Possible impact of COVID-19 pandemic and lockdown on suicide behavior among patients in Southeast Serbia.

Individuals with serious mental illness are more affected by emotional reactions, including suicidal behavior due to COVID-19 and psychosocial consequences of pandemic. The current cross-sectional study aimed to explore the possible association of COVID-19 and suicidal behavior (suicide ideation and attempt) before and during pandemic-associated lockdown in Serbia. We retrospectively reviewed the clinical records of 104 adult psychiatric inpatients admitted at Psychiatric Clinic, University Clinic Center Nis, Serbia, after ending lockdown and compared the obtained results with 181 adult psychiatric inpatients admitted during the same period in 2019 and 2018. Suicide ideation were more frequent in 2020 comparing with 2019 and 2018 (25 vs 12.5%, vs 9.41%; p < 0.05). Around 28% of patients with suicide attempts were exposed daily to the information related to COVID-19 coming from social media, while this frequency was significantly lower, only 7.55% (p < 0.1), among patients with no suicide ideation or attempts. Adjustment disorder was more frequent among patients with suicide attempts in comparison to the patients with suicide ideation (32 vs 11%), especially in patients without suicide ideation and attempts (32 vs 0%, p < 0.001). Of all studied patients with suicide attempts during 2020, 60% were not in the previous psychiatric treatment before admission.

The Relationship Between Alexithymia and Risk for Postpartum Depression

Coronavirus disease 2019 (COVID-19) is classified as a stressful life experience. The aim of this study was to assess the levels of alexithymia and risk for postpartum depression in women during the COVID-19 pandemic and state-of-emergency lockdown in Serbia. This cross-sectional study included 108 adult (age ≥18 years) postpartum women with children age 12 months or younger. We used the following questionnaires: Edinburgh Post-natal Depression Scale (EPDS), Toronto alexithymia scale (TAS), Hamilton scale for the assessment of anxiety (HAM-A) and depression (HAM-D), and an additional questionnaire constructed for this study. We found that 14.8% of participants had a score of 10 or higher on EPDS, 23.15% had alexithymia, and 31.32% had borderline alexithymia. There was a significant positive correlation of alexithymia with risk for postpartum depression, high-intensity anxiety, and depression in postpartum women with a score of 10 or higher on HAM-D and 18 or higher on HAM-A. Higher rates on TAS were noticed in mothers who were older, single, and dissatisfied with emotional status, with lower educational level, unemployment, and lack of family support. Multiple linear regression analysis including all factors that correlate with higher TAS scores showed that higher scores on HAM-D (beta = 0.75, P < .01) and higher scores on EPDS (beta = 0.69;P < .01) were independent predictors of higher EPDS scores (adjusted R2 = 0.52, P < .01 for overall model). Alexithymia could develop in response to pandemics, and pandemics and the measures taken to combat a pandemic could be considered as risk factors for postpartum depression. [Psychiatr Ann. 2021;51(9):431–436.]

Perceived stress among university students in south-east Serbia during the COVID-19 outbreak.

BACKGROUND: The COVID-19 pandemic has brought into focus the mental health of the student population. The study aimed to analyze the psychological response to the COVID-19 outbreak in terms of perceived stress and its related factors among university students in south-east Serbia. The study was conducted during the increased incidence of COVID-19 in Serbia. METHOD: A total of 434 students from the public university in south-east Serbia enrolled in the study and completed the measures of socio-demographic data, the perceived stress scale (PSS-10), the Coping Strategy Indicator (CSI) and the General Health Questionnaire (GHQ-28). The data were analyzed through quantitative and qualitative methods. RESULTS: Study findings suggest that the mean perceived stress score was placed to 20.43 (± 7.67). Our model showed that female gender, higher scores on anxiety/insomnia and depression subscale as well as the coping strategy avoidance predicted higher perceived stress, while higher scores on social dysfunction were related to the reduced perceived stress scores.  CONCLUSION: Notwithstanding the study limitation, findings provided authentic data of stress reactions of the students in south-east Serbia during the COVID-19 outbreak. The findings confirm the need to examine students' experiences in emergencies and crises, as well as to make a plan for online stress management programs that would help alleviate stress during a global pandemic.

The risk for nonpsychotic postpartum mood and anxiety disorders during the COVID-19 pandemic.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) appears to be the largest pandemic of our times. The aim was to recognize the risk factors for nonpsychotic postpartum mood and anxiety disorders (NPMADs) in women during the pandemic and state of emergency police lockdown in Serbia. METHODS: We assessed 108 postpartum women who completed the Edinburgh Postnatal Depression Scale (EPDS) and an additional survey constructed for this study. We also used the additional, previously mentioned survey, in 67 healthy age-matched women with children who were ≥2 years of age. The additional survey allowed us to gain insight into the impact of the pandemic as well as postpartum period on the risk of NPMADs. RESULTS: In 16 (14.8%) subjects we found a score ≥10 on EPDS. Higher rates on the EPDS were noticed in elderly, single, and unemployed, women who lost their jobs due to the pandemic, or women who were dissatisfied with their household income (p < 0.05). The risk of NPMADs was linked significantly to quarantine, and social isolation, the absence of social support, as well as having emotional problems. Postpartum women, compared to non-postpartum women, were more anxious and had feelings of helplessness during social isolation. CONCLUSION: Understanding the factors that increase the risk of NPMADs during the pandemic could help prevent mental disorders during a possible future pandemic.

Mental health of medical personnel during the COVID-19 pandemic.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic caused significant changes in the everyday functioning of the general population, as well as medical workers. Medical personnel, especially those in direct contact with COVID-19 patients, could have increased levels of stress, anxiety, and depression. The objective of this study was to explore the mental health status of medical personnel in Serbia during the pandemic by assessing stress levels, symptoms of anxiety, and depression. METHODS: This cross-sectional study was conducted as an online-based survey, in the period from 8 April to 14 April 2020, during the COVID-19 pandemic. The study included 1678 participants, and the snowball sampling technique was used to reach healthcare professionals. The level of stress and symptoms of depression and anxiety were assessed among medical personnel in Serbia by the 10-item Perceived Stress Scale (PSS), the Beck Depression Inventory IA (BDI-IA), and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. RESULTS: A total of 1678 participants completed the survey, with a mean age of 40.38 ± 10.32 years, of which 1,315 (78.4%) were women, and 363 (21.6%) were men. Out of these, 684 (40.8%) participants were medical personnel, and 994 (59.2%) were people of other professions. Frontline medical personnel reported higher scores on all measurement tools than second-line medical personnel (e.g., mean PSS scores: 19.12 ± 5.66 versus 17.53 ± 5.71; p = .006; mean GAD-7 scores: 8.57 ± 6.26 versus 6.73 ± 5.76; p = .001; mean BDI-IA scores: 9.25 ± 8.26 versus 7.36 ± 7.28; p = .006). Binary logistic regression showed that the probability of developing more severe anxiety symptoms doubles in frontline medical personnel. CONCLUSION: Our findings suggest that frontline medical personnel is under an increased psychological burden during the COVID-19 pandemic, having higher levels of stress, anxiety, and depression than second-line medical personnel. Adequate measures should be taken to relieve this burden and preserve the mental health of frontline medical personnel.