The impact on mental health patients of COVID-19 outbreak in Spain

Public health studies warn of the vulnerability of people with mental disorders during the COVID-19 outbreak. Thus, the aims of this study were to (1) explore the presence of symptoms of anxiety, depression and acute stress among people with a mental disorder (MD); (2) evaluate the rate of COVID-19 infection between MD and nonMD, and (3) study the relationship between the emotional state of people with a mental disorder and some environmental variables. A cross-sectional study starting on March 29 to April 5, 2020 based on a national online survey using snowball sampling techniques was conducted. Symptoms of anxiety (Hamilton Anxiety Scale), depression (Beck Depression Inventory) and acute stress (Acute Stress Disorder Inventory) were compared in MD and non-MD. The rate of COVID-19 confirmed cases among MD and non-MD was compared as well as the relationship between some environmental variables and the emotional state within MD. Up to 1839 [201 (10.9%) MD] participants completed the survey. MD showed significant higher mean (SD) in anxiety [24.7 (11.8) vs. 17 (10.3); p = 0.001], depression [7.9 (6.0) vs. 4.2 (4.2); p = 0.001] and acute stress [6.3 (3.2) vs. 4.4 (3.1); p = 0.001] scores than non-MD. The COVID-19 confirmed cases rate was higher in MD participants than in non-MD (3.5% vs. 0.4%; p < 0.001). Among the MD group, being a COVID-19 confirmed case, the lack in basic needs coverage, the rpesence of violence, drug use and the absence of physical excercise were associated with more severe depressive symptoms. Findings suggest that the COVID-19 has an impact on the emotional state of people with mental disorders.