How did Different Generations Cope with the COVID-19 Pandemic? Early Stages of the Pandemic in Spain / ¿Cómo se Enfrentaron las Diferentes Generaciones a la Pandemia por COVID-19? Primeras Etapas de la Pandemia en España

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

ANTECEDENTES: la Organización Mundial de la Salud ha destacado la importancia de estudiar sus consecuencias sobre la salud mental de la COVID-19. Esta investigación estudia el papel de la edad sobre las respuestas psicológicas tempranas a la pandemia. MÉTODO: se realizó una encuesta online en la población adulta de España durante la cuarentena. Las variables sociodemofráficas, de salud y conductuales fueron estudiadas en 5 grupos de edad. El estado mental se estudió a través del DASS-21 (Depression, Anxiety and Stress Scale) y el impacto psicológico a través del IES-R (Impact of Event Scale-Revised). RESULTADOS: 3.524 participantes fueron incluidos (Medad = 39.24, DTedad = 12.00). Los participantes entre 18 y 33 se mostraban más hiperactivados, evitativos, ansiosos, deprimidos y estresados. Aquellos entre 26 y 33 años presentaban más intrusión. Los participantes entre 18 y 25 años dormían peor, presentaban más claustrofobia y somatizaciones, mayores dificultades para mantener rutinas, mientras que los mayores presentaban mejores respuestas en general. CONCLUSIONES: este estudio indica que la población española más joven se ha visto más afectada por las consecuencias psicológicas de la pandemia. Algunas de las diferencias en conductas y preocupaciones que dependieron de la edad deberían tenerse en cuenta para elaborar estrategias de intervención

Revisiting the concept of severe mental illness: severity indicators and healthcare spending in psychotic, depressive and dissociative disorders.

Background: The concept of severe mental illness (SMI) has been related to bipolar or psychotic diagnosis, or to some cases of depressive disorders. Other mental health problems such as personality disorders or posttraumatic dissociative conditions, which can sometimes lead to relevant functional impairments, remain separate from the SMI construct.Aims: This study aimed to evaluate the clinical severity as well as healthcare spending on dissociative disorders (DDs). This diagnostic group was compared with two other groups usually considered as causing severe impairment and high healthcare spending: bipolar and psychotic disorders, and unipolar depression.Methods: From a random sample of 200 psychiatric outpatients, 108 with unipolar depression (N = 45), psychotic/bipolar (N = 31) or DDs (N = 32) were selected for this study. The three groups were compared by the severity of their disorder and healthcare indicators.Results: Of the three groups, those with a DD were more prone to and showed higher indices of suicide, self-injury, emergency consultations, as well as psychotropic drug use. This group ranked just below psychotic/bipolar patients in the amount of psychiatric hospitalisations.Conclusions: Despite a certain intra-professional stigma regarding DDs, these data supported the severity of these posttraumatic conditions, and their inclusion in the construct of SMI.

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.

El papel de la desregulación emocional en el Trastorno Conversivo / The role of emotion dysregulation in Conversion Disorder

Introducción. El papel que juega la regulación de las emociones en la etiopatogénesis del Trastorno Conversivo (TC) es todavía poco conocido. Esta investigación pretende profundizar en este tema, buscando describir las diferencias principales que existen entre un grupo de pacientes con TC y un grupo control en lo que concierne a la forma de regular sus emociones así como a otras variables clínicas fundamentales. Métodos. Se ha realizado un estudio de tipo casos (n=43) y controles (n=42). Ambos grupos se sometieron a dos entrevistas psiquiátricas y completaron 6 cuestionarios autoadministrados evaluando la depresión, ansiedad, alexitimia, desregulación emocional, intensidad efectiva, así como la disociación psicomorfa y somatomorfa. Resultados. Los pacientes con TC puntuaron significativamente más alto en las seis variables estudiadas a través de los cuestionarios (p<0.001). La reactividad y la intensidad emocional negativas fueron mayores en el grupo de pacientes (p<0.01) mientras que ambos grupos puntuaron de manera similar en afectividad positiva y serenidad. La ansiedad, la alexitimia y la desregulación emocional fueron los factores de riesgo más importantes identificados (OR=5.85/3.50/3.23 respectivamente). La ansiedad y las dificultades en la regulación de las emociones fueron las variables que mejor explicaron la pertenencia al grupo de pacientes en los modelos de regresión logística calculados. Entre los 5 factores que midieron diferentes dificultades en la regulación emocional los más relevantes fueron la falta de control emocional y la interferencia en conductas orientadas a una meta. La sintomatología conversiva positiva y la sintomatología conversiva negativa se correlacionaron con distintos patrones de regulación emocional. Conclusiones. Los pacientes con TC sufrieron múltiples dificultades a la hora de regular sus emociones, comparados con el grupo control. La desregulación emocional puede ser considerada un factor de riesgo para padecer un TC. Se discute la posibilidad de que existan diferentes patrones de regulación emocional en pacientes con distintos tipos de sintomatología conversiva

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