Depression and stress levels in patients with different psychiatric disorders during concurrent early-phase COVID-19 pandemic and earthquake in Croatia

BACKGROUND

While Croatia shared COVID-19 pandemic with other countries, its capital area was also hit by a 5.6 magnitude earthquake. The simultaneous impact of these two disasters on psychiatric patients is largely unknown, and we addressed those knowledge gaps.

METHODS

The cross-sectional study was conducted during the pandemic's first peak, in the aftermath of earthquake, by telephonic survey. Measurements included the Patient Health Questionnaire-9, the Perceived Stress Scale and the semi-structured interview to evaluate the impact of pandemic stress and earthquake. Overall 396 patients with depression and/or anxiety disorders (DAD), 229 participants with schizophrenia spectrum disorders (SSD) and 205 healthy controls were enrolled.

RESULTS

Both patient groups had higher depression and stress levels than controls, independent of sex, age and the presence of somatic comorbidity. After controlling for the same covariates, patient groups had higher COVID-19- and earthquake-related fears than controls. In patients with DAD, both fears were greater than among SSD patients. When comparing the two fears, the fear from earthquake was higher in DAD and control groups, whereas in SSD patients there was no such difference.

CONCLUSIONS

Patients with DAD were the most vulnerable group during disasters, while earthquake seems to be associated with more fear than the pandemics, at least in DAD patients and healthy individuals. Future longitudinal studies should determine if early psychological support might alleviate stress levels after disasters and prevent further worsening of mental health, particularly among DAD patients.

Could alexithymia predict suicide attempts - a study of Croatian war veterans with post-traumatic stress disorder

BACKGROUND

To investigate the possibility if alexithymia could be used as a predictor of attempted suicide among patients suffering from post-traumatic stress disorder.

SUBJECTS AND METHODS

The study was based on 127 veterans from the 1991-1995 war in Croatia. All the patients involved in this study were previously diagnosed with PTSD. The questionnaires (socio-demographic questionnaire, Mississippi scale for combat related PTSD questionnaire, and 20-item Toronto Alexithymia Scale questionnaire) were administered by investigators.

RESULTS

The results suggest that alexithymia was significantly associated with attempted suicide (P=0.020). Furthermore, alexithymia remained a significant predictor of an attempted suicide even in the multivariate regression model, which yielded an odds ratio (OR) of 2.87 (95% confidence intervals 1.18-7.00).

CONCLUSIONS

These results point out that alexithymia can be considered as a potential risk factor for suicide in this population, suggesting that it may also be used as an indicator of worsening psychological status and attempted suicide in other population groups with higher alexithymia prevalence.