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Coronavirus disease 2019 (COVID-19) has dramatically changed the epidemiology of several diseases. Much evidence on this has been published in the pandemic phase. In addition, many studies have shown that phenomena such as stress, substance abuse, and burnout increased in the general population during the lockdown. Unfortunately, few studies analyze the post-pandemic phase.
The study aimed to evaluate the trend of broad social problems, such as a diagnosis by the emergency department (ED), in the post-pandemic phase in the Lombardy (Italy) region.
The study is a retrospective observational cohort study. All admissions to emergency rooms in the Lombardy region registered in the Emergency Urgency OnLine (EUOL) portal made from January through June 2019 were analyzed, having as main causes: psychiatric disorders, self-harm, substance abuse, social disadvantage, and violence. All accesses in emergency rooms in the Lombardy region registered in the EUOL portal made from January 1, 2019 through June 30, 2019 were analyzed and compared with the same period in 2022.
The study recorded an increase in the likelihood of events of self-harm (OR = 2.1; 95% CI, 1.8-2.6; P <.0001), substance abuse (OR = 1.2; 95% CI, 1.1-1.3; P <.0001), violence by others (OR = 1.3; 95% CI, 1.2-1.4; P <.0001), and social disadvantage (OR = 1.2; 95% CI, 1.1-1.4; P = .0045). The events are more concentrated in suburban areas (OR = 1.3; 95% CI, 1.2-1.4; P <.001).
The increase in diagnoses of these social problems in the ED is only the culmination of a phenomenon that hides an underlying rise in social illness. In the post-COVID-19 phase, there is a need to invest in community care and social illness prevention policies.
Symptoms of depression are transdiagnostic heterogenous features frequently assessed in psychiatric disorders, that impact the response to first-line treatment and are associated with higher suicide risk. This study assessed whether severe mental pain could characterize a specific phenotype of severely depressed high-risk psychiatric patients. We also aimed to analyze differences in treatments administered.
2,297 adult patients (1,404 females and 893 males; mean age = 43.25 years, SD = 15.15) treated in several Italian psychiatric departments. Patients were assessed for psychiatric diagnoses, mental pain, symptoms of depression, hopelessness, and suicide risk.
More than 23% of the patients reported high depression symptomatology and high mental pain (HI DEP/HI PAIN). Compared to patients with lower symptoms of depression, HI DEP/HI PAIN is more frequent among females admitted to an inpatient department and is associated with higher hopelessness and suicide risk. In addition, HI DEP/HI PAIN (compared to both patients with lower symptoms of depression and patients with higher symptoms of depression but lower mental pain) were more frequently diagnosed in patients with personality disorders and had different treatments.
Patients reporting severe symptoms of depression and high mental pain presented a mixture of particular dangerousness (high trait hopelessness and the presence of suicide ideation with more frequency and less controllability and previous suicide behaviors). The presence of severe mental pain may act synergically in expressing a clinical phenotype that is likewise treated with a more complex therapeutic regime than that administered to those experiencing symptoms of depression without mental pain.
During the COVID-19 pandemic, a total lockdown was enforced all over Italy starting on March 9, 2020. This resulted in the shrinking of economic activities. In addition, all formal occupational security-training courses were halted, among them the 81/08 law lectures and Basic Life Support-Defibrillation (BLS-D) laypersons training courses. The aim of this study was to evaluate the impact of the pandemic on BLS-D laypersons training courses in the Lombardy region.
BLS-D training courses records for the Lombardy region were analyzed. The analysis was conducted from 2016 to 2020 as part of the Hippo project.
In the period between 2017 and 2019, BLS-D trained laypersons kept increasing, moving from 53500 trained individuals up to 74700. In 2020, a stark reduction was observed with only 22160 individuals trained. Formal courses were not halted completely during 2020. Still, in the months available for training, the number of individuals enrolled showed a sharp 50% reduction.
Laypersons training courses for emergency management are a fundamental component of primary prevention practice. The 81/08 and 158/12 Italian laws have decreed this practice mandatory in the workplace. Following the enforcement of the lockdown and the subsequent interruption of emergency management courses, efforts will be necessary to re-establish and guarantee the high quality training of the pre-pandemic period.
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