LAUSR

Introduction: After the outbreak of a new coronavirus subtype SARS-CoV-2 in China in late 2019, a global pandemic developed, generating a health, economic, and social emergency [1] In Spain, the COVID-19 pandemic crisis forced the government to declare a state of emergency on 14 March 2020 and to implement unprecedented lockdown restriction In this context, patients with severe mental disorders (SMD) may be particularly exposed to stress and social distancing measures [2, 3] and thus disproportionately vulnerable to public health interventions to fight the COVID-19 [4] However, the early psychological impact of the pandemic and the lockdown in this population is still mostly unknown Aims of the study: Here, we aim to compare the early psychological impact (depression, anxiety, and stress responses, intrusive and avoidant thoughts, and coping strategies) in a sample of people with SMD compared with two control groups: other mental disorders (OMD) and healthy controls (HC) Methods: 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 Spanish versions of the Depression, Anxiety, and Stress Scale (DASS-21) and the Impact of Event Scale (IES) A total of 21,279 people living in Spain answered the questionnaire, and 125 people with SMD were included in the analysis Subjects in each of the two control groups (OMD, n = 250;HC, n = 250) were matched (ratio 1:2) for sex and age (± 1 year) with the SMD group We performed descriptive and bivariate analyses and multinomial and linear regression models Results: People with SMD [mean age = 43 25 years (SD = 14 41);61 6% females] had statistically significantly higher scores on anxiety, stress, and depression subscales of the DASS-21 compared with the HC group, but lower scores than OMD in all domains (p < 0 05) 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, the multiple linear regression model (R2 = 0 580, F = 41 027, p < 0 001) found that higher anxiety was associated with being single (ẞ = 0 144, t = 2 291, p = 0 024), having COVID-19 symptoms (ẞ = 0 146, t = 2 395, p = 0 018), and a higher score on the stress subscale (ẞ = 0 538, t = 7 635, p < 0 001);whereas being able to enjoy free time was a protective factor (ẞ = -0 244, t = -3 692, p < 0 001) Conclusions: Our results showed that patients with SMD reacted to the pandemic and the lockdown restrictions with higher anxiety levels than the general public, suggesting that this domain could be a criterion for early intervention strategies and closer follow-up No conflict of interest