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)

Platelet and white blood-cell-based ratios: Differential inflammatory markers of severe mental disorders?

INTRODUCTION: Neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), and platelet/lymphocyte (PLR) ratios, and systemic inflammatory index (SII) represent peripheral markers of inflammation associated with different severe mental disorders. MATERIAL AND METHODS: In this study, these parameters were analyzed in a sample of 622 participants [197 patients with major depressive disorder (MDD), 154 with bipolar disorder (BD), 176 with schizophrenia (SCH), and 95 healthy controls (HC)]. Sociodemographic and clinical data of patients were recorded. RESULTS: Differences in age and sex were detected among groups (p<0.001), with SCH patients being younger and MDD patients being older. After stratifying by sex, these ratios were compared using the nonparametric ANCOVA (Quade's test) using age as a covariate. In males, no significant statistical differences were found between groups. However, differences were observed in MLR in the subgroup of females [MDD: 0.23 (SD=0.09); BD: 0.23 (SD=0.11); SCH: 0.24 (SD=0.11); HC: 0.29 (SD=0.13); F=5.376, p=0.001]. Post hoc testing revealed that there are MLR differences between HC versus MDD and between HC versus BD, with higher values in HC versus the other two groups. On the other hand, no differences were found in either males or females for any of the studied ratios, among the three diagnostic groups. CONCLUSIONS: MLR is reduced in MDD and BD patients versus HC, but exclusively in the female group. However, based on the analyzed indices, it is not possible to differentiate among the three diagnostic groups of patients. As a limitation of this study, note that the effects of psychopharmacological treatments and smoking have not been controlled for.

Endocrine biomarkers related to sleep-wake cycle and sleep disturbances in patients with bipolar disorder: A systematic review

Background and objectives: Sleep and circadian disturbances have been widely studied in patients with bipolar disorder. However, there is no clear evidence about the role of peripheral biomarkers of the circadian cycle in this population. This systematic review aims to identify potential endocrine blood biomarkers of circadian rhythms and study their relationship with sleep problems in these patients.MethodsAn electronic search was performed of PubMed and PsycINFO databases. It included articles about the topic from 1991 through 2021. The search strategy was: ("peripheral biomarkers" OR "biological markers" OR biomarker OR cortisol OR melatonin OR orexin OR hypocretin) AND (blood OR serum OR plasma) AND (“sleep-wake” OR "circadian rhythm" OR sleep OR insomnia) AND "bipolar."ResultsAfter excluding duplicates, 92 records were obtained. Only 5 studies met the inclusion criteria (n=499; bipolar disorder=125; unipolar depression=148; schizophrenia=80; controls=146). The endocrine parameters analyzed were: cortisol (3 studies), melatonin (1 study), and orexin-A (1 study). Overall, no significant associations were detected between these biomarkers and sleep disturbances, assessed with subjective (psychometric evaluation) and/or objective (polysomnography) measures.ConclusionThis review highlights the lack of studies exploring the role of endocrine biomarkers related to circadian function in the pathophysiology of sleep disturbances in bipolar 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)

COVID-19 lockdown in people with severe mental disorders in Spain: Do they have a specific psychological reaction compared with other mental disorders and healthy controls?

The COVID-19 pandemic and the lockdown restrictions could have adverse consequences for patients with severe mental disorders (SMD). Here, we aim to compare the early psychological impact (depression, anxiety, and stress responses, intrusive and avoidant thoughts, and coping strategies) on people with SMD (n = 125) compared with two control groups: common mental disorders (CMD, n = 250) and healthy controls (HC, n = 250). An anonymous online questionnaire using a snowball sampling method was conducted from March 19-26, 2020 and included sociodemographic and clinical data along with the DASS-21 and IES scales. We performed descriptive and bivariate analyses and multinomial and linear regression models. People with SMD had higher anxiety, stress, and depression responses than HC, but lower scores than CMD in all domains. Most people with SMD (87.2%) were able to enjoy free time, although control groups had higher percentages. After controlling for confounding factors, anxiety was the only significant psychological domain with lower scores in HC than people with SMD (OR = 0.721; 95% CI: 0.579-0.898). In the SMD group, higher anxiety was associated with being single (beta = 0.144), having COVID-19 symptoms (beta = 0.146), and a higher score on the stress subscale of DASS-21 (beta = 0.538); whereas being able to enjoy free time was a protective factor (beta = -0.244). Our results showed that patients with SMD reacted to the pandemic and the lockdown restrictions with higher anxiety levels than the general public, and suggesting this domain could be a criterion for early intervention strategies and closer follow-up.