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Access to a psychiatric emergency setting during the COVID-19 pandemic: focus on youth populations
- F. Masini, G. Caramanico, G. Menculini, G. Latini, F. De Giorgi, K. Amantini, P. Moretti, A. Tortorella
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S216-S217
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Introduction
The COVID-19 outbreak and the related containment measures led to the emergence of psychological distress in youth populations, possibly due to concern for their families, social isolation, increased time spent on the Internet and social media, and anxiety about the future.
ObjectivesThe study aims to evaluate differences in the access of children, adolescents, and young adults to a psychiatric emergency setting before and after the onset of the COVID-19 pandemic.
MethodsData concerning the psychiatric consultations carried out at the Emergency Department of the University Hospital of Perugia was collected. Socio-demographic and clinical information, including diagnostic and treatment features, was entered into an electronic database. We considered two different time spans, one before (01.06.2017-31.12.2018) and one after (01.06.2020-31.12.2021) the COVID-19 pandemic outbreak. The characteristics of consultations carried out before and after the pandemic outbreak were compared by means of bivariate analyses (p<0.05).
Results2,457 psychiatric consultations were carried out in the index periods. 1,319 (53.7%) were requested before, while 1,138 (46.3%) after the COVID-19 outbreak. As for the latter, these were more frequently requested for female subjects (64.2% vs 54.5%, p=0.0042), while institutionalized people underwent psychiatric consultations less frequently in the post-COVID-19 period (5.6% vs 18.2% p<0.001). A significant difference in the prevalence of anxiety disorders (9.7% post-COVID-19 vs 18.8% pre-COVID-19, p=0.009) and adjustment disorders was found (7.1% vs 1.5%, p=0.009). Substance-related disorders were significantly reduced (8.0% vs 15.8%, p=0.016) after the COVID-19 outbreak. About psychopharmacological treatment, there was an increase in people who had received treatment in the past but were no longer on treatment (52.3% vs 30.8%, p<0.001). The prescription of antipsychotics also increased (29.3% vs 18.5%, p=0.012). At discharge, subjects were more frequently hospitalized in the Psychiatric Inpatient Unit in the post-COVID-19 period (22.2% vs 12.8%, p=0.012).
ConclusionsOur data confirms the vulnerability of youth populations during the pandemic. The consequences of health emergencies on the psychological well-being of this population must not be underestimated and tailored treatment strategies should be implemented.
Disclosure of InterestNone Declared
Suicidality among adolescents and young adults in a Psychiatry Inpatient Unit: a two-year retrospective study in Umbria, central Italy
- E. Valentini, A. Minuti, G. Menculini, F. De Giorgi, T. Sciarma, K. Amantini, P. Moretti, A. Tortorella
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S332
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Introduction
Suicide is the fourth leading cause of death among adolescents and young adults (AYA) (Czyz EK, King CA. J Clin Child Adolesc Psychol.2015;44(1):181-19), and psychiatric disorders are a major contributing factor (WHO Global Health Estimates 2000-2019). Studies focusing on suicidality in Italian inpatients samples are scant.
ObjectivesThe present cross-sectional study aimed to define clinical variables associated with suicidality related phenomena in a sample of young inpatients. The main objectives were to assess the prevalence of suicidal ideation and deliberate self-harm in inpatients aged 16–24 years and to determine the relationship between suicidal behaviours and psychiatric disorders.
MethodsThis retrospective study was conducted in a naturalistic setting, at the Psychiatric Inpatient Unit, Perugia Hospital/Local Mental Health Unit 1, from January 2018 to December 2019. Sociodemographic information, clinical history, diagnostic and treatment features were collected. Descriptive and bivariate analyses were performed (p<0,05).
ResultsAmong 120 patients (14,2% of the overall 850 hospitalizations in the index period) admitted for suicidality-related phenomena, 21 (17,5%) were AYA. Admission was due to deliberate self-harm in 85,7% (n=18) and to suicidal ideation in 14,3% (n=3) cases. Personality disorders (p=0.006), were significantly more prevalent among AYA, while mood disorders were more frequent among adults (p=0.0018) (Tab.1).
Tab.1. Differences in diagnostic features between AYA and adult population. AYA n (%) Adults n (%) χ2 P PERSONALITY DISORDERS 10 (47.6) 17 (17,2) 7.547 0.006 Borderline personality disorder 7 (33.3) 9 (9.1) 6.838 0.009 MOOD DISORDERS 0 (0) 26 (26,3) 5.578 0.018 ConclusionsPersonality is under construction among youths, and affective symptoms may have unusual characteristics (Lack CW, Green AL. J Pediatr Nurs. 2009;24(1):13-25), as demonstrated by the fact that irritable rather than depressed mood is a core diagnostic mood symptom for adolescents (Rice F, et al. J Affect Disord. 2019;243:175-181). We hypothesized that symptoms of irritability, emotional dysregulation, and impulsivity could be linked to suicidality (Ghanem M, et al. Arch Suicide Res. 2013;17(3):262-274). Further investigations are needed for the characterization of AYA inpatients who experience suicidal thoughts or self-injurious behaviours, in order to redefine preventive tools and reduce suicide mortality rates.
Disclosure of InterestNone Declared
Circadian rhythm disturbances in mood disorders: characterisation and clinical impact
- G. Cappannini, S. Bianchi, G. Menculini, B. Semeraro, F. De Giorgi, K. Amantini, P. Moretti, A. A. V. Tortorella
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S197
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Introduction
Circadian rhythms, defined as endogenous oscillations that regulate metabolism, physiology and behaviour, may be frequently disrupted in mood disorders, influencing their clinical presentation and course (Srinivasan V. et al. World J Biol Psychiatry. 2006;7(3):138-151).
ObjectivesTo characterise circadian rhythm disruptions in a population of patients with mood disorders, analysing clinical and course differences in subjects with and without clinically significant circadian rhythm alterations
MethodsPatients selected for this cross-sectional study were assessed with CGI-BP, HAM-D, MRS, and PANSS. Circadian rhythm disturbances were evaluated with BRIAN. Patients with clinically relevant circadian rhythm disturbances were defined as BRIAN > 36 (Mondin TC et al. J Psychiatr Res. 2017;84:98-104). Bivariate analyses were subsequently performed to compare subgroups of patients.
ResultsIn our study, 61 subjects with DD or DB were enrolled. The overall mean BRIAN test score was 40.08 ± 10.26. When comparing the BRIAN test scores, both total and subscales, between subjects with DB and DD, social rhythms were significantly more altered in subjects with DB (8.63 ± 2.90 VS 6.80 ± 2.11, p=0.034). Subjects with disruption of circadian rhythms displayed greater severity of depressive symptoms (mean total HAM-D test score 16.06±8.61 VS 8.94±5.85; p<0.003, mean CGI-BP severity of depression test score 3.14±1.68 VS 1.88±1.11; p<0.010) and with a longer duration of untreated illness (6.14±8.64 VS 2.53±6.28; p= 0.040).
ConclusionsAlterations in circadian rhythms should be routinely investigated in all individuals with mood disorders, especially BD, and may represent a transdiagnostic psychopathological construct that defines a more severe disease phenotype.
Disclosure of InterestNone Declared
COVID-19 pandemic and eating disorders: What impact on specific and general psychopathology?
- E. Barone, F. Marciello, G. Cascino, G. Abbate-Daga, S. Anselmetti, M. Baiano, M. Balestrieri, S. Bertelli, B. Carpiniello, G. Castellini, G. Corrivetti, S. De Giorgi, A. Favaro, C. Gramaglia, E. Marzola, F. Monaco, M.G. Oriani, P. Federica, M. Rania, C. Renna, V. Ricca, P. Salvo, C. Segura-Garcia, F. Scarabel, P. Todisco, U. Volpe, P. Zeppegno, P. Monteleone, A.M. Monteleone
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S114-S115
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Introduction
The coronavirus disease 2019 (COVID-19) pandemic and the resulting containment measures, such as “lockdown” and “social distancing”, have had important consequences on people’s mental and physical health.
ObjectivesWe aimed to study the effect of social isolation and subsequent re- exposure and eventual changes in general and ED-specific psychopathology in people with Eating Disorders (EDs).
MethodsThree-hundred twelve Italian people with EDs (179 Anorexia Nervosa, 83 Bulimia Nervosa, 48 Binge Eating Disorder and 22 Other Specific Feeding Eating Disorder) were asked to fill-in an online survey to explore several dimensions such as: anxiety, depression, panic, insomnia, suicide ideation, stress, post-traumatic stress and obsessive-compulsive symptoms. Differences in ED specific and general symptoms among the 3 investigated time periods (before, during and after the end of lockdown) were assessed with a one-way ANOVA with repeated measures. Subsequently, ED diagnosis was introduced as covariate in the analysis in order to investigate the possible contribution on psychopathological changes.
ResultsED core symptoms increased during the lockdown but most of them returned to pre-COVID19 levels at re-opening. The severity of general psychopathology also increased during the lockdown and persisted high in the following phase, except for depression and suicide ideation. None of this symptoms was affected by ED diagnosis, participants’age and illness duration.
ConclusionsPeople with EDs showed worsening of both general and specific psychopathology; moreover, changes in general psychopathology persisted in the re-opening period suggesting a higher stress vulnerability in this kind of patients.
DisclosureNo significant relationships.
KeywordCOVID19 and Eating Disorders