ABSTRACT
BACKGROUND: Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered. METHODS: We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. RESULTS: A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). CONCLUSIONS: Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.
ABSTRACT
Objetivo: Conocer la prevalencia y factores predictores de depresión en pacientes diagnosticados de enfermedad pulmonar obstructiva crónica (EPOC) y remitidos desde Atención Primaria a consultas de Neumología, servicios que comparten la atención al proceso EPOC.DiseñoEstudio observacional, multicéntrico, prospectivo con muestreo no probabilístico, transversal.EmplazamientoDos consultas de neumología de dos hospitales de diferente nivel asistencial.ParticipantesSe diagnosticaron 293 pacientes de EPOC en fase estable de la enfermedad.IntervencionesAplicación de cuestionarios clínicos habituales en la EPOC y test HADS (Hospital Anxiety and Depression Scale).VariablesVariables demográficas, clínicas y funcionales de la EPOC y escala de depresión del test HADS (Hospital Anxiety and Depression Scale).ResultadosSe incluyeron 229 hombres (78,16%) y 64 mujeres (21,8%), con una edad media de 68,2 ± 10,3 años, de los que 93 (31,7%) eran fumadores activos y 200 (68,3%) exfumadores. El 19,45% de los pacientes tenía diagnóstico clínico previo de depresión, pero mediante el test HADS se estableció el diagnóstico de sospecha en el 32,6%. Las variables predictoras fueron: ser mujer, vivir solo y variables relacionadas con la gravedad de la enfermedad (volumen espiratorio forzado en 1 segundo [FEV1] postbroncodilatador, ser paciente de riesgo y fenotipo agudizador según criterios de la Guía Española de la EPOC [GesEPOC] y grados C y D de criterios Global Initiative for Chronic Obstructive Lung Disease [GOLD]).ConclusionesLa prevalencia de la depresión en pacientes con EPOC es alta y está infradiagnosticada. El test diagnóstico HADS es útil para establecer el diagnóstico de sospecha en las consultas de Atención Primaria y Neumología.
Objective: to determine the prevalence of and predictive factors for depression in patients diagnosed with COPD and referred from primary care to pneumology departments, departments that share care for COPD patients.Designobservational, multicentric, prospective with non-probabilistic sample, transversal study.Settingtwo pneumology visit offices at two hospitals offering different levels of care.Participants293 patients diagnosed with COPD in a stable phase of the disease.InterventionsCarryng out common clinical questionnaires in COPD & HADS.Main measurementsDemographic, clinical, and functional variables of COPD, and HADS depression scale.ResultsIncluded were 229 men (78.16%) and 64 women (21.8%), with an average age of 68.2 ± 10.3 years of whom 93 (31.7%) were active smokers and 200 (68.3%) ex-smokers. 19.45% of patients had a previous diagnosis of clinical depression but the HADS test established a diagnosis of suspicion of depression in 32.6%. Predictive factors included: being female, living alone, and variables related to the severity of the disease (FEV1 postbronchodilator, being a high-risk patient, exacerbating phenotype criteria, and C and D GOLD criteria levels).ConclusionsThe prevalence of depression in patients with COPD is high and is infra-diagnosed. The HADS diagnostic test is useful for establishing a diagnosis of suspicion of depression at primary care and pneumology visit offices. There are personal and clinical factors that may be considered predictive and aid healthcare professionals in determining which patients should take the HADS test and, based on results, referring patients to the mental health department to confirm or reject the diagnosis.
Subject(s)
Humans , Female , Health Sciences , Depression/diagnosis , Depression/epidemiology , Depression/etiology , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Prospective Studies , Prevalence , Surveys and QuestionnairesABSTRACT
OBJECTIVE: to determine the prevalence of and predictive factors for depression in patients diagnosed with COPD and referred from primary care to pneumology departments, departments that share care for COPD patients. DESIGN: observational, multicentric, prospective with non-probabilistic sample, transversal study. SETTING: two pneumology visit offices at two hospitals offering different levels of care. PARTICIPANTS: 293 patients diagnosed with COPD in a stable phase of the disease. INTERVENTIONS: Carryng out common clinical questionnaires in COPD & HADS. MAIN MEASUREMENTS: Demographic, clinical, and functional variables of COPD, and HADS depression scale. RESULTS: Included were 229 men (78.16%) and 64 women (21.8%), with an average age of 68.2 ± 10.3 years of whom 93 (31.7%) were active smokers and 200 (68.3%) ex-smokers. 19.45% of patients had a previous diagnosis of clinical depression but the HADS test established a diagnosis of suspicion of depression in 32.6%. Predictive factors included: being female, living alone, and variables related to the severity of the disease (FEV1 postbronchodilator, being a high-risk patient, exacerbating phenotype criteria, and C and D GOLD criteria levels). CONCLUSIONS: The prevalence of depression in patients with COPD is high and is infra-diagnosed. The HADS diagnostic test is useful for establishing a diagnosis of suspicion of depression at primary care and pneumology visit offices. There are personal and clinical factors that may be considered predictive and aid healthcare professionals in determining which patients should take the HADS test and, based on results, referring patients to the mental health department to confirm or reject the diagnosis.
