Análisis de redes de síntomas del trastorno de agorafobia en personas mayores de 65 años / Analysis of symptom networks of agoraphobia disorder in people over 65 years of age

El objetivo es realizar un análisis de redes de síntomas del trastorno de agorafobia (con o sin pánico) según la edad y el sexo, en una muestra representativa de 555 personas mayores de 65 años de la Comunidad de Madrid. La red se estimó utilizando el paquete InsingFit que implementa un procedimiento llamado eLasso. Los resultados revelan redes diferenciadas para hombres y mujeres, y para los grupos de edad de 65-74 y 75-84 años, encontrando un mayor porcentaje de ocurrencia en las mujeres tanto en las situaciones como en los síntomas de ansiedad y en las razones para sentir miedo. Las mujeres temen un mayor número de situaciones, mientras que los hombres parecen tener sus miedos más localizados y centralizados en situaciones relacionadas con el transporte y los viajes cuando los hacen solos. Estos resultados pueden ser interesantes para diseñar intervenciones que aborden los síntomas y sus relaciones mutuas más importantes, diferentes y características en función de la edad y el sexo. (AU)

The aim of this study is to conduct a network analysis of agoraphobia disorder symptoms (with or without panic) according to age and gender, in a representative sample of 555 people over 65 years of age in the Community of Madrid. The network was estimated using the InsingFit package that implements a procedure called eLasso. The results reveal differentiated networks for men and women, and for the age groups 65-74 and 75-84 years, finding a higher percentage of occurrence in women in both situations and symptoms of anxiety and reasons for fear. Women fear a greater number of situations, while men seem to have their fears more localized and centralized in situations related to transport and travel when travelling alone. These results may be of interest for designing interventions that address the symptoms and the most important, different and characteristic relationships among them according to age and gender. (AU)

Efectos psicológicos del confinamiento por la pandemia de la Covid-19 en el año 2020: una revisión sistemática / Psychological effects of confinement due to the Covid-19 pandemic in 2020: a systematic review

El objetivo fue revisar de manera sistemática los estudios acerca del impacto psicológico delconfinamiento por Covid-19 en la población general española y profesionales sanitarios en elprimer año de pandemia. La revisión incluye 18 estudios publicados entre enero y diciembre de2020. Se encontró que el impacto psicológico incrementaba según avanzaba el confinamiento,con porcentajes de afectación que van del 3-30% en sintomatología de ansiedad (37-72% ensanitarios), del 6-57% en sintomatología depresiva (27-61% en sanitarios), del 2-40% ensintomatología de estrés (14-47% en sanitarios), del 15-20% en sintomatología asociada alestrés postraumático (15,8% en sanitarios), del 12-53% en problemas de sueño (29% ensanitarios), y del 9-37% en sentimientos de soledad. Los grupos de riesgo identificados fueronlas mujeres, los jóvenes, los desempleados y las personas con problemas previos de saludmental. La Covid-19 ha tenido importantes repercusiones en la salud mental de la poblacióngeneral española y los profesionales sanitarios, siendo necesario establecer protocolos deevaluación e intervención que permitan detectar e intervenir sobre la población afectada tras elconfinamiento y durante futuros confinamientos (AU)

Mental health in a heterogeneous clinical sample. A cross-sectional study of predictors and gender differences.

Introduction: Women have been shown to be a vulnerable group in relation to mental health problems over time. Despite this, gender-focused studies are uncommon. The aim of this research is to study mental health in a sample of people with mental health problems and to analyze the differences and predictors focusing on gender. Methods: A cross-sectional study is conducted in a heterogeneous clinical sample in terms of mental health problems (N = 160). Interviews with hetero-reported standardized questionnaires to collect the data are conducted. Descriptive analyses, mean difference and a regression analysis on mental health are carried out taking into account different sociodemographic, clinical and psychosocial variables. Results: Women in the study present worse levels of mental health and subjective severity of the disorder. The main predictors of mental health are being female, followed by severity, shorter time with the diagnosis and internalized stigma. Conclusion: Being female is the most robust predictor of worse mental health and symptomatology. Recommendations according to the results found proposing a gender perspective are suggested.

Specific phobia disorder symptoms in people over 65 in Madrid: a network analysis / El trastorno de fobia específica en las personas mayores de 65 años en Madrid: análisis de redes de síntomas

A symptom network analysis of specific phobia disorder (SPD) was conducted according to gender and age in 555 people over 65 in the Region of Madrid (Spain). The network was estimated using the InsingFit package that implements a procedure called eLasso. These results reveal differences in the strength, closeness, and betweenness of the different networks according to gender but not for the 65-74 and 75-84 age groups. The gender variable presents a greater presence of symptoms in women than in men. For all types of specific phobia, the symptom of greater occurrence for both groups was fear. The main difference between men and women over 65 with SPD lies in the situational type, where centrality is more distributed and where the most central symptoms are distress for women and fear for men. These differences in the networks seem to support the conceptualization of SPD from a dimensional point of view. (AU)

Se realizó un análisis de redes de síntomas del trastorno de fobia específica (TFE) según el género y la edad en 555 personas mayores de 65 años de la Comunidad de Madrid (España). La red se estimó utilizando el paquete InsingFit que implementa un procedimiento llamado eLasso. Los resultados presentan diferencias en la fuerza, cercanía e intermediación de las distintas redes según el género, pero no para los grupos de edad de 65-74 y 75-84 años. El análisis de la variable género muestra una mayor presencia de síntomas en las mujeres que en los hombres. Para todos los tipos de fobia específica, el síntoma de mayor presencia para ambos grupos fue el miedo. La principal diferencia entre hombres y mujeres mayores de 65 años con TFE radica en el tipo situacional, donde la centralidad está más distribuida y donde los síntomas más centrales son la angustia para las mujeres y el miedo para los hombres. Estas diferencias en las redes parecen reforzar la conceptualización del TFE desde un punto de vista dimensional. (AU)

Longitudinal study of age-related differences in the psychological impact of confinement as a consequence of COVID-19 in a Spanish sample / Estudio longitudinal de las diferencias relacionadas con la edad en el impacto psicológico del confinamiento como consecuencia de la Covid-19 en una muestra española

This research aims to analyze age-related differences in the psychological impact of the Covid-19 confinement situation in a Spanish sample. A longitudinal study (N= 1,041) was conducted through an online survey with two measurements: at two and five weeks after the declaration of the alarm state in Spain. Post- traumatic stress disorder (PTSD), anxiety and depressive symptoms, spiritual well- being and perceived loneliness were evaluated by screening tests. Means and their confidence intervals (95%) were calculated for all variables in the study, for the three age groups: 18-30, 31-59, 60-80. Linear mixed models with random slopes (Time nested to Subjects) were calculated for each variable. The results indicate that the psychological impact caused by the pandemic persists over time, and even increases in some of the variables studied. The older age group (60-80 years) shows the least impact and the greatest well-being. They presented less depressive, anxious and PTSD symptoms and less loneliness. These results may be explained by the greater resilience of this group to recover from adverse situations, in addition to having a greater number of coping strategies.

Se analizan las diferencias relacionadas con la edad en el impacto psicológico del confinamiento a consecuencia de la Covid-19 en una muestra española. Se realizó un estudio longitudinal (N= 1.041) mediante una encuesta online con dos mediciones: a las dos y cinco semanas de la declaración del estado de alarma en España. Se evaluaron mediante cuestionarios de detección los síntomas de trastorno de estrés postraumático (TEPT), ansiedad y depresión, bienestar espiritual y soledad percibida. Se calcularon las medias y sus intervalos de confianza (95%) para todas las variables del estudio, para los tres grupos de edad: 18-30, 31-59, 60-80. Para cada variable se calcularon modelos lineales mixtos con pendientes aleatorias (tiempo anidado a los sujetos). El impacto psicológico persiste a lo largo del tiempo, aumentando en algunas de las variables. El grupo de mayor edad muestra menor impacto y mayor bienestar. Presentan menos síntomas de depresión, ansiedad y TEPT y menos soledad. Estos resultados pueden explicarse por la mayor resiliencia de este grupo para recuperarse de situaciones adversas, y el mayor número de estrategias de afrontamiento.

People over 65 Years Old in Social Isolation: Description of an Effective Community Intervention in the City of Madrid (Spain).

Loneliness and social isolation in the elderly population can be shown to be a significant independent risk factor for several conditions, such as poor health behaviours, physical health problems and psychiatric conditions. Although, in the last 20 years, several interventions have been developed to reduce the impact of social isolation and loneliness on the health of older people. However, only a small proportion of these interventions are effective. This study aims to describe the components of the Psychological Support Service for Socially Isolated Elderly People (PSIE), in addition to analysing the effectiveness of a community intervention based on an outreach strategy to combat situations of social isolation in the elderly population. The sample consisted of 63 people over 65 years of age from the city of Madrid (Spain), detected by the socio-health services as people at risk of social isolation. Sociodemographic, mental health, health and psychosocial functioning, global functioning, disability and socio-sanitary needs were evaluated with observational scales. Descriptive statistics were calculated for sociodemographic and mental health variables. An analysis was carried out to study the possible influence of gender in the initial sample on the different variables assessed, using Chi-squared and Student's t-tests for independent samples, with measures of effect size in each case. A study of the effectiveness of PSIE was carried out with an analysis of pre- and post-treatment measures. A Student's t-test was used for related samples, as well as the effect size of Cohen's d statistic. For the assessment of the possible influence of gender on the results of the intervention, a 2 × 2 repeated-measures ANOVA (pre-/post-measures × gender) was conducted. Regarding mental health, 65.2% of the sample presented symptoms compatible with a severe mental disorder, the most frequent being psychotic disorder (22.7%), alcohol use disorder (16.7%), personality disorder (15.2%), anxiety disorders (10.4%) and mood disorders (10.4%). The gender variable does not seem to have an influence on any of the outcome measures studied. The results of the effectiveness study indicate that the PSIE is an intervention programme that serves to improve the scores of people in the sample in all variables that the programme studied. Some of the components of PSIE that could explain its effectiveness are individualized interventions, with a home-based approach by professionals, serving as a link between the older person and the normalized social-sanitary network. Further research is required to provide more robust data on the effectiveness of interventions.

The Psychological Impact of the COVID-19 Pandemic in Spain: A Longitudinal Study.

BACKGROUND: This study aims to longitudinally assess the psychological impact of the COVID-19 pandemic in the general Spanish population. It uses four assessment points: two weeks after the start of confinement, one month after, two months after, and one year after the first evaluation. METHODS: Evaluations were conducted through an online survey, with a sample of 3,480 people at the first data collection and 1,041, 569, and 550 people at successive evaluation points. Depressive symptoms (PHQ-2), anxiety (GAD-2), post-traumatic stress (PCL-C-2), social support (EMAS), loneliness (UCLA-3), and discrimination (InDI-d) were evaluated. RESULTS: Significant changes were found in the variables depression and anxiety with a greater presence of this kind of symptomatology after one year (p < .01). There were also significant changes in the variable social support, which showed a substantial reduction after one year (p < .001). Similarly, there were significant variations in the variable intersectional discrimination (p < .001), with greater levels of discrimination. The temporal models show no significant differences in terms of post-traumatic symptomatology (p = .12) or loneliness (p = .19). CONCLUSIONS: The pandemic had a negative impact on mental health and these effects were further exacerbated one year later.

The Psychological Impact of the COVID-19 Pandemic in Spain: A Longitudinal Study / Impacto Psicológico de la Pandemia de la COVID-19 en España: un Estudio Longitudinal

Background: This study aims to longitudinally assess the psychologicalimpact of the COVID-19 pandemic in the general Spanish population.It uses four assessment points: two weeks after the start of confinement,one month after, two months after, and one year after the first evaluation.Methods: Evaluations were conducted through an online survey, with asample of 3,480 people at the first data collection and 1,041, 569, and 550people at successive evaluation points. Depressive symptoms (PHQ-2),anxiety (GAD-2), post-traumatic stress (PCL-C-2), social support (EMAS),loneliness (UCLA-3), and discrimination (InDI-d) were evaluated.Results: Significant changes were found in the variables depression and anxiety witha greater presence of this kind of symptomatology after one year (p < .01).There were also significant changes in the variable social support, whichshowed a substantial reduction after one year (p < .001). Similarly, therewere significant variations in the variable intersectional discrimination (p <.001), with greater levels of discrimination. The temporal models show nosignificant differences in terms of post-traumatic symptomatology (p = .12)or loneliness (p = .19). Conclusions: The pandemic had a negative impacton mental health and these effects were further exacerbated one year later.

Antecedentes: el objetivo es evaluar el impactopsicológico de la pandemia generada por la COVID-19 en la poblacióngeneral española longitudinalmente en cuatro momentos: tras dos semanasdel inicio del confinamiento, al mes, a los dos meses y al año. Método: lasevaluaciones se realizaron mediante una encuesta online, se siguió a unamuestra de 3.480 personas en la primera recogida de datos y de 1.041, 569y 550 personas en los sucesivos momentos de evaluación. Se evaluó lapresencia de síntomas depresivos (PHQ-2), de ansiedad (GAD-2), de estréspostraumático (PCL-C-2), el apoyo social (EMAS), la soledad (UCLA-3)y la discriminación (InDI-D). Resultados: se han producido cambios significativos en las variables de depresión y ansiedad con una presenciamayor de dicha sintomatología al año (p < .01), así como en la variable deapoyo social, que muestra una reducción significativa un año después (p <.001), y en la discriminación interseccional, con una mayor discriminación (p < .001). Los modelos temporales no muestran diferencias significativasen cuanto a sintomatología postraumática (p = .12) ni soledad (p = .19).Conclusiones: la pandemia ha tenido un impacto negativo en la saludmental y estos efectos son todavía peores un año después.

Evolution of intersectional perceived discrimination and internalized stigma during COVID-19 lockdown among the general population in Spain.

BACKGROUND: Stigma and discrimination have been associated with different diseases and pandemics, with negative consequences for the people who suffered them and for their communities. Currently, COVID-19 has become a new source of stigmatization. AIMS: The aim of the present study is to analyze longitudinally the evolution of intersectional perceived discrimination and internalized stigma among the general population of Spain, at three points in time throughout the confinement. METHOD: Participants completed an online survey. RESULTS: Results show an increase in both variables from the first to the second evaluation, and a slight decrease from the second to the third evaluation. Moreover, these changes are explained by depression, anxiety and family support. CONCLUSIONS: These findings indicate the factors that need to be considered to reduce the perception of discrimination and the internalization of stigma, and their detrimental consequences, during an especially stressful event such as the current pandemic outbreak.

Depressive symptom complexes of community-dwelling older adults: a latent network model.

Late-life depression has multiple, heterogeneous clinical presentations. The aim of the study was to identify higher-order homogeneous clinical features (symptom complexes), while accounting for their potential causal interactions within the network approach to psychopathology. We analyzed cross-sectional data from community-dwelling adults aged 65-85 years recruited by the European MentDis_ICF65+ study (n = 2623, mean age 74, 49% females). The severity of 33 depressive symptoms was derived from the age-adapted Composite International Diagnostic Interview. Symptom complexes were identified using multiple detection algorithms for symptom networks, and their fit to data was assessed with latent network models (LNMs) in exploratory and confirmatory analyses. Sensitivity analyses included the Partial Correlation Likelihood Test (PCLT) to investigate the data-generating structure. Depressive symptoms were organized by the Walktrap algorithm into eight symptom complexes, namely sadness/hopelessness, anhedonia/lack of energy, anxiety/irritability, self-reproach, disturbed sleep, agitation/increased appetite, concentration/decision making, and thoughts of death. An LNM adequately fit the distribution of individual symptoms' data in the population. The model suggested the presence of reciprocal interactions between the symptom complexes of sadness and anxiety, concentration and self-reproach and between self-reproach and thoughts of death. Results of the PCLT confirmed that symptom complex data were more likely generated by a network, rather than a latent-variable structure. In conclusion, late-life depressive symptoms are organized into eight interacting symptom complexes. Identification of the symptom complexes of late-life depression may streamline clinical assessment, provide targets for personalization of treatment, and aid the search for biomarkers and for predictors of outcomes of late-life depression.

Incidence and risk factors of mental disorders in the elderly: The European MentDis_ICF65+ study.

OBJECTIVE: While incidence rates of depression and anxiety disorders in the elderly have been comprehensively investigated, the incidence rates of other mental disorders have rarely been researched. The incidence rate and predictors of various mental disorders in the elderly were evaluated in different European and associated countries. METHODS: A cross-sectional and longitudinal multi-centre survey of Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnoses was conducted in different European and associated countries (Germany, Italy, Spain, Switzerland, the United Kingdom and Israel) to collect data on the prevalence and incidence of mental disorders in the elderly. The sample size of the longitudinal wave was N = 2592 elderly. RESULTS: The overall 1-year incidence rate for any mental disorder in the elderly is 8.65%. At 5.18%, any anxiety disorder had the highest incidence rate across all diagnostic groups. The incidence rate for any affective disorder was 2.97%. The lowest incidence rates were found for agoraphobia (1.37%) and panic disorder (1.30%). Risk factors for the development of any mental disorder were never having been married, no religious affiliation, a higher number of physical illnesses and a lower quality of life. CONCLUSION: In comparison to other studies, lower incidence rates for any affective disorder and middle-range incidence for any anxiety disorder were found. To the authors' knowledge, no prior studies have reported 1-year incidence rates for somatoform disorder, bipolar disorder and substance misuse in community-dwelling elderly. These findings indicate the need to raise awareness of psychosocial problems in the elderly and to ensure adequate availability of mental health services.

The Role of the Sense of Belonging During the Alarm Situation and Return to the New Normality of the 2020 Coronavirus Pandemic (COVID-19) in Spain.

In this study we intend to understand the impact of the COVID-19 crisis and the subsequent stay-at-home orders, on the Spanish population's sense of belonging at three moments in time: at the beginning of the lockdown, after one month of lockdown and with the return to the "new normality". A cross-sectional study was conducted through an online survey (N0 = 3480; N1 = 1041; N2 = 569). The sense of belonging was evaluated by means of four Likert-type items. These questions included membership in different groups: work/studies, friends, family and neighborhood or community. Sociodemographic and COVID-19-related data were collected. Additionally, mental health, spiritual well-being, loneliness, social support and discrimination were assessed. Descriptive analyses were carried out and linear regression models compiled. The sense of belonging increased significantly during confinement, dropping dramatically with the start of the return to the "new normality" process. The only variable that showed interaction with time and sense of belonging was discrimination. Work condition (not working providing the lowest sense of belonging scores), social support from friends and loneliness were the main predictors of the sense of belonging. The impact caused by the pandemic and the actions adopted during the first weeks regarding the sense of belonging is evident. It has been a key variable in dealing with COVID-19. Actions are now needed to increase our sense of belonging to face the post-epidemic crisis and avoid a greater impact in other areas.

Effects of COVID-19 lockdown on perceived discrimination and internalized stigma in people with previous mental disorder diagnoses in Spain.

COVID-19 disease control efforts and consequences are likely to be complicated by the impact of fear and stigmatization of the novel coronavirus. These complications may also worsen due to the potential compounding of COVID-19 related stigma with stigmatization associated with previously diagnosed conditions. This exploratory study analyzes the experiences of the stigma associated with COVID-19 lockdown in people with different previous diagnoses 2 and 5 weeks after the beginning of the state of emergency in Spain. Gender and age were controlled as covariables and 1,052 people participated in the study. The diagnosis groups were: Psychiatry and mental health (n = 71), Cardiovascular disease (n = 42), Neurological disease (n = 23), Lung disease (n = 53), and No diagnosis (n = 863). The instruments used to measure the stigma were the Intersectional Day-to-Day Discrimination Index and two items of the Internalized Stigma of Mental Illness scale. Analysis of covariance of repeated measures and analysis of variance, including Scheffe's post hoc test, were performed. We found significant differences in stigma among the first and second evaluation. Regarding the previous diagnosis, no differences were found at Time 1, but significant differences were found at Time 2, with those having a previous psychiatric or mental health diagnosis reporting higher levels of perceived discrimination and internalized stigmatization. Our results suggest that people with previous stigmatizing conditions might be more vulnerable to experiencing stigma in a confinement situation. In order to reduce the burden of the COVID-19 stigma, health interventions should also consider the resulting intersection of effects on internalized stigma and perceived discrimination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Network Analysis of Major Depressive Disorder Symptoms and Age- and Gender-Related Differences in People over 65 in a Madrid Community Sample (Spain).

Major depressive disorder (MDD) is one of the most prevalent conditions among mental disorders in individuals over 65 years. People over 65 who suffer from MDD are often functionally impaired, chronically physically ill, and express cognitive problems. The concordance between a clinician-assessed MDD diagnosis in a primary care setting and MDD assessed with a structured clinical interview in older adults is only approximately 18%. Network analysis may provide an alternative statistical technique to better understand MDD in this population by a dimensional approach to symptomatology. The aim of this study was to carry out a network analysis of major depressive disorder (MDD) in people over 65 years old. A symptom network analysis was conducted according to age and gender in 555 people over 65, using a sample from the MentDis_ICF65+ Study. The results revealed different networks for men and women, and for the age groups 65-74 and 75-84. While depressive mood stood out in women, in men the network was more dispersed with fatigue or loss of energy and sleep disturbances as the main symptoms. In the 65-74 age group, the network was complex; however, in the 75-84 age group, the network was simpler with sleep disturbances as the central symptom. The gaps between the networks indicate the different characteristics of MDD in the elderly, with variations by gender and age, supporting the idea that MDD is a complex dynamic system that has unique characteristics in each person, rather than a prototypical classification with an underlying mental disorder. These unique characteristics can be taken into account in the clinical practice for detection and intervention of MDD.

Mental Health Consequences of the Coronavirus 2020 Pandemic (COVID-19) in Spain. A Longitudinal Study.

Background: Covid-19 remains a pandemic that most countries in the world are still dealing with. This is study aims to report the psychological impact of Covid-19 over time on the Spanish population. Methods: A longitudinal study (N = 1041) was carried out with two measurements: after 2 and 5 weeks starting from the declaration of the state of emergency in Spain. The presence of depressive symptoms, anxiety, and posttraumatic stress disease (PTSD) was evaluated by means of screening tests. Sociodemographic data, variables about Covid-19, loneliness, spiritual well-being, social support, discrimination, and a sense of belonging were collected. Results: The data showed how depressive symptomatology increased significantly over time, while anxiety and PTSD did not show statistically significant changes. Spiritual well-being and loneliness were the main predictors of psychological impact. A younger age was a significant predictor of depression and anxiety, while female gender was associated with anxiety and PTSD. Conclusions: The impact of the pandemic is sustained over time, even increasing in depression, and vulnerable groups that need greater psychological health support could be identified.

Relationship between Quality of Life and Sociodemographic, Physical and Mental Health Variables in People over 65 in the Community of Madrid.

Except in the case of depression, there are few studies that analyze mental health variables related to quality of life (QoL) in people over 65 years of age. The objective of this study is to analyze the relationship between QoL and the following variables: sociodemographic and physical and mental health of people over 65 years of age. The sample was randomly selected and consists of men and women between 65 and 84 years of age (N = 555) from the Community of Madrid. Mental disorders were evaluated with the CIDI65+ interview and QoL with the WHOQoL-BREF scale. Means, ANOVA and multiple linear regression analyses were performed. Women have worse QoL than men and QoL worsens with age. The regression model for the dependent variable "WHOQoL BREF Scale" explains 41.43% of the variance (R2 = 0.413). The variables that have the greatest impact on QoL are as follows: a greater number of physical and psychological symptoms, experiencing financial difficulties and the presence of a psychological disorder, while continuing to work has a positive effect on QoL. Physical and mental disorders have a similar impact on QoL. The presence of a greater number of psychological symptoms (without necessarily fulfilling the criteria of a mental disorder) is a predictive variable of worse QoL. Mental health has a burden on the QoL of people over 65 years of age that is as powerful as physical health.

Prevalencia de los trastornos de uso y abuso de alcohol en las personas mayores de 65 años: una revisión sistemática / Prevalence of use and alcohol abuse disorders in adults over 65 years: a systematic review

El objetivo de este trabajo es estudiar de manera sistemática los datos de prevalencia de los trastornos de uso y abuso de alcohol en las personas mayores. Se han seleccionado los estudios de prevalencia en inglés o español escritos entre 2008 y 2018 que aporten datos de prevalencia de trastornos por consumo de alcohol y que incluyan en su muestra a personas mayores de 65 años, la selección final es de 30 artículos. Los estudios encuentran tasas de prevalencia muy heterogéneas, con medidas anuales entre 0,7% y 5,2%, lo cual puede deberse a diferencias metodológicas. Esta revisión pone de relieve que existe una correlación negativa entre la edad y los trastornos de uso y abuso de alcohol. Los hombres sufren en mayor medida trastornos de uso y abuso de alcohol que las mujeres. Se observa que la cultura juega un papel relevante en los trastornos de uso y abuso de alcohol en las personas mayores. Estos trastornos son cada vez más frecuentes en la población mayor y es necesario actualizar los sistemas de evaluación por parte de los servicios de salud para mejorar la detección de estos problemas y aplicar tratamientos adecuados a este colectivo

The aim of this study is to systematically study the prevalence data on alcohol use and abuse disorders in the elderly. We have selected the prevalence studies in English or Spanish written between 2008 and 2018 that provide data on the prevalence of alcohol use disorders and that include people over 65 years of age, the final selection is 30 articles. The studies are found in very heterogeneous prevalence rates, with measures between 0.7% and 5.2%, which can reduce methodological differences. This review highlights that there is a negative correlation between age and alcohol use and abuse disorders. Men suffer more from alcohol use and abuse disorders than women. It is observed that culture plays a relevant role in alcohol use and abuse disorders in the elderly. These disorders are increasingly frequent in the elderly population and it is necessary to update the evaluation systems of the health services to improve the detection of these problems and apply them to this group

Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain.

The pandemic caused by Covid-19 has been an unprecedented social and health emergency worldwide. This is the first study in the scientific literature reporting the psychological impact of the Covid-19 outbreak in a sample of the Spanish population. A cross-sectional study was conducted through an online survey of 3480 people. The presence of depression, anxiety and post-traumatic stress disorder (PTSD) was evaluated with screening tests from 14 March. Sociodemographic and Covid-19-related data was collected. Additionally, spiritual well-being, loneliness, social support, discrimination and sense of belonging were assessed. Descriptive analyses were carried out and linear regression models compiled. The 18.7% of the sample revealed depressive, 21.6% anxiety and 15.8% PTSD symptoms. Being in the older age group, having economic stability and the belief that adequate information had been provided about the pandemic were negatively related to depression, anxiety and PTSD. However, female gender, previous diagnoses of mental health problems or neurological disorders, having symptoms associated with the virus, or those with a close relative infected were associated with greater symptomatology in all three variables. Predictive models revealed that the greatest protector for symptomatology was spiritual well-being, while loneliness was the strongest predictor of depression, anxiety and PTSD. The impact on our mental health caused by the pandemic and the measures adopted during the first weeks to deal with it are evident. In addition, it is possible to identify the need of greater psychological support in general and in certain particularly vulnerable groups.

Prevalence and Characterization of Specific Phobia Disorder in People over 65 Years Old in a Madrid Community Sample (Spain) and its Relationship to Quality of Life.

The prevalence of anxiety disorders over the last year among seniors ranged from 3.6% to 17.2%. The most prevalent disorders are specific phobias. Data are needed concerning the consequences of specific phobia disorder on the level of functioning and quality of life of older people, the age of onset of specific phobia disorder, and the duration of episodes. In total, 555 community-dwelling people aged between 65 and 84 years who lived in Madrid (Spain) were assessed (Composite International Diagnostic Interview for people over 65 years (CIDI65+), WHO Disability Assessment Schedule (WHODAS II), Health of the Nation Outcome Scales for Older Adults (HoNOS65+), World Health Organization Quality of Life Brief (WHOQOL-BREF). Prevalence rates and odds ratio, t-tests, binary logistic regression, and point-biserial correlations were calculated. A total of 12.07% of the sample suffered a specific phobia disorder over the last year. The average age at onset of the specific phobia was 38.78 (sd = 21.61) years. The mean duration of the phobia was approximately 20 (sd = 20) years. A significant effect of the specific phobia was found for the current levels of functioning and quality of life: WHOQOL-BREF total score (p < 0.05), WHODAS II overall score (p < 0.01), and HoNOS65+ total score (p < 0.001). Having specific phobia disorder decreased the level of functioning and negatively affected the quality of life. These data suggest the need for primary healthcare professionals to include the detection of specific phobia disorders in their protocols because people do not receive treatment for this problem, and they might carry it throughout their lives.

Quality of life, level of functioning, and its relationship with mental and physical disorders in the elderly: results from the MentDis_ICF65+ study.

BACKGROUND: An ageing population worldwide needs to investigate quality of life (QoL) and level of functioning (LoF) in the elderly and its associated variables. We aimed to study the relationship between Quality of Life (QoL) and Level of Functioning (LoF) in an elderly population in Europe. METHOD: As part of the Ment_Dis65+ European Project, 3142 community-dwelling adults aged 65-84 years in six countries were assessed by using the adaptation for the elderly of the Composite International Diagnostic Interview (CIDI65+) to provide psychiatric diagnosis according to the International Classification of Diseases (10th edition) (ICD-10 Classification of Mental and Behavioural Disorders). Socio-demographic and clinical interviews, and two self-report tools, the World Health Organization QoL assessment (WHO QoL BREF), to assess QoL, and the WHO Disability Assessment Schedule -II (WHODAS-II), to assess LoF, were also administered. RESULTS: Most subjects reported good levels of QoL (56.6%) and self-rated health (62%), with no or mild disability (58.8%). There was a linear decrease of the QoL and the LoF by increase of age. Elderly with ICD-10 mental disorder (e.g. somatoform, affective and anxiety disorders) had poorer QoL and lower LoF. There were a number of predictors of lower levels of QoL and disability, including both socio-demographic variables (e.g. male gender, increase in age, poor financial situation, retirement, reduced number of close significant others), ICD-10 psychiatric diagnosis (mainly anxiety, somatoform disorders) and presence of medical disorders (mainly heart and respiratory diseases). CONCLUSIONS: The study indicates that QoL and LoF were quite acceptable in European elderly people. A series of variables, including psychiatric and somatic disorders, as well as socio-demographic factor influenced in a negative way both QoL and LoF. More specific links between mental health, social and health services dedicated to this segment of the population, should be implemented in order to provide better care for elderly people with conditions impacting their QoL and functioning.