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

ABSTRACT

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