Longitudinal mental health state during the COVID-19 pandemic. Longitudinal change of mental symptoms and its predictors during the COVID-19 pandemic: A prospective longitudinal study on Spanish population.

OBJECTIVE: The general objective of this study is to analyze the change in mental health and post-traumatic symptoms over 6 months during the COVID-19 pandemic in a Spanish community sample, with a particular focus on individual differences in longitudinal change in symptoms and its predictors. METHOD: This longitudinal prospective study surveyed a Spanish community sample three times (T1: during the initial outbreak, T2: after 4 weeks and T3: after 6 months). Four thousand one hundred and thirty-nine participants from all the Spanish regions completed the questionnaires. However, the longitudinal analysis was performed only with participants which responded at least two times (1,423 participants). Mental health assessments included depression, anxiety, and stress (measured by the Depression, Anxiety and Stress Scale (DASS-21) and post-traumatic symptoms were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: All the mental health variables achieved worse results at T2. Depression, stress, and posttraumatic symptoms did not recover at T3 when compared with the initial measure, while anxiety was practically stable across the timeline. Women, younger age, having a previous mental health diagnosis and contact with individuals with COVID-19 were linked to worse psychological evolution during the 6-months period. A good perception of one's physical health may be a protective factor. CONCLUSIONS: After 6 months of the pandemic, the general population's mental health was still worse than at the initial outbreak for most of the variables analyzed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Immediate Psychological Response during the Very Early Stage of the Coronavirus Pandemic (COVID-19) in a Spanish Community Sample.

The World Health Organization declared a pandemic due to COVID-19 on 11 March 2020 and remarked on the relevance of studying its consequences on mental health. A cross-sectional study was conducted to evaluate the immediate psychological response to the pandemic and quarantine in Spain.

Respuesta psicológica inmediata durante una etapa muy temprana de la pandemia por coronavirus (COVID-19) en una muestracomunitaria española / Immediate Psychological Response during the Very Early Stage of the Coronavirus Pandemic (COVID-19) in a Spanish Community Sample

Introducción: La Organización Mundial de la Salud declaró la pandemia por COVID-19 el 11 de marzo de 2020 ysubrayó la importancia de estudiar sus consecuencias en lasalud mental de la población. Se presenta un estudio transversal evaluando las respuestas psicológicas a la primera olade la pandemia en España.Metodología. Entre el 23 y 28 de marzo, se realizó unaencuesta online en una muestra española seleccionada trasun muestreo en bola de nieve. Se recogieron variables sociodemográficas, de salud y comportamentales. Se evaluaron laansiedad y depresión a través de la Escala de Depresión, Ansiedad y Estrés (DASS-21), los síntomas postraumáticos a través de la Escala de Impacto del Evento Revisada (IES-R) y lospatrones de autocuidado con la Escala de Autocuidado (SCS).Resultados. Se incluyeron 3524 participantes, 24,1 %mostraron síntomas postraumáticos moderados o severos,21,9 % refirieron síntomas depresivos moderados, severos o extremadamente severos y 32 % síntomas ansiososmoderados, severos o extremadamente severos. El génerofemenino, la menor edad, menor nivel educativo, diagnóstico psiquiátrico previo, peor salud física, contacto con COVID-19, falta de rutinas y algunos síntomas psicológicos serelacionaron con peores respuestas psicológicas.Conclusiones. Se confirma el impacto sobre la saludmental que la primera ola de la pandemia tuvo en España yse identifican algunas variables relacionadas con peor respuesta que pueden resultar útiles en la prevención en salud mental en futuras situaciones equivalentes. (AU)

Introduction: The World Health Organization declared apandemic due to COVID-19 on 11 March 2020 and remarkedon the relevance of studying its consequences on mentalhealth. A cross-sectional study was conducted to evaluatethe immediate psychological response to the pandemic andquarantine in Spain.Methods. From March 23 to 28, an online survey wasconducted in a Spanish community sample. Sociodemographic,health and behavioral variables were surveyed. Depressionand anxiety sypmtoms were measured by the Depressión,Anxiety and Stress Scale (DASS-21), posttraumatic symptomsby the Impact of Event Scale-Revised (IES-R) and self-carepatterns by the Self-Care Scale (SCS).Results. 3524 respondents were included, 24.1%showed moderate or severe psychological impact, 21.9%reported moderate, severe or extremely severe depressionand 32% moderate, severe or extremely severe anxiety.Female gender, younger age, low education, psychiatricdiagnosis, worse physical health, contact history, lack ofroutines, and some psychological symptoms were related toworse psychological responses.Conclusions. This study provides evidence for a negativemental health impact of the pandemic in the Spanishcommunity that started at the early stages and identifiessome variables linked to worse psychological response. (AU)

Psychological Responses According to Gender during the Early Stage of COVID-19 in Spain.

BACKGROUND: Current research has pointed out an increased risk of mental health problems during the COVID-19 pandemic in women compared to men, however the reason for this difference remains unclear. The aim of this research is to study early psychological responses to the pandemic in the Spanish general population, focusing on gender differences. METHODS: Nine to 14 days after the declaration of a state of emergency an online survey was conducted assessing sociodemographic, health, behavioral and COVID-19-related variables. Mental health status was evaluated by the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the Self-Care Scale (SCS). RESULTS: The study included 3520 respondents: 2611 women and 909 men. Women scored significantly higher in DASS-21 and IES-R (p < 0.05) and were more likely to somatize, suffer from hypochondriasis, sleeping disturbances and claustrophobia (p < 0.05). Being a woman can be considered a risk factor for intrusive thoughts, avoidance mechanisms, stress and anxiety (Odd Ratio = 2.7/2.3/2.3/1.6). The risk of presenting posttraumatic symptoms and emotional distress was greater in women (Odd Ratio = 6.77/4.59). General linear models to predict IES-R and DASS-21 scores clarified which variables were gender specific, such as main concerns. CONCLUSIONS: This study provides evidence that at early stages of the pandemic, women mental health was more impacted and that both genders show different concerns. Gender perspective in secondary and tertiary prevention strategies must be taken into account when facing the distress associated with the pandemic.

How did Different Generations Cope with the COVID-19 Pandemic? Early Stages of the Pandemic in Spain.

BACKGROUND: The World Health Organization has highlighted the importance of studying the consequences of the COVID-19 pandemic on mental health. The aim of this study is to examine the role of age in the early psychological responses to the pandemic in a Spanish community sample, focusing on how different generations coped with it. METHOD: An online survey was conducted during the early stages of the quarantine. Sociodemographic, health and behavioral variables were compared for five age groups. Mental health was assessed by the Depression, Anxiety and Stress Scale (DASS-21) and psychological impacts were assessed by the Impact of Event Scale-Revised (IES-R). RESULTS: 3,524 participants were included (Mage = 39.24, SDage = 12.00). Participants aged between 18 and 33 years old showed more hyperactivation and evitation, were more depressed, anxious and stressed. Those aged between 26 and 33 years old showed more intrusion. Those aged between 18 and 25 years old suffered more sleep disturbances, claustrophobia and somatization and maintained worse routines. Elderly people showed better psychological responses in general. CONCLUSIONS: This study provides initial evidence that the negative psychological impact of COVID-19 pandemic hits young people harder. These results should be taken into account when developing specific evidence-based strategies.

The role of emotion dysregulation in Conversion Disorder.

INTRODUCTION: The role that emotion regulation plays in Conversion Disorders (CD) is not well known. This research deepens in this subject and describes the main differences between a group of conversion patients and a control group on different measures of emotion regulation and other clinical variables. METHODS: A case-control study was conducted including 43 patients suffering from CD and 42 healthy controls. Both groups went thought two psychiatric interviews and fulfilled 6 questionnaires assessing depression, anxiety, alexithymia, emotion dysregulation, affect intensity, psychoform and somatoform dissociation. RESULTS: Patients suffering from CD scored significantly higher on all the six questionnaires (p<0.001). Negative reactivity and negative intensity were also higher in patients (p<0.01), while cases and controls did not show any significant differences on positive affectivity and serenity. Anxiety, alexithymia and emotional dysregulation were the most relevant factors (OR=5.85/3.50/3.23 respectively). Anxiety and difficulties in emotion regulation were the most explicative variables for conversion in the regression analysis performed. Within the five factors assessing difficulties in emotion regulation, lack of emotional control and interference in goal directed behaviors were the most relevant. Positive and negative conversion where correlated to different emotional impairments. CONCLUSIONS: People suffering from CD show several emotional impairments when compared to healthy controls. Emotion dysregulation can be considered a relevant aspect in CD. The existence of specific emotional patterns for different conversion manifestations is suspected.

Validity and reliability of the Spanish version of the Somatoform Dissociation Questionnaire (SDQ-20).

BACKGROUND: The Somatoform Dissociation Questionnaire (SDQ-20) is a self-reported questionnaire measuring somatoform dissociation. The aim of this study is to analyze the psychometric properties of the Spanish version of the SDQ-20 and its short version (SDQ-5). METHODS: Validity and reliability were examined in a sample of 360 psychiatric outpatients: 38 dissociative (conversion) disorders, 30 dissociative (psychoform) disorders, and 292 patients suffering from other disorders. Dissociative disorders were diagnosed using the SCID-D and a specific interview for conversion disorders. RESULTS: Subjects meeting criteria for any dissociative or conversion disorder scored significantly higher in the SDQ-20 (criterion validity). Somatoform dissociation, psychoform dissociation and early trauma were significantly correlated (construct validity). An alpha coefficient of .866 (reliability) and a test-retest correlation of 0.91 were obtained. The cut-off score maximizing sensitivity and specificity was 27.5 for psychoform dissociative disorders (sensitivity of 81.6% and specificity of 71.0%) and 29.5 for conversion disorders (81.6% and 71.0%). For the SDQ-5, the coefficient alpha was 0.561 and the selected cut-off score was 5.5 (sensitivity of 73.33% and specificity of 70.41%). CONCLUSIONS: The Spanish version of the SDQ-20 presents good psychometric properties while the SDQ-5 shows worse characteristics and its use with Spanish samples is not recommended.

Integrating neurobiology of emotion regulation and trauma therapy: reflections on EMDR therapy.

Emotion dysregulation is a frequent feature in trauma-related disorders. Different kinds of emotion dysregulation seem to be linked to particular psychiatric conditions, and there is growing evidence of the association between neurobiological correlates and those dysregulation patterns. Nevertheless, many of the recent findings from the field of the neurobiology have not been translated into clinical practice and are insufficiently contemplated in trauma-oriented therapies. The aim of this article is to review recent developments in the field of emotion regulation connecting these issue with the practical implementation of psychotherapeutic procedures. The evaluation of emotion dysregulation patterns can guide decision making during the therapy independently to the approach, but there are some findings that can be especially useful for some concrete modalities of therapy. In this article we will focus our discussion on how emotion dysregulation may influence eye movement desensitization and reprocessing (EMDR) treatment in trauma-related disorders. EMDR is a well-defined and protocol-based intervention, with a strong empirical support for post-traumatic stress disorder (PTSD). We describe how different patterns of emotion dysregulation may influence EMDR treatment and procedures, and also how the application of EMDR beyond non-dissociative PTSD should take into account the predominant emotion-regulation strategies in specific posttraumatic disorders.

Emotion regulation strategies in trauma-related disorders: pathways linking neurobiology and clinical manifestations.

Emotion regulation impairments with traumatic origins have mainly been studied from posttraumatic stress disorder (PTSD) models by studying cases of adult onset and single-incident trauma exposure. The effects of adverse traumatic experiences, however, go beyond the PTSD. Different authors have proposed that PTSD, borderline personality, dissociative, conversive and somatoform disorders constitute a full spectrum of trauma-related conditions. Therefore, a comprehensive review of the neurobiological findings covering this posttraumatic spectrum is needed in order to develop an all-encompassing model for trauma-related disorders with emotion regulation at its center. The present review has sought to link neurobiology findings concerning cortico-limbic function to the field of emotion regulation. In so doing, trauma-related disorders have been placed in a continuum between under- and over-regulation of affect strategies. Under-regulation of affect was predominant in borderline personality disorder, PTSD with re-experiencing symptoms and positive psychoform and somatoform dissociative symptoms. Over-regulation of affect was more prevalent in somatoform disorders and pathologies characterized by negative psychoform and somatoform symptoms. Throughout this continuum, different combinations between under- and over-regulation of affect strategies were also found.

[Psychosis as debut of antiphospholipid syndrome]. / Psicosis como presentacion del sindrome antifosfolipido primario.

INTRODUCTION: Antiphospholipid syndrome (APS) is an autoimmune disorder which causes an hypercoagulation state characterized by thrombotic events, repetitive miscarriages and the presence of antiphospholipid antibodies. APS may be an isolated disease (primary APS) or associated to systemic lupus erythematous or another autoimmune conditions (secondary APS). Neuropsychiatric manifestations accompanying APS include migraine, epilepsy, chorea, dementia or psychosis. Detailed descriptions of clinical cases are lacking, and correlations between clinical and analytical findings are far from being well known. We review literature concerning neuropsychiatric manifestations in general and psychosis in particular, in patients suffering from AFS. CASE REPORT: A 23 years-old female who presented a primary AFS with a clinical debut consisting of neuropsychiatric manifestations characterized by psychosis (with two delusion episodes) and abnormal movements such as choreiform and hemiballistic movements, initially understood as conversive symptoms. CONCLUSIONS: We discuss the pathogenesis of the psychotic and motor manifestations. The etiology is nowadays not completely understood, but cerebral small vessel thrombosis might explain part of the manifestations. We also review the role of antipsychotic and antithrombotic medication for these patients. Currently, our patient remains asymptomatic without any antipsychotic agent, only being treated with antiagregant and antipalludic therapy.

TITLE: Psicosis como presentacion del sindrome antifosfolipido primario.Introduccion. El sindrome antifosfolipido (SAF) es un trastorno autoinmune que determina un estado de hipercoagulabilidad caracterizado por eventos tromboticos, abortos de repeticion y la presencia de anticuerpos antifosfolipido. Puede presentarse de manera aislada (SAF primario) o asociado a lupus eritematoso sistemico u otras enfermedades autoinmunes (SAF secundario). Las manifestaciones neuropsiquiatricas del SAF incluyen jaqueca, epilepsia, corea, demencia y psicosis. Se realiza una revision bibliografica de la sintomatologia neuropsiquiatrica en general y psicotica en particular de los pacientes afectos de SAF. Caso clinico. Mujer de 23 años afecta de un SAF primario que comenzo con manifestaciones clinicas unicamente neuropsiquiatricas consistentes en sintomatologia psicotica (dos episodios de clinica delirante) y movimientos anormales coreiformes y hemibalisticos que inicialmente se interpretaron como clinica conversiva. Conclusiones. Se discute la patogenesis de la sintomatologia motora y psicotica. La etiologia de los sintomas neuropsiquiatricos todavia no se conoce con claridad, pero la trombosis de pequeños vasos en el cerebro podria explicar parte de los sintomas. Asimismo, se revisa el papel que la medicacion antipsicotica y antitrombotica tiene para estos pacientes. En la actualidad, nuestra paciente se mantiene asintomatica sin necesidad de terapia antipsicotica y recibe tratamiento unicamente con un agente antiagregante y otro antipaludico.