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?

doi:10.1016/j.schres.2020.07.018

Schizophrenia Research

Volume 223, September 2020, Pages 192-198

https://doi.org/10.1016/j.schres.2020.07.018 Get rights and content

Abstract

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.

Keywords

COVID-19

Pandemics

Bipolar disorder

Psychosis

Psychological distress

Anxiety

Cited by (0)

Leticia González-Blanco, Specialist in Psychiatry (2016) and PhD in Medicine (2018) from the University of Oviedo. Extraordinary PhD Award. Assistant Professor in Health Sciences (Psychiatry) at the University of Oviedo and Psychiatrist at Mental Health Center of Corredoria (Oviedo). Researcher of the Centro de Investigación Biomédica en Red de Salud Mental -CIBERSAM, supported by the Spanish Ministry of Economy and Competitiveness, and of the Psychiatric Research Group of the Instituto de Investigación Sanitaria del Principado de Asturias (ISPA). Collaboration in National, European, WHO Research Projects, and linked as Co-Investigator to 2 FIS Projects. Interested in clinical research, focusing on schizophrenia and psychotic spectrum disorders.

Francesco Dal Santo, Bachelor of Medicine and Surgery (University of Padova, Italy) and Master's Degree in Mental Health Research (Complutense University of Madrid, Spain). Resident in Psychiatry (4th year) at the Hospital Universitario Central de Asturias (Oviedo, Spain) and Ph.D. student at the Department of Psychiatry of the University of Oviedo. Visiting researcher at University of Cambridge (2019). Interested in clinical research, focusing on cognition in people with schizophrenia and psychotic spectrum disorders.

Leticia García-Álvarez, Bachelor of Psychology (University of Oviedo) 2006, Master in Behavior Therapy (National University of Distance Education, UNED) 2010 and Master in Teacher Training (University of Nebrija) 2018. PhD in the department of Psychology (University of Oviedo) 2012 and in Health Sciences (University of Oviedo) 2016. Extraordinary Doctorate Award from the University of Oviedo and award for the best Doctoral Thesis in Other Medical Specialties by the Royal Academy of Medicine of the Principality of Asturias.

Lorena de la Fuente-Tomás is a postdoctoral researcher at the University of Oviedo. She obtained her degree in Psychology (2012) at the same university, and her Master in Research and Mental Health (2016) at the Complutense University of Madrid. She was awarded by “Severo Ochoa Grant” (2016–2019) to get her PhD under supervision of Prof. García-Portilla and Dr. García-Alvarez. She performed a three-month predoctoral stay at the Brain and Mind Sciences Department at Cambridge University (2018). She was awarded by the “Extraordinary PhD Award” by the Institute of Health Research of the Principality of Asturias (2020). She is co-author of more than 20 publications indexed in Pubmed in the last 4 years.

Carlota Moya Lacasa, Specialist in Psychiatry (2020) at Hospital Universitario Central de Asturias (Oviedo, Asturias), and PhD student in Health Sciences at the University of Oviedo. Research internship at the University of Nevada in the Department of Psychiatry and Behavioral Sciences (Reno, march-may 2019). Interested in clinical research, focused on bipolar disorder.

Gonzalo Paniagua, Bachelor of Medicine and Surgery (University of Cantabria 1996–2002), Specialist in Psychiatry (Hospital Universitario de Salamanca 2003–2007). University Expert in Bipolar Disorder (University Of Barcelona 2014). University Expert in Forensic Psychiatry (UNED 2009). Extensive clinical experience of more than 15 years in inpatients and outpatients of Mental Health, in Psychiatric Service of Hospital Central de Asturias, Oviedo, Spain.

Pilar A Sáiz, Clinical Biochemistry and Psychiatrist, is Professor of Psychiatry at the University of Oviedo, Spain, and also member of the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), of the Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), and of the Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA). She has been involved in research of bio-psycho-social aspects of suicidal behavior and major mental disorders for over 25 years and she is co-author of several publications ranging from biological aspects to psycho-social correlates of those disorders.

María Paz García-Portilla is currently Professor of Psychiatry at the University of Oviedo (Spain) and responsible for the Mental Health Center of La Eria (Oviedo) with a catchment area of more than 80,000 people. I am co-principal investigator of the Group 05 (University of Oviedo) of the Centro de Investigación Biomédica en Red de Salud Mental -CIBERSAM, supported by the Spanish Ministry of Economy and Competitiveness, and of the Psychiatric Research Group of the Instituto de Investigación Sanitaria del Principado de Asturias (ISPA). My areas of interest are severe mental disorders, mainly schizophrenia and bipolar disorders, and I am co-author of more than 125 papers in peer-reviewed journals.

Julio Bobes, Professor of Psychiatry at the University of Oviedo, currently headsthe Psychiatry Area of the Department of Medicine of the University and is Head of the Psychiatry Department of the Sanitary Area of Oviedo. He is the principal investigator of the Center for Biomedical Research in Mental Health Network (CIBERSAM) of Oviedo. He has published more than 100 articles and is the author and coordinator of several books, as well as a contributor to numerous chapters. His research interests include different aspects of the evaluation, management, treatment and impact of different psychiatric disorders.

¹: Joint first authors.

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