower mean (SD) BDI levels than the less than 60 group (3.02 [3.28] versus 4.30 [4.93]);and lower mean (SD) acute stress disorder inventory scores than the less than 60 group (3.68 [3.20] versus 4.45 [3.06]). There were no gender differences in any of the clinical measures. The presence of economic losses as well as the increase in the use of anxiolytics was significantly associated with higher emotional distress in the elderly compared to the younger group. Conclusions: Older people have shown less emotional distress, with no differences between men and women. Economic loss and substance use should be monitored to guarantee the emotional well-being of the elderly. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Different emotional profile of health care staff and general population during the COVID-19 outbreak.

OBJECTIVE: The aims of this study were to assess COVID-19 outbreak-related emotions, to identify vulnerable groups within health care workers (HCW) and to study the relationship between the emotional state and some environmental features. METHOD: We conducted a cross-sectional study on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques. A list of emotional states was compared in HCW and non-HCW and within HCW roles. The relationship between COVID-19 related symptoms, information, and protective measures and the emotional state was analyzed. RESULTS: Fear (p < .001, φc = .11), irritability (p = .001, φc = .08), frustration (p < .001, φc = .10), anger (p = .013, φc = .06), and helplessness (p < .001, φc = .13) appear significantly more frequently in HCW compared to non-HCW. Within HCW, a higher percentage of physicians, especially the less experienced, significantly perceived uncertainty and frustration (p = .001, φc = .13 and p = .025, φc = .10, respectively), while a higher percentage of nurses significantly experienced sadness (p = .024, φc = .10). Having a confirmatory diagnosis of the disease was related to hypochondria sensation (p = .026, φc = .10). Sadness (p = .035, φc = .09), intolerance (p = .058, φc = .09), anger (p = .024, φc = .10), and helplessness (p = .028, φc = .10) appeared as the most relevant emotions when information was perceived as insufficient. CONCLUSIONS: The knowledge of the most prevalent different emotional patterns in HCW, as well as in the general population, will allow the detection of subjects at risk for the development of mental disorders and the implementation of therapeutic approaches in future similar situations of pandemic or outbreak of the current one. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The impact on mental health patients of COVID-19 outbreak in Spain.

Public health studies warn of the vulnerability of people with mental disorders during the COVID-19 outbreak. Thus, the aims of this study were to (1) explore the presence of symptoms of anxiety, depression and acute stress among people with a mental disorder (MD); (2) evaluate the rate of COVID-19 infection between MD and non-MD, and (3) study the relationship between the emotional state of people with a mental disorder and some environmental variables. A cross-sectional study starting on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques was conducted. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory) and acute stress (Acute Stress Disorder Inventory) were compared in MD and non-MD. The rate of COVID-19 confirmed cases among MD and non-MD was compared as well as the relationship between some environmental variables and the emotional state within MD. Up to 1839 [201 (10.9%) MD] participants completed the survey. MD showed significant higher mean (SD) in anxiety [24.7 (11.8) vs. 17 (10.3); p = 0.001], depression [7.9 (6.0) vs. 4.2 (4.2); p = 0.001] and acute stress [6.3 (3.2) vs. 4.4 (3.1); p = 0.001] scores than non-MD. The COVID-19 confirmed cases rate was higher in MD participants than in non-MD (3.5% vs. 0.4%; p < 0.001). Among the MD group, being a COVID-19 confirmed case, the lack in basic needs coverage, the rpesence of violence, drug use and the absence of physical excercise were associated with more severe depressive symptoms. Findings suggest that the COVID-19 has an impact on the emotional state of people with mental disorders.

Gender differences in emotional response to the COVID-19 outbreak in Spain.

OBJECTIVE: We aim to explore the differential presence of symptoms of anxiety, depression, and acute stress between men and women during the COVID-19 outbreak, and to study the relationship between these symptoms and two environmental variables, coexistence, and violence. METHODS: We conducted a cross-sectional study starting on March 29 to April 5, 2020, based on a national online survey using snowball sampling techniques. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory), and acute stress (Acute Stress Disorder Inventory) were assessed. Differences in the presence of symptoms and the relationship of coexistence and domestic violence were evaluated from a gender perspective. RESULTS: Men showed significant lower mean (SD) in anxiety, depression, and acute stress levels than women [HARS, 14.1 (9.8) versus. 18.4 (10.2), F = 56.2, p < .001; BDI 3.4 (3.9) versus 4.5 (4.3), F = 16.6, p < .001, and ASDI 3.6 (2.9) versus 4.7 (3.1), F = 39.0, p < .001, respectively), as well as a weaker depressive syndrome (28.1% males versus 39.9% females, χ2  = 25.5, p < .001). In addition, an interaction Gender × Coexistence was found in anxiety (F = 56.2, p < .001) and acute stress (F = 3.52, p = .06) and, according to depressive symptoms, an interaction Gender × Violence was found marginally significant (F = 3.3, p = .07). CONCLUSIONS: Findings indicate that women present greater severity in symptoms of anxiety, depression, and acute stress. Moreover, loneliness and violence specifically worsen the emotional state in women. These results can undoubtedly guide better healthcare planning adopting a gender perspective.