Estrategias de afrontamiento durante el confinamiento por COVID-19 en pacientes con primer episodio psicótico: el impacto en su vida diaria / Coping strategies during covid-19 lockdown in patients with first-episode psychosis: the impact on their daily life

Introducción: El confinamiento por la enfermedad del coronavirus 2019 (COVID-19) interrumpió la vida de todo el mundo en marzo de 2020. El confinamiento obligatorio duró dos meses, lo que tuvo un impacto en la salud mental de las personas. Sin embargo, se desconoce en gran medida cómo afectó a quienes ya luchaban con problemas de salud mental. Métodos: Se recopiló información de 18 pacientes con primer episodio psicótico (PEP) mediante una encuesta en línea. La encuesta tenía preguntas sobre COVID-19, el impacto del confinamiento en la vida diaria y las estrategias de afrontamiento utilizadas durante el confinamiento entre marzo y abril de 2020 en España. Resultados: Algunas estrategias de afrontamiento se asociaron con diferentes actividades de la vida diaria: normalizar la situación, buscar ayuda de amigos o familiares y buscar ayuda de profesionales en situaciones estresantes, leer fuentes de información y autoayuda para enfrentar el estrés, enfocarse en las emociones que generan estrés, intentar centrarse en problemas concretos y buscar soluciones, y aceptar la situación con resignación. Conclusiones: Como conclusión, los resultados sugieren que no todas las estrategias de afrontamiento impactaron de la misma manera en la vida diaria de los/las pacientes con PEP durante el confinamiento por COVID-19.(AU)

Introduction: Lockdown for 2019 coronavirus disease (COVID-19) disrupted life worldwide from March 2020. Mandatory lockdown lasted two months, which had an impact on people’s mental health. However, how it affected those who already struggled with mental health problems is largely unknown. Methods: We collected information from 18 patients with first-episode psychosis (FEP) through an online survey. The survey contained questions regarding COVID-19, impact of confinement on daily life, and coping strategies during lockdown between March and April 2020 in Spain. Results: Some coping strategies were associated with different daily life activities: normalizing the situation, seeking help from friends or family, and seeking help from professionals in stressful situations, reading information sources and self-help to cope with stress, focusing on the emotions that generate stress, trying to focus on specific problems and seek solutions, and accepting the situation with resignation. Discussion: As a conclusion, results suggest that not all coping strategies impacted in the same way in daily life of patients with FEP during COVID-19 lockdown.(AU)

Sex differences in symptomatology in people with schizophrenia and other psychotic disorders: protocol for a systematic review and pairwise meta-analysis of observational studies.

SUMMARY: Sex differences in symptomatology in people with psychosis have been studied extensively in recent decades. Although studies have pointed to such differences, to date there is no review that has performed a systematic search and quantitative synthesis. In this paper, we describe the protocol for a pairwise meta-analysis comparing a range of symptom outcome measures between men and women diagnosed with a psychotic spectrum disorder at different stages of the disorder (PROSPERO registration number CRD42021264942). In August 2021 we conducted systematic searches of PsychInfo, PubMed, Web of Science, Scopus and Dialnet to identify observational studies that report data on symptoms for males and females separately. Two independent reviewers will conduct literature searches, select studies, extract data, assess the risk of bias and assess outcome quality. To assess the effect size of all outcome measures, we will conduct pairwise meta-analysis using random-effects models. The quality of studies will be evaluated using a National Heart, Lung and Blood Institute's quality assessment tool and the confidence in the results will be evaluated using the GRADE tool. Meta-regression and sensitivity analyses will be conducted to assess the robustness of the findings. No ethical problems are foreseen. Results from this study will be published in peer-reviewed journals and presented at relevant conferences.

Emotional abuse and perceived stress: The most relevant factors in suicide behavior in first-episode psychosis patients.

People with a mental disorder have a higher risk of suicidal behavior. Little research has examined the role of childhood trauma in suicide behavior, and even fewer studies have assessed the specific relevance of subtypes of childhood trauma and suicidal behavior in first-episode psychosis (FEP). The aims of the present study were: 1) to compare suicide behavior between FEP and HC; 2) to study the relationship between the five types of ChT and suicide risk in FEP controlling for confounding sociodemographic, clinical, and psychosocial variables. 95 patients diagnosed with FEP and 92 healthy control (HC) were recruited as a part of the PROFEP study. ChT was evaluated using The Childhood Trauma Questionnaire-Short Form (CTQ) and suicide behavior through The Suicide Risk Scale of Plutchik (SRSP). Our results showed that patients with FEP presented more suicide behavior (ideation, attempt, and suicide risk) than HC. Emotional abuse was the most relevant type of ChT in suicide ideation and suicide risk. After controlling for other relevant variables, perceived stress seemed to play an important role in suicide ideations, suicide attempt, and suicide risk. The results highlight the importance of assessing and considering in the clinical practice ChT and the perceived stress.

Suicidal behaviour in first-episode psychosis: The relevance of age, perceived stress and depressive symptoms.

The onset of first episode psychosis (FEP) is a period of increased risk of suicide, which is 60% higher than in other stages of the disease. This work explored suicidal behaviour and its most relevant factors in a population with FEP and a healthy control (HC) sample. We used the Suicide Risk Scale of Plutchik (SRSP) to assess suicide behaviour, and Calgary Depression Scale for Schizophrenia (CDSS), Young Mania Rating Scale (YMRS), Personal and Social Performance Scale (PSP), Perceived Stress Scale (PSS) and Positive and Negative Syndrome Scale (PANSS) were administered to assess the severity of depression, mania, psychosocial functioning, perceived stress and psychopathology, respectively. Patients with FEP showed a higher prevalence in all measures of suicide behaviour than HC. Younger age and depressive symptoms were the most important predictors of suicide ideation and suicide attempt. More perceived stress and higher hopelessness were the most relevant predictors of suicide risk. Symptoms did not appear to be important factors in suicide behaviour. Younger age, perceived stress and depressive symptoms seem to be the most important factors in suicide behaviours in FEP.

Types, prevalence and gender differences of childhood trauma in first-episode psychosis. What is the evidence that childhood trauma is related to symptoms and functional outcomes in first episode psychosis? A systematic review.

This paper reviews and discusses the literature on childhood trauma (CT) in people with first-episode psychosis (FEP). The aim is to update the knowledge on the prevalence and the types of CT suffered by FEP people, to compare them with other samples, to study the impact of gender, and to examine the relationship between CT and symptoms and functional outcomes. We conducted a literature search (1995-2019), to identify reported data on any topic related to CT in FEP samples. The following terms were used in the search: CT or sexual abuse or physical abuse or neglect, and first-episode psychosis. We found 493 studies, of which 68 were included in the review. FEP presented a higher prevalence of CT than controls. Women suffer more sexual abuse. The effect of CT on the severity, the prognosis and the evolution of FEP is unclear. FEP have a high prevalence of CT. Its relationship with symptoms and functional outcomes indicates its importance within treatment. This suggests the importance of creating and implementing specific interventions and personalized therapies addressed to work through their past traumatic experiences to improve their quality of live and their prognosis.

Cognitive functioning in first episode psychosis. Gender differences and relation with clinical variables.

AIMS: to study the differences in cognitive functioning in patients and controls. In addition, study the influence of symptoms, cannabis consumption, chlorpromazine doses, DUP and IQ in cognitive performance in patients, both in the total sample and divided by gender. METHODS: 70 first episode psychosis patients and 63 healthy controls (HC) participated in the study and were assessed with the MATRICS battery and the Vocabulary subtest of WAIS-IV. Symptoms in FEP patients were evaluated with the Emsley factors of the PANSS scale. RESULTS: patients showed lower scores than controls in all cognitive domains studied. There were no significant differences between FEP men and FEP women, but we found gender differences in favour of women in processing speed, working memory and composite total scored domains in the HC group. Finally, symptoms and Chlorpromazine doses showed an influence on cognitive performance in the total FEP sample. When splitting the sample by gender, positive symptoms may be more detrimental to women's cognitive functioning, while disorganized symptoms may play the most important role in cognitive performance in men. CONCLUSIONS: patients showed worse cognitive performance in all cognitive domains compared to healthy controls. In our FEP sample, gender does not seem to influence cognitive performance measured with the MATRICS. Severity of symptoms influences positively in cognitive performance. The dose of Chlorpromazine and symptoms are influential variables to be taken into account in cognition rehabilitation programs.