Psychological impact of the COVID-19 pandemic and lockdown in a Spanish sample with anxiety disorder: sex differences.

The early psychological impact of the COVID-19 pandemic and lockdown is greater in people with mental disorders. This study explored the differences in the psychological impact on people with an anxiety disorder by sex in Spain.

Impacto psicológico de la pandemia de COVID-19 y el confinamiento en una muestra española con trastorno de ansiedad: diferencias entre sexos / Psychological impact of the covid-19 pandemic and lockdown in a spanish sample with anxiety disorder: sex differences

Introducción. El impacto psicológico en las etapas iniciales de la pandemia por COVID-19 y el confinamiento fue mayor en personas con trastornos mentales. En este estudio se exploraron las diferencias en el impacto psicológico según el sexo en personas con trastorno de ansiedad en España. Metodología. Estudio transversal, descriptivo y comparativo de los datos aportados por los participantes en una encuesta online anónima realizada entre el 19 y el 26 de marzo de 2020. El cuestionario ad hoc incluyó datos sociodemográficos, clínicos y variables relacionadas con COVID-19,junto con preguntas sobre estrategias de afrontamiento y las versiones en español de la Escala de Escalas de Depresión Ansiedad Estrés (DASS-21) y la Escala de Impacto del Estresor(IES). Se utilizaron análisis descriptivos bivariados y modelos de regresión logística. Resultados. De los 21.207 participantes, se analizaron1617 (7,6%) personas con trastorno de ansiedad autoinformado [1347 (83,3%) mujeres; 270 (16,7%) varones]. El impacto psicológico fue mayor en las mujeres que en los hombres con diferencias estadísticamente significativas en cada subescala del DASS-21 y subescalas del IES. Después de ajustar por posibles variables de confusión, se observó que ser mujer se asoció con puntuaciones más altas en las subescalas de pensamientos intrusivos y evitativos. Conclusiones. Nuestro estudio sugiere que las mujeres con trastorno de ansiedad son un grupo vulnerable a un mayor impacto negativo en la salud mental y, especialmente, en los síntomas relacionados con el trastorno de estrés postraumático. (AU)

Background. The early psychological impact of the COVID-19 pandemic and lockdown is greater in peoplewith mental disorders. This study explored the differences in the psychological impact on people with an anxiety disorder by sex in Spain. Methods. Cross-sectional, descriptive, comparative study of the data provided by participants in an anonymous online survey between March 19 and 26, 2020. Thead hoc questionnaire included sociodemographic, clinical,and variable data related to COVID-19, along with questions about coping strategies, and the Spanish versions ofthe Depression, Anxiety, and Stress Scale (DASS-21) andImpact of Event Scale (IES). Descriptive bivariate analyses and logistic regression models were used. Results. Of the 21,207 participants, 1617 (7.6%) people with self-reported anxiety disorder were analyzed [1347(83.3%) females; 270 (16.7%) males]. The psychological impact was greater on women than men with statistically significant differences in each subscale of the DASS-21and subscales of the IES. After adjusting for potential confounding variables, it was observed that being awoman was associated with higher scores on the intrusiveand avoidant thoughts subscales. Conclusions. Our study suggests that women with ananxiety disorder are a group vulnerable to a greater negative impact on mental health and, especially, symptomsr elated to post-traumatic stress disorder. (AU)

Impact of the coronavirus outbreak on mental health in the different Spanish regions.

COVID-19 is an infectious disease that has affected millions of people worldwide, Spain being one of the countries most affected by the pandemic. It is key to study its impact on the mental health of the Spanish population during the lockdown situation.

Impacto de la pandemia COVID-19sobre la salud mental en las diferentescomunidades autónomas españolas / Impact of the COVID-19 pandemic on mental health in different countries on mental health in the different Spanish Spanish autonomous communities

Introducción: La COVID-19 es una enfermedad infecciosa que está afectando a millones de personas alrededor delmundo, siendo España uno de los países más afectados porla pandemia. Es fundamental evaluar el impacto en la saludmental de la población española durante el periodo de confinamiento. El objetivo es analizar las respuestas desadaptativas en cada comunidad autónoma durante las dos primerassemanas tras la declaración del estado de alarma en España.Metodología. A través de un cuestionario “online”, serecogieron variables clínicas y sociodemográficas de los participantes del 19 al 26 de marzo. Para estudiar las respuestasdesadaptativas, se utilizaron los cuestionarios DASS-21 y EIE.Resultados. 21.152 personas completaron el cuestionario.La edad media fue 39,75 (DE 14,039) y el 69,6 % eran mujeres.La mayoría de los participantes vivía en Asturias (36,2 %) yCantabria (11,9 %). La respuesta desadaptativa más frecuentede la muestra fueron los síntomas depresivos (46,7 %), seguidadel estrés (33,2 %) y la ansiedad (10,7 %). Los resultados dela DASS-21 desvelaron que en Andalucía [n = 1979 (9,3 %)]se observó un mayor porcentaje en los tres dominios: síntomas depresivos (59,7 %), estrés (41,7 %) y ansiedad (16,2 %).Castilla-La Mancha tuvo el porcentaje más alto de respuestaintrusiva (31,2 %) y Andalucía de respuesta evitativa (55,7 %).Conclusiones. Casi la mitad de la muestra presentórespuestas desadaptativas, siendo los síntomas depresivos yla conducta evitativa las más frecuentes. El impacto sobrela salud mental durante y tras eventos traumáticos de granescala debería de abordarse minuciosamente para minimizarlas respuestas desadaptativas en la población general. (AU)

Introduction: COVID-19 is an infectious disease that hasaffected millions of people worldwide, Spain being one ofthe countries most affected by the pandemic. It is key tostudy its impact on the mental health of the Spanish population during the lockdown situation.The aim is to analyse maladaptive responses in eachautonomous community during the first two weeks afterthe state of emergency was declared in Spain.Material and Methods. Through an online questionnaire, clinical and sociodemographic information was collected from participants between 19 and 26 March 2020. TheDASS-21 and the IES questionnaires were used to evaluatethe maladaptive psychological responses.Results. A total of 21,152 people completed the questionnaire. Mean age was 39.75 (SD 14.039), and 69.6% werewomen. Most of the participants lived in Asturias (36.2%)and Cantabria (11.9%). In the sample as a whole, among themaladaptive responses, depressive symptoms represented thehighest percentage (46.7%), followed by stress (33.2%) andanxiety (10.7%) symptoms. The results of the DASS-21 revealed that a higher proportion of the people from Andalusia[n = 1979 (9.3%))]were affected in all three domains: depressive (59.7%), stress (41.7 %), and anxiety (16.2%) symptoms,Castilla La Mancha had the highest percentage of intrusiveresponse (31.2%), while Andalusia had the highest percentage of avoidance behaviour (55.7%). Conclusions. Almost half of the sample showed maladaptive reactions, depressive symptoms and avoidance behaviour being the most common responses. Repercussionson mental health during and after large-scale traumaticevents should be addressed carefully to minimize maladaptive responses in the general population. (AU)

Cognitive impairment and C-reactive protein in clinically stable schizophrenia outpatients: a focus on sex differences.

Although previous findings identified an association between C-reactive protein (CRP) levels, and impaired cognitive functions in patients with schizophrenia (SZ), little is currently known about the relationship between inflammation, cognition, and sex in SZ. The current study aimed to explore the association between peripheral inflammation and cognitive impairment in SZ as a function of sex. The sample included 132 clinically stable patients with SZ, of whom 82 were males (62.1%) and 50 females (37.9%). Sociodemographic data were collected, an accurate assessment was performed using the Positive and Negative Syndrome (PANSS), Clinical Assessment Interview for Negative Symptoms (CAINS), and Calgary Depression (CDS) scales, and the MATRICS Consensus Cognitive Battery (MCCB), and CRP levels were tested. A Pearson correlation and multiple regression analyses, including potential confounding factors, were performed. We found an inverse association between CRP levels and performance on visual learning (r = - 0.386, p = 0.006) domain in female patients only, whereas no correlations were found in males. The regression model for women retained age (ß = - 0.319, p = 0.017), the CAINS-MAP score (ß = - 0.247, p = 0.070), and the CRP (ß = - 0.321, p = 0.013) as predictors of visual learning. Our results suggest the possible existence of sex-specific modulation of the association between systemic inflammation and the cognitive features of the illness.

Glutamine and New Pharmacological Targets to Treat Suicidal Ideation.

Glutamate is the major excitatory neurotransmitter in the central nervous system, and it is linked with the amino acid glutamine through a metabolic relationship of enzymatic compound interconversion and transportation, also known as the glutamate-glutamine cycle.A growing body of evidence suggests involvement of the glutamatergic neurotransmitter system in suicidal behaviours. The initial evidence comes from the pathophysiology of neuropsychiatric disorders, as disruptions in glutamate neurotransmission have been found underlying pathology in multiple suicide-related psychiatric conditions such as major depressive disorder, schizophrenia, post-traumatic stress disorder, and bipolar disorder.Existing data from experimental animal models and human in vivo studies also demonstrate that glutamate plays a key role in suicide-related personality traits including aggression and impulsive aggression.Further studies on glutamate system dysfunction underlying suicidal behaviours have focused on the different steps of the glutamate-glutamine cycle: an inflammation-mediated reduction of glutamine synthetase activity has been found in depressed suicide attempters, phosphate-activated glutaminase genes are reduced in suicide completers, and gene expression abnormalities in NMDA receptors have also been discovered in suicide victims.Evidence of a role of the glutamate-glutamine cycle in suicidal behaviours unveils new targets for anti-suicide interventions. Lithium's mechanism to reduce the risk of suicide in people with mood disorders may be related to its ability to increase glutamine synthetase, whereas novel NMDA antagonists such as ketamine [or its S(+) enantiomer esketamine] have already demonstrated positive results in reducing suicidal ideation.

Reacciones adversas asociadas a la vacuna del meningococo B (4CMenB) en adultos en situaciones especiales / Adverse reactions associated with meningococcal group B vaccine (4CMenB) in adults in special situations

Objetivo: Conocer el perfil de seguridad de la vacuna del meningococo B (4CMenB) en adultos en situaciones especiales. Método: Estudio prospectivo de seguridad de fase IV. Se aplicaron criterios de inclusión y ciertas condiciones de vacunación. Se recogieron las reacciones adversas descritas en la ficha técnica. La evaluación de las reaccio nes adversas se realizó a las 24 horas de la vacunación ("solicitadas") y durante los siete primeros días ("no solicitadas"). Resultados: Se incluyeron 72 pacientes (54,2% hombres; media de edad 52,5 años; 81,9% asplenia anatómica). La frecuencia de fiebre > 38 ºC en las primeras 24 horas fue mayor de la observada en la ficha técnica para el grupo de adultos (12,5% versus no conocida). Más del 75% de los pacientes refirió dolor local en las primeras horas [media de la puntuación de la Escala Visual Analógica 3,22 (IC95%: 2,67-3,76) en la primera dosis y 3,23 (IC95%: 2,69-3,78) en la segunda dosis]. No hubo diferencias estadísticamente significativas. El 97,22% registró síntomas hasta los siete días postvacunación. Conclusiones: 4CMenB muestra un buen perfil de seguridad en adultos en situaciones especiales. La frecuencia de fiebre > 38 ºC es mayor que la esperada. El dolor local es la reacción adversa más frecuentemente registrada, pero la intensidad es baja. Estos resultados invitan a una revisión de la situación de cara a sugerir una posible modificación de la ficha técnica

Objective: To know the safety profile of the 4CMenB vaccine in adults in special situations. Method: Security prospective study of phase IV. Inclusion criteria and some vaccination conditions were applied. The adverse reactions described in the data sheet were collected. The adverse reactions evaluation was performed 24 hours after vaccination ("requested") and during the first seven days ("not requested"). Results: 72 patients were included (54.2% men, mean age 52.5 years, 81.9% anatomic asplenia). The frequency of fever > 38 ºC in the first 24 hours of vaccination was higher than the observed in the summary of product characteristics for the group of adults (12.5% vs. not known). More than 75% of the patients reported local pain in the first hours [average of the Analog Visual Scale score 3.22 (95% CI: 2.67-3.76) in the 1st dose and 3.23 (95% CI: 2.69-3.78) in the 2nd dose]. There were no statistically significant differences. 97.22% registered symptoms until 7 days after vaccination. Conclusions: 4CMenB shows a good safety profile in adults in special situations. The frequency of fever > 38 ºC is higher than expected. Local pain is the most frequently recorded adverse reactions, but the intensity is low. These results suggest a review of the situation in order to suggest a possible modification of the summary of product characteristics of the vaccine

Adverse reactions associated with meningococcal group B vaccine (4CMenB) in adults in special situations.

OBJECTIVE: To know the safety profile of the 4CMenB vaccine in adults in special situations. METHOD: Security prospective study of phase IV. Inclusion criteria and some  vaccination conditions were applied. The adverse reactions described in the data  sheet were collected. The adverse reactions evaluation was performed 24 hours  after vaccination ("requested") and during the first seven days ("not  requested"). RESULTS: 72 patients were included (54.2% men, mean age 52.5 years, 81.9%  anatomic asplenia). The frequency of fever > 38 ºC in the first 24 hours of  vaccination was higher than the observed in the summary of product characteristics for the group of adults (12.5% vs. not known). More than 75% of the patients reported local pain in the first hours [average of the Analog Visual Scale score 3.22 (95% CI: 2.67-3.76) in the first dose and 3.23 (95% CI: 2.69-3.78) in the second dose]. There were no statistically significant differences. 97.22% registered symptoms until 7 days  after vaccination. CONCLUSIONS: 4CMenB® shows a good safety profile in adults in special situations. The frequency of fever > 38 ºC is higher than expected. Local  pain is the most frequently recorded adverse reactions, but the intensity is low.  These results suggest a review of the situation in order to suggest a possible  modification of the summary of product characteristics of the vaccine.

Objetivo: Conocer el perfil de seguridad de la vacuna del meningococo B  (4CMenB) en adultos en situaciones especiales.Método: Estudio prospectivo de seguridad de fase IV. Se aplicaron criterios de  inclusión y ciertas condiciones de vacunación. Se recogieron las reacciones adversas descritas en la ficha técnica. La evaluación de las reacciones adversas se realizó a las 24 horas de la vacunación ("solicitadas") y  durante los siete primeros días ("no solicitadas").Resultados: Se incluyeron 72 pacientes (54,2% hombres; media de edad 52,5  años; 81,9% asplenia anatómica). La frecuencia de fiebre > 38 ºC en las  primeras 24 horas fue mayor de la observada en la ficha técnica para el grupo  de adultos (12,5% versus no conocida). Más del 75% de los pacientes refirió  dolor local en las primeras horas [media de la puntuación de la Escala Visual  Analógica 3,22 (IC95%: 2,67-3,76) en la primera dosis y 3,23 (IC95%: 2,69- 3,78) en la segunda dosis]. No hubo diferencias estadísticamente significativas.  El 97,22% registró síntomas hasta los siete días postvacunación.Conclusiones: 4CMenB® muestra un buen perfil de seguridad en adultos en  situaciones especiales. La frecuencia de fiebre > 38 ºC es mayor que la  esperada. El dolor local es la reacción adversa más frecuentemente registrada,  pero la intensidad es baja. Estos resultados invitan a una revisión de la situación  de cara a sugerir una posible modificación de la ficha técnica.