The impact of the COVID-19 Pandemic on the Greek population: Suicidal ideation during the first and second lockdown.

Q3 Medicine
Psychiatrike = Psychiatriki Pub Date : 2021-12-20 Epub Date: 2021-11-26 DOI:10.22365/jpsych.2021.041
Rossetos Gournellis, Vasiliki Efstathiou
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The impact of the pandemic on suicidal behavior, especially on the Greek population, is of critical importance, due to the increase in suicidality during the recent financial crisis in the country.2 The impressive decline in the GDP during the first months of the COVID-19 pandemic (-9% of GDP),3 unemployment, isolation, reduced social contacts, problems in accessing mental health services, and also the limitations in terms of psychological support may increase the risk of suicidal behavior.4 With a view to investigating the psychosocial effects of the COVID-19 pandemic, an online questionnaire was developed in March 2020 by the Second Department of Psychiatry of the National and Kapodistrian University of Athens (NKUA) and the Postgraduate Program \"Liaison Psychiatry: Integrated Care of Physical and Mental Health\" of NKUA. This questionnaire included items regarding demographic characteristics, physical and mental health data, and issues related to the pandemic and the imposed restriction measures, such as perceived changes in participants' biorhythms, habits, and relationships with their colleagues, friends, and family. In addition, participants were asked to complete psychometric scales with regard to anxiety, depression and suicidal ideation, family functioning, anger and resilience. During the first national lockdown in Greece (April 7 to May 3) a total of 5,748 adults from the community participated in the survey by anonymously completing the aforementioned questionnaire on a secure website of NKUA. A considerable effort was devoted to make the sample as representative as possible and to include members of the community who do not usually participate in such surveys, as individuals of older age or individuals with health conditions. The 5.20% two-week prevalence of suicidal ideation found in our study is an intermediate rate with respect to the 2.4% one-month prevalence in 2008, the 6.7% in 2011 and the 2.6% prevalence in 2013.5 Among the respondents, 14.1% were potential cases of anxiety, while 26.5% of depression. Independent risk factors for suicidal ideation included anxiety, depression, impaired family functioning, being unmarried or divorced, having a mental health history, as well as a poor perceived quality of physical health. In contrast, higher resilience, positive feelings with regard to the lockdown measures, relationship with friends, and faith in a Supreme Being emerged as protective factors for suicidal ideation.6 Investigating the risk and protective factors for suicidal ideation is especially important during this difficult period of the pandemic. There was an additional significant finding in this study: individuals who completed the questionnaire during the last two weeks of the first lockdown reported statistically significantly higher suicidal ideation, depression, and anxiety than those who completed it in the previous two weeks, while a similar finding was revealed in a study from USA.7 Therefore, we were looking forward to the results of our survey conducted during the second lockdown.8 From the 5,116 individuals who had fully completed our questionnaire with respect to suicidal ideation during the first lockdown, 811 fully completed it for the second time from November 22 to December 21, 2020. Suicidal ideation was not found significantly different compared to the first lockdown. Independent risk factors for suicidal ideation during the second lockdown were depression, anxiety, living with a person with frail health and vulnerable for COVID-19 and suicidal ideation during the first lockdown. It is noted that during the second lockdown the rates of potential depression cases remained unchanged, whereas anxiety rates increased. Greater accessibility to health services, state financial support and increased mobility might have contributed to the stability of suicidal ideation despite the greater severity of the second wave of the COVID-19 pandemic. The aforementioned studies determined the prevalence of suicidal ideation and its association with various demographic, clinical, social, familial, and psychopathological factors in a cohort context at different stages of the COVID-19 pandemic, with the relevant literature being rather poor. 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引用次数: 6

Abstract

More than a year has passed since World Health Organization (WHO) declared COVID-19 as a pandemic, and during this period over 237 million cases and more than 4.8 million deaths have occurred worldwide due to COVID-19.1 This unprecedented pandemic not only has burdened health systems but it also constitutes a major stressful event both due to the threat of illness and death that it poses, and to the drastic impact on human relations, financial activity, access to health services, etc. Additional factors that may contribute to stress include the protection measures against COVID-19, social distancing, and mobility restrictions. The impact of the pandemic on suicidal behavior, especially on the Greek population, is of critical importance, due to the increase in suicidality during the recent financial crisis in the country.2 The impressive decline in the GDP during the first months of the COVID-19 pandemic (-9% of GDP),3 unemployment, isolation, reduced social contacts, problems in accessing mental health services, and also the limitations in terms of psychological support may increase the risk of suicidal behavior.4 With a view to investigating the psychosocial effects of the COVID-19 pandemic, an online questionnaire was developed in March 2020 by the Second Department of Psychiatry of the National and Kapodistrian University of Athens (NKUA) and the Postgraduate Program "Liaison Psychiatry: Integrated Care of Physical and Mental Health" of NKUA. This questionnaire included items regarding demographic characteristics, physical and mental health data, and issues related to the pandemic and the imposed restriction measures, such as perceived changes in participants' biorhythms, habits, and relationships with their colleagues, friends, and family. In addition, participants were asked to complete psychometric scales with regard to anxiety, depression and suicidal ideation, family functioning, anger and resilience. During the first national lockdown in Greece (April 7 to May 3) a total of 5,748 adults from the community participated in the survey by anonymously completing the aforementioned questionnaire on a secure website of NKUA. A considerable effort was devoted to make the sample as representative as possible and to include members of the community who do not usually participate in such surveys, as individuals of older age or individuals with health conditions. The 5.20% two-week prevalence of suicidal ideation found in our study is an intermediate rate with respect to the 2.4% one-month prevalence in 2008, the 6.7% in 2011 and the 2.6% prevalence in 2013.5 Among the respondents, 14.1% were potential cases of anxiety, while 26.5% of depression. Independent risk factors for suicidal ideation included anxiety, depression, impaired family functioning, being unmarried or divorced, having a mental health history, as well as a poor perceived quality of physical health. In contrast, higher resilience, positive feelings with regard to the lockdown measures, relationship with friends, and faith in a Supreme Being emerged as protective factors for suicidal ideation.6 Investigating the risk and protective factors for suicidal ideation is especially important during this difficult period of the pandemic. There was an additional significant finding in this study: individuals who completed the questionnaire during the last two weeks of the first lockdown reported statistically significantly higher suicidal ideation, depression, and anxiety than those who completed it in the previous two weeks, while a similar finding was revealed in a study from USA.7 Therefore, we were looking forward to the results of our survey conducted during the second lockdown.8 From the 5,116 individuals who had fully completed our questionnaire with respect to suicidal ideation during the first lockdown, 811 fully completed it for the second time from November 22 to December 21, 2020. Suicidal ideation was not found significantly different compared to the first lockdown. Independent risk factors for suicidal ideation during the second lockdown were depression, anxiety, living with a person with frail health and vulnerable for COVID-19 and suicidal ideation during the first lockdown. It is noted that during the second lockdown the rates of potential depression cases remained unchanged, whereas anxiety rates increased. Greater accessibility to health services, state financial support and increased mobility might have contributed to the stability of suicidal ideation despite the greater severity of the second wave of the COVID-19 pandemic. The aforementioned studies determined the prevalence of suicidal ideation and its association with various demographic, clinical, social, familial, and psychopathological factors in a cohort context at different stages of the COVID-19 pandemic, with the relevant literature being rather poor. We consider that the provision of such data is critical for the plans of health system in pandemic conditions, while this longitudinal study is in progress during the subsequent waves of the pandemic.

COVID-19大流行对希腊人口的影响:第一次和第二次封锁期间的自杀念头。
自世界卫生组织(世卫组织)宣布COVID-19为大流行以来,一年多过去了,在此期间,全球因COVID-19而发生的病例超过2.37亿例,死亡人数超过480万人。这一前所未有的大流行不仅给卫生系统带来了负担,而且由于其造成的疾病和死亡威胁以及对人际关系、金融活动、获得卫生服务等方面的巨大影响,它也构成了重大压力事件。可能导致压力的其他因素包括针对COVID-19的保护措施、社交距离和行动限制。疫情对自杀行为的影响,特别是对希腊人口的影响至关重要,因为在该国最近的金融危机期间,自杀率有所上升在2019冠状病毒病大流行的头几个月,国内生产总值大幅下降(占国内生产总值的-9%)、失业、孤立、社会接触减少、获得精神卫生服务方面的问题以及心理支持方面的限制,都可能增加自杀行为的风险为了调查COVID-19大流行的社会心理影响,2020年3月,雅典国立和卡波迪斯特兰大学精神病学第二系与雅典国立和卡波迪斯特兰大学“联络精神病学:身心健康综合护理”研究生课程编制了一份在线问卷。该问卷包括人口统计特征、身心健康数据以及与大流行和实施的限制措施有关的问题,例如参与者的生物节律、习惯以及与其同事、朋友和家人的关系的感知变化。此外,参与者还被要求完成关于焦虑、抑郁和自杀意念、家庭功能、愤怒和恢复力的心理测量量表。在希腊第一次全国封锁期间(4月7日至5月3日),共有5748名来自社区的成年人在NKUA的安全网站上匿名填写了上述问卷。为使抽样尽可能具有代表性,并包括通常不参加这种调查的社区成员,如老年人或有健康问题的个人,作出了相当大的努力。与2008年的2.4%、2011年的6.7%和2013年的2.6%相比,本研究中自杀意念的两周患病率为5.20%,属于中等水平。在调查对象中,潜在焦虑病例占14.1%,潜在抑郁病例占26.5%。产生自杀意念的独立风险因素包括焦虑、抑郁、家庭功能受损、未婚或离婚、有精神健康史以及认为身体健康质量差。相比之下,更高的复原力、对封锁措施的积极感受、与朋友的关系以及对上帝的信仰成为自杀意念的保护因素在大流行的这一困难时期,调查自杀意念的风险和保护因素尤为重要。在这项研究中还有一个重要的发现:在第一次封锁的最后两周内完成问卷的个体报告的自杀意念、抑郁和焦虑程度在统计上显著高于前两周完成问卷的个体,而美国的一项研究也显示了类似的发现。因此,我们期待着在第二次封锁期间进行的调查结果在第一次封城期间完整填写自杀意念问卷的5116人中,有811人在2020年11月22日至12月21日期间第二次完整填写了问卷。自杀意念与第一次封锁相比没有显著差异。第二次封城期间产生自杀意念的独立风险因素是抑郁、焦虑、与身体虚弱、易感染COVID-19的人一起生活,以及第一次封城期间产生自杀意念。值得注意的是,在第二次封锁期间,潜在抑郁症病例的比例保持不变,而焦虑率却增加了。尽管第二波COVID-19大流行更加严重,但更容易获得卫生服务、国家财政支持和流动性增加可能有助于自杀意念的稳定。上述研究确定了2019冠状病毒病大流行不同阶段的队列背景下自杀意念的患病率及其与各种人口统计学、临床、社会、家庭和精神病理因素的关系,相关文献较少。 我们认为,提供此类数据对于大流行条件下卫生系统的计划至关重要,而这项纵向研究正在随后的大流行浪潮中进行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Psychiatrike = Psychiatriki
Psychiatrike = Psychiatriki Medicine-Medicine (all)
CiteScore
2.60
自引率
0.00%
发文量
37
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