Onset of Mental Disorders Following Hospitalization for COVID-19: A 6-Month Follow-Up Study

(1) Background: The present study aimed to investigate the onset of mental disorders in the six months following hospitalization for COVID-19 in people without a previous psychiatric history. (2) Methods: This was a longitudinal study carried out among adults who had been hospitalized due to COVID-19 infection. Six months after discharge, a series of questionnaires were administered (the World Health Organization Well-being Index (WHO-5), the Patient Health Questionnaire-9, the General Anxiety Disorder Questionnaire-7, and the Drug Abuse Screen Test, among others). Based on these scores, a compound Yes/No variable that indicated the presence of common mental disorders was calculated. A multivariate logistic regression was built to explore the factors associated with the presence of common mental disorders. (3) Results: One hundred and sixty-eight patients (57.34%) developed a common mental disorder in the 6 months following hospital discharge after COVID-19 infection. Three variables were independently associated with the presence of common mental disorders after hospitalization for COVID-19, and the WHO-5 duration of hospitalization), and severity of illness. (4) Conclusions: Among people with no previous psychiatric history, we observed a high incidence of mental disorders after COVID-19 hospitalization. A moderate (1-2 weeks) duration of hospitalization may pose a higher risk of post-COVID-19 onset of a mental health condition than longer or shorter durations of medical hospitalization. Further research is needed to better understand the mechanisms underlying the psychopathological consequences of COVID-19 and their predictors.

Psychiatric Emergencies and Suicide Attempts Before and During COVID-19 Lockdown in Spain.

Background: The COVID-19 pandemic had a significant impact on the mental health of the population. The lockdown period in Spain - from March 14 to June 21, 2020 - was particularly stressful. This study aims to examine the differences in visits to the emergency department for psychiatric reasons before and during the lockdown period in a hospital in the province of Lleida (Catalonia, Spain), which has a catchment area of 431,183 inhabitants. We hope that this study can contribute to the understanding of this difficult period in our recent history and help us to be prepared in case of new social emergencies that may affect the mental health of the general population. Aims: This study aims to examine the differences in ER visits due to psychiatric reasons before and during the COVID-19 lockdown period in a province hospital in Spain. Methods: We compared the n = 1,599 visits to the emergency room and their characteristics before (June 13 to March 13, 2020) and during (March 14 to June 21, 2020) the lockdown period in the province of Lerida, Spain. Data were obtained from the electronic health records. Information collected included sociodemographic variables, reason for consultation, previous diagnosis, and characteristics of suicidal ideation and attempts - including history of previous suicidal behavior, method, days spent in the ER, suicide reattempts at 6-month follow-up. Results: Before lockdown, there were an average of 11.2 psychiatric emergencies per day compared with 9.2 psychiatric emergencies per day during lockdown. Regarding suicidal behavior, before lockdown, there were an average of 0.9 suicide attempts before lockdown compared with 0.7 attempts per day during lockdown. Limitations: Since the data came from the electronic health records, we have relied on the clinical diagnosis made by different psychiatrists. Also, we did not record psychiatric comorbidities, but instead only registered one main Axis I diagnosis and one main Axis II diagnosis. Conclusions: We observed a decrease in the number of visits to the ER in general, as well as a lower frequency of patients with suicidal behavior during the first and only lockdown period in Spain, which occurred during the initial months of the pandemic. This is consistent with previous studies showing a reduction of suicidal behavior during periods of social emergency. However, this decrease could be only temporary, and several authors predict an increase of suicidal behavior in the aftermath of the COVID-19 crisis. Ensuring access to mental healthcare during periods of crisis is crucial for the population.

Smartphone-based Ecological Momentary Intervention for secondary prevention of suicidal thoughts and behaviour: protocol for the SmartCrisis V.2.0 randomised clinical trial.

INTRODUCTION: Suicide is one of the leading public health issues worldwide. Mobile health can help us to combat suicide through monitoring and treatment. The SmartCrisis V.2.0 randomised clinical trial aims to evaluate the effectiveness of a smartphone-based Ecological Momentary Intervention to prevent suicidal thoughts and behaviour. METHODS AND ANALYSIS: The SmartCrisis V.2.0 study is a randomised clinical trial with two parallel groups, conducted among patients with a history of suicidal behaviour treated at five sites in France and Spain. The intervention group will be monitored using Ecological Momentary Assessment (EMA) and will receive an Ecological Momentary Intervention called 'SmartSafe' in addition to their treatment as usual (TAU). TAU will consist of mental health follow-up of the patient (scheduled appointments with a psychiatrist) in an outpatient Suicide Prevention programme, with predetermined clinical appointments according to the Brief Intervention Contact recommendations (1, 2, 4, 7 and 11 weeks and 4, 6, 9 and 12 months). The control group would receive TAU and be monitored using EMA. ETHICS AND DISSEMINATION: This study has been approved by the Ethics Committee of the University Hospital Fundación Jiménez Díaz. It is expected that, in the near future, our mobile health intervention and monitoring system can be implemented in routine clinical practice. Results will be disseminated through peer-reviewed journals and psychiatric congresses. Reference number EC005-21_FJD. Participants gave informed consent to participate in the study before taking part. TRIAL REGISTRATION NUMBER: NCT04775160.

Physical comorbidity and use of healthcare services in people with schizophrenia: protocol for a systematic review.

INTRODUCTION: People with schizophrenia die about 15-20 years earlier than the general population. A constellation of factors contributes to this gap in life expectancy: side effects of psychotropic drugs, unhealthy lifestyles (inactivity, unhealthy diet) and inequality in the provision of healthcare services. This is a topic of main importance, which requires constant update and synthesis of the literature. The aim of this review is to explore the evidence of physical comorbidity and use of healthcare services in people with schizophrenia. METHODS AND ANALYSIS: We will conduct a systematic literature search in the databases PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO and Cochrane Library, Proquest Health Research Premium Collection, in order to identify studies that answer to our research question: Are patients with schizophrenia different from the non-psychiatric population in terms of physical comorbidity and use of healthcare services? Two authors will independently review the studies and extract the data. ETHICS AND DISSEMINATION: This study does not include human or animal subjects. Thus, ethics considerations are not applicable. Dissemination plans include publications in peer-reviewed journals and discussion of results in psychiatric congresses. PROSPERO REGISTRATION NUMBER: CRD42020139972.

Patients at high risk of suicide before and during a COVID-19 lockdown: ecological momentary assessment study

The coronavirus disease 2019 (COVID-19) outbreak may have affected the mental health of patients at high risk of suicide. In this study we explored the wish to die and other suicide risk factors using smartphone-based ecological momentary assessment (EMA) in patients with a history of suicidal thoughts and behaviour. Contrary to our expectations we found a decrease in the wish to die during lockdown. This is consistent with previous studies showing that suicide rates decrease during periods of social emergency. Smartphone-based EMA can allow us to remotely assess patients and overcome the physical barriers imposed by lockdown.