Our study aimed to (1) identify trajectories on different mental health components during a two-year follow-up of the COVID-19 pandemic and contextualise them according to pandemic periods; (2) investigate the associations between mental health trajectories and several exposures, and determine whether there were differences among the different mental health outcomes regarding these associations.

We included 5535 healthy individuals, aged 40–65 years old, from the Barcelona Brain Health Initiative (BBHI). Growth mixture models (GMM) were fitted to classify individuals into different trajectories for three mental health-related outcomes (psychological distress, personal growth and loneliness). Moreover, we fitted a multinomial regression model for each outcome considering class membership as the independent variable to assess the association with the predictors.

For the outcomes studied we identified three latent trajectories, differentiating two major trends, a large proportion of participants was classified into ‘resilient’ trajectories, and a smaller proportion into ‘chronic-worsening’ trajectories. For the former, we observed a lower susceptibility to the changes, whereas, for the latter, we noticed greater heterogeneity and susceptibility to different periods of the pandemic. From the multinomial regression models, we found global and cognitive health, and coping strategies as common protective factors among the studied mental health components. Nevertheless, some differences were found regarding the risk factors. Living alone was only significant for those classified into ‘chronic’ trajectories of loneliness, but not for the other outcomes. Similarly, secondary or higher education was only a risk factor for the ‘worsening’ trajectory of personal growth. Finally, smoking and sleeping problems were risk factors which were associated with the ‘chronic’ trajectory of psychological distress.

Our results support heterogeneity in reactions to the pandemic and the need to study different mental health-related components over a longer follow-up period, as each one evolves differently depending on the pandemic period. In addition, the understanding of modifiable protective and risk factors associated with these trajectories would allow the characterisation of these segments of the population to create targeted interventions.

This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.

We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.

Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.

These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.

Suicide is a global public health problem. More than 800,000 people die due to suicide every year according to the WHOM. In Spain, about 9 people die due to suicide every day, and the rates increase every year. The presence of previous suicide attempts is one of the strongest risk factors for suicide consumption. Nevertheless, patients sometimes do not receive a correct assistance after a suicide attempt.

To study the follow-up of patients, without previous psychiatrichistory, who commit a first suicide attempt in the area of Huelva (Spain).

Retrospective review of the electronic clinical histories of patients attended in the Emergency service of Juan Ramón Jiménez Hospital after a first suicide attempt during the first six months of 2015.

From January to June of 2015 we collected a total of 159 patients who committed a firs suicide attempt in our area. A total of 69.18% were women and 30.82 were men. In both sex the mean age was 39 years. Out of the 159 attended after a first suicide attempt, only 54% were referred to the Psychiatry service to be followed up. Out of those referred, only 62% actually attended and only half of them really staying treatment.

An adequate psychiatric follow up after a suicide attempt is needed to reduce the risk of more suicide attempts or consumption. A minority (30.8%) of the patients attended in our area after a first suicide attempt received an adequate attention.

The authors have not supplied their declaration of competing interest.

Because abnormal vital signs indicate the potential for clinical deterioration, it is logical to make emergency physicians immediately aware of those patients who present with abnormal vital signs.

To determine if a clinical triggers program in the emergency department (ED) setting that utilized predetermined abnormal vital signs to activate a rapid assessment by an emergency physician-led multidisciplinary team had a measurable effect on inpatient hospital metrics.

The study design was a retrospective pre and post intervention study. The intervention was the implementation of an ED clinical “triggers” program. Abnormal vital sign criteria that warranted a trigger response included: heart rate <40 beats/minute or>130 beats/minutes, respiratory rate <8 breaths/minute or>30 breaths/minute, systolic blood pressure <90 mm Hg, or oxygen saturation <90% on room air. The primary outcome investigated was the median days admitted with secondary outcomes of median days in special care unit, in-hospital 30-day mortality and proportion of patients who required an upgrade in inpatient care level.

There was no difference in median days admitted for inpatient care (3.8 v. 4.0 days, p=0.21) or median days spent in a special care unit (5.0 v. 5.6 days, p=0.42) between the groups. There was no difference in the percentage of in-hospital patient deaths (6.0% v. 5.6%, p=0.66) or frequency of upgrade in level of care within 24 hours (4.9% v. 4.0%, p=0.52).

In our study, the implementation of an ED clinical triggers program did not result in a significant change in measured inpatient outcomes.