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