Psychological impact of COVID-19 lockdown on a population with serious mental illness. A prospective cohort study

Number and nature of psychiatric emergency department visits in a tertiary hospital before, during, and after coronavirus pandemic

Introduction

The COVID-19 pandemic has significantly impacted mental health globally, leading to a deterioration in the overall mental health of the population and changes across all healthcare levels, including emergency departments (ED). However, the evolution of the quantity and nature of psychiatric ED visits in the post-pandemic period remains uncertain.

Aims

To examine changes in the number and nature of psychiatric emergencies at a general hospital before, during, and after the COVID-19 pandemic.

Materials and methods

Psychiatric ED visits from a tertiary hospital in the Basque Country (Spain) between January 2019 and November 2023 were investigated. Electronical health registers detailing the number and nature of psychiatric care consultations were analyzed for the study timeframe. Three periods were then compared: pre-pandemic (from January 2019 to February 2020), pandemic (from March 2020 to January 2022), and post-pandemic (from February 2022 onwards).

Results

16,969 psychiatric ED visits were recorded for the study period. The number of psychiatric ED visits remained stable from pre-pandemic (269.93 visits/month) to pandemic (264.48 visits/month) periods but experienced a significant rise during the post-pandemic period (330.00 visits/month; t=-6.42; p<0.001), which was not reflected in medical and traumatological visits. The proportion of visits for anxiety (Z=-2.97; p=0.003), suicidal ideation (Z=-5.48; p<0.001), and administrative and social consultations (Z=-5.69; p<0.001) increased over the course of the pandemic. In contrast, visits for schizophrenia and other psychotic disorders (Z=4.85; p<0.001), as well as unspecified behavioral alterations (Z=2.51; p=0.012), significantly decreased.

Conclusion

The COVID-19 pandemic and its aftermath have altered the patterns of urgent psychiatric care, characterized by a sharp increase of average monthly number of consultations and a shift in their nature. Future efforts should focus on characterizing this surge in demand and enhancing both emergency services and outpatient settings.

Understanding the relationship between time spent outdoors, mental well-being and health-related behaviours in a Spanish sample: A real time smartphone-based study

INTRODUCTION

COVID-19 pandemic has affected our lifestyle and physical and mental well-being. We aimed to study the effect of being outdoors and mental well-being after the COVID-19 pandemic.

MATERIAL AND METHODS

We used smartphone based ecological momentary assessments (EMA) (Urban Mind app) to study the mental well-being of the Spanish general population. We collected socio-demographic data, past and current physical and mental health, and social and physical environment. Participants were recruited during 5 months (February to June 2021). Longitudinal associations between EMA and anxiety, depression, loneliness, tiredness, and happiness during the assessments were investigated using random intercept ordinal logistic regression models.

RESULTS

274 subjects downloaded the app and completed the baseline assessment. 66 participants completed at least 50 % of the assessments. Being outdoors was related to a lower likelihood of anxiety (OR: 0.48, 95 %CI 0.34-0.66), depression (OR: 0.40, 95 %CI 0.28-0.56), tiredness (OR: 0.47, 95 %CI 0.35-0.63), and loneliness (OR: 0.59, 95 %CI 0.42-0.84), and a higher likelihood of happiness (OR: 2.14, 95 %CI 1.57-2.93).

CONCLUSIONS

Being outdoors is related to better mental health in the general population independently of other factors (baseline mental well-being or socio-demographic characteristics). Public policies should include measurements to promote outdoor spaces in urban settings.

Prevalence of Depression, Anxiety, and Stress among High School Students during the COVID-19 Pandemic: A Survey Study in Western Mexico

Social isolation and school closure may predispose adolescents to higher prevalence rates of depression, anxiety, and stress. In this cross-sectional observational study, the validated Spanish version of the Depression, Anxiety, and Stress Scale was administered to 3112 students aged 14-22 years old. We also collected data on participant gender, age group, school shift (morning or afternoon), school year, family type, whether they or any first-degree relative had been infected with COVID-19, whether any family member had died of COVID-19, and whether either of their parents worked. Mean scores were 8.34 ± 6.33 for depression, 7.75 ± 5.89 for anxiety, and 10.26 ± 5.84 for stress. Female students presented significantly higher scores on all three measures compared with male students. Students who had been infected with COVID-19, who had an infected family member, or who had a family member who died of COVID-19 also presented higher scores on all three measures. Identifying the symptoms and warning signs of depression and anxiety disorders is critical, particularly in vulnerable populations like adolescents.