Self-reported increase in alcohol and drugs intake as a coping strategy in hospital workers during COVID-19 outbreak: A cross-sectional study. / Incremento de la ingesta de alcohol y drogas como estrategia de afrontamiento en trabajadores hospitalarios durante el brote de COVID-19: Estudio transversal.

Situations of psychological stress, such as the current COVID-19 pandemic, could lead to an increase in the consumption of alcohol and other drugs of abuse as an inadequate coping strategy in health workers. This study aimed to investigate the intake of alcohol and drugs of abuse in hospital workers during the first wave of COVID-19. A further focus was to define the worker profile most vulnerable to this behavior through a logistic regression analysis. A cross-sectional study in a tertiary hospital in Madrid, Spain, during the first wave of COVID-19 was designed. Information was collected from a sample (n = 657) of healthcare workers (n = 536) and non-healthcare workers (n = 121). An online survey (including questions about basic health habits, working environment conditions, sociodemographic data, and the 12-item version of the General Health Questionnaire as a measure of psychological well-being) was conducted. Increased consumption of alcohol and/or drugs of abuse during the analyzed period of the pandemic was reported by 17.1% of workers. The following variables were associated with a higher probability of increased consumption of alcohol and/or drugs of abuse: male gender (p = .044), living alone or without dependents (p = .005), staff physician or resident (p = .010), having worked on the COVID frontline (p = .058), poor nutritional habits (p = .004) and self-prescription of psychotropic drugs to manage anxiety and insomnia (p = .003). A significant percentage of hospital workers increased their consumption of alcohol and drugs of abuse during the first wave of the COVID-19 pandemic. A professional risk profile can be defined for this practice.

Las situaciones de estrés psicológico, como la actual pandemia COVID-19, pueden implicar un aumento del consumo de alcohol y otras drogas de abuso como estrategia inadecuada de afrontamiento en profesionales sanitarios. Esta investigación tiene como objetivo estudiar el incremento de la ingesta de alcohol y drogas de abuso en los trabajadores hospitalarios. Persigue también, mediante un análisis de regresión logística, definir qué perfil de trabajador es el más vulnerable a este comportamiento. Para ello se realizó un estudio transversal en un hospital terciario en Madrid, España, durante la primera oleada de COVID-19. Participaron en el estudio un total de 657 trabajadores del hospital, 536 de ellos sanitarios y 121 no sanitarios. La recogida de datos se realizó a través de una encuesta en línea que incluía preguntas sobre hábitos básicos de salud, condiciones del entorno laboral, datos sociodemográficos, así como la versión de 12 ítems del Cuestionario de Salud General. El 17,1% declaró haber aumentado su consumo de alcohol y/o drogas de abuso durante el período analizado. Se asoció a una mayor probabilidad de dicho incremento: sexo masculino (p = ,044), vivir sin personas dependientes a cargo (p = ,005), ser médico adjunto o residente (p = ,010), haber trabajado en primera línea de COVID (p = ,058), presentar malos hábitos nutricionales (p = ,004) y realizar autoprescripción de fármacos psicotrópicos para controlar la ansiedad y el insomnio (p = ,003). Un porcentaje significativo de los trabajadores hospitalarios ha aumentado su consumo de alcohol y drogas de abuso durante la primera oleada de la pandemia COVID-19, existiendo un perfil de mayor riesgo para esta práctica.

Incremento de la ingesta de alcohol y drogas como estrategia de afrontamiento en trabajadores hospitalarios durante el brote de COVID-19: Estudio transversal / Self-reported increase in alcohol and drugs intake as a coping strategy in hospital workers during COVID-19 outbreak: A cross-sectional study

Las situaciones de estrés psicológico, como la actual pandemia COVID-19,pueden implicar un aumento del consumo de alcohol y otras drogas de abuso como estrategia inadecuada de afrontamiento en profesionales sanitarios. Esta investigación tiene como objetivo estudiar el incremento de la ingesta de alcohol y drogas de abuso en los trabajadores hospitalarios. Persigue también, mediante un análisis de regresión logística, definir qué perfil de trabajadores el más vulnerable a este comportamiento. Para ello se realizó un estudio transversal en un hospital terciario en Madrid, España, durante la primera oleada de COVID-19. Participaron en el estudio un total de 657 trabajadores del hospital, 536 de ellos sanitarios y 121 no sanitarios. La recogida de datos se realizó a través de una encuesta en línea que incluía preguntas sobre hábitos básicos de salud, condiciones del entorno laboral, datos sociodemográficos, así como la versión de 12 ítems del Cuestionario de Salud General. El 17,1%declaró haber aumentado su consumo de alcohol y/o drogas de abuso durante el período analizado. Se asoció a una mayor probabilidad de dicho incremento: sexo masculino (p = ,044), vivir sin personas dependientes a cargo (p = ,005), ser médico adjunto o residente (p = ,010), haber trabajado en primera línea de COVID (p = ,058), presentar malos hábitos nutricionales(p = ,004) y realizar autoprescripción de fármacos psicotrópicos para controlar la ansiedad y el insomnio (p = ,003). Un porcentaje significativo delos trabajadores hospitalarios ha aumentado su consumo de alcohol y drogas de abuso durante la primera oleada de la pandemia COVID-19, existiendo un perfil de mayor riesgo para esta práctica. (AU)

Situations of psychological stress, such as the current COVID-19 pandemic,could lead to an increase in the consumption of alcohol and other drugs ofabuse as an inadequate coping strategy in health workers. This study aimedto investigate the intake of alcohol and drugs of abuse in hospital workersduring the first wave of COVID-19. A further focus was to define the workerprofile most vulnerable to this behavior through a logistic regression analysis.A cross-sectional study in a tertiary hospital in Madrid, Spain, during the firstwave of COVID-19 was designed. Information was collected from a sample(n = 657) of healthcare workers (n = 536) and non-healthcare workers (n =121). An online survey (including questions about basic health habits, workingenvironment conditions, sociodemographic data, and the 12-item versionof the General Health Questionnaire as a measure of psychological wellbeing) was conducted. Increased consumption of alcohol and/or drugs ofabuse during the analyzed period of the pandemic was reported by 17.1%of workers. The following variables were associated with a higher probabilityof increased consumption of alcohol and/or drugs of abuse: male gender(p = .044), living alone or without dependents (p = .005), staff physician orresident (p = .010), having worked on the COVID frontline (p = .058), poornutritional habits (p = .004) and self-prescription of psychotropic drugs tomanage anxiety and insomnia (p = .003). A significant percentage of hospitalworkers increased their consumption of alcohol and drugs of abuse duringthe first wave of the COVID-19 pandemic. A professional risk profile can be defined for this practice. (AU)

Psychological Impact of COVID-19 Pandemic and Related Variables: A Cross-Sectional Study in a Sample of Workers in a Spanish Tertiary Hospital.

Introduction: We intend to objectify the psychological impact of the COVID-19 pandemic on the workers of a tertiary hospital. Methods: All the workers were invited to an online survey. In total, 657 workers were recruited, including 536 healthcare workers (HCWs) and 121 non-healthcare workers (nHCWs). General Health Questionnaire-12 items (GHQ-12) was used as a screening tool. Sociodemographic data, working environmental conditions, and health behaviors were also analyzed. Results: inadequate sleep, poor nutritional and social interaction habits, misuse of psychotropics, female gender, COVID-19 clinical diagnosis, and losing a relative by COVID-19 were variables associated with higher probability of GHQ-12 positive screening. Significant differences between "frontline workers" and the rest were not found, nor was higher the probability of psychological distress in healthcare workers compared to non-healthcare workers. After 3 months from the peak of the pandemic, 63.6% of participants screening positive in GHQ-12 reported remaining "the same or worse." Limitations: Causal inferences cannot be established. Retrieval and selection biases must be considered as the survey was not conducted during the peak of the outbreak. Conclusions: psychological impact of COVID-19 has been broad, heavy, and persistent in our institution. Proper assessment and treatment must be offered to all hospital workers.

[The Need of a New Integral Approach to the Care of Patient with Severe Mental Disorder Thirty Years after the Psychiatric Reform]. / Necesidad de un nuevo enfoque en la atención integral a los pacientes con trastorno mental grave treinta años después de la reforma psiquiátrica.

More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance. We think this is a right time to check the state of the community-based care programmes for severe mental disorders, and the role of mental health center. We propose to have a reflexion about two relevant topics: where we are and where we are heading.

Han pasado más de 30 años desde el inicio de los procesos de reforma psiquiátrica, periodo además de importantes e intensos cambios sociales, científicos y culturales que afectan de manera directa a la enfermedad mental grave y a su manejo. Las mejoras del tratamiento farmacológico, un nuevo modelo de relación médico-paciente, el empoderamiento del paciente como elemento clave y la lucha contra el estigma social de la enfermedad, los cambios en la gestión de los recursos, el incremento de la carga que suponen los pacientes con patología menor en los centros de salud mental, las mejoras en el trabajo en equipo y en la coordinación de los recursos implicados… son algunas de las modificaciones importantes que condicionan el escenario de la atención en salud mental comunitaria. Se nos antoja, por tanto, como un buen momento para revisar el estado de los programas de gestión del trastorno mental grave en el adulto y de los centros de salud mental, y plantear dos cuestiones sencillas a la par que relevantes: dónde estamos y hacia dónde nos dirigimos.

Necesidad de un nuevo enfoque en la atención integral a los pacientes con trastorno mental grave treinta años después de la reforma psiquiátrica / The need of a new integral approach to the care of patient with severe mental disorder thirty years after the psychiatric reform

Han pasado más de 30 años desde el inicio de los procesos de reforma psiquiátrica, periodo además de importantes e intensos cambios sociales, científicos y culturales que afectan de manera directa a la enfermedad mental grave y a su manejo. Las mejoras del tratamiento farmacológico, un nuevo modelo de relación médico-paciente, el empoderamiento del paciente como elemento clave y la lucha contra el estigma social de la enfermedad, los cambios en la gestión de los recursos, el incremento de la carga que suponen los pacientes con patología menor en los centros de salud mental, las mejoras en el trabajo en equipo y en la coordinación de los recursos implicados… son algunas de las modificaciones importantes que condicionan el escenario de la atención en salud mental comunitaria. Se nos antoja, por tanto, como un buen momento para revisar el estado de los programas de gestión del trastorno mental grave en el adulto y de los centros de salud mental, y plantear dos cuestiones sencillas a la par que relevantes: dónde estamos y hacia dónde nos dirigimos (AU)

More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance. We think this is a right time to check the state of the community-based care programmes for severe mental disorders, and the role of mental health center. We propose to have a reflexion about two relevant topics: where we are and where we are heading (AU)