Highlights A retrospective analysis was performed of all patients admitted to the Psychiatric Emergency Service 90 days before and after March 14 th , 2020, the first day of lockdown in Spain due to COVID-19. During the lockdown the number of admissions decreased by 37.9% while a significant increase in the percentage of patients requiring acute psychiatric hospitalization was observed Anxiety spectrum disorders accumulated the greatest decrease in admission rates compared to the three months before lockdown. A statistically significant increase in admissions rates was found in patients with dementia-like cognitive impairments, autism spectrum, and substance use disorders during the lockdown

Background Healthcare professionals are a reliable and impactful source of information on vaccination for parents and children. Objectives We aimed to describe the knowledge, attitudes and beliefs primary care professionals involved in administration of childhood vaccines in Barcelona have about vaccines and vaccination. Methods In 2016/17, surveys were administered in person to every public primary care centre (PCC) with a paediatrics department (n = 41). Paediatricians and paediatric nurses responded to questions about disease susceptibility, severity, vaccine effectiveness, vaccine safety, confidence in organisations, key immunisation beliefs, and how they vaccinate or would vaccinate their own children. We used standard descriptive analysis to examine the distribution of key outcome and predictor variables and performed bivariate and multivariate analysis. Results Completed surveys were returned by 277 (81%) of 342 eligible participants. A quarter of the respondents reported doubts about at least one vaccine in the recommended childhood vaccination calendar. Those with vaccine doubts chose the response option ‘vaccine-hesitant’ for every single key vaccine belief, knowledge and social norm. Specific vaccine knowledge was lacking in up to 40% of respondents and responses regarding the human papilloma virus vaccine were associated with the highest degree of doubt. Being a nurse a risk factor for having vaccine doubts (adjusted odds ratio (ORa) = 2.0; 95% confidence interval (95% CI): 1.1–3.7) and having children was a predictor of lower risk (ORa = 0.5; 95% CI: 0.2–0.9). Conclusions Despite high reported childhood immunisation rates in Barcelona, paediatricians and paediatric nurses in PCC had vaccine doubts, especially regarding the HPV vaccine.

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Objective Seasonal pattern (SP) is a bipolar disorder (BD) specifier that indicates a tendency towards affective relapses during specific moments of the year. SP affects 15%–25% of BD patients. In the past, SP was applied only to depressive relapses while, in DSM‐5, SP may be applied to both depressive and (hypo)manic episodes. We examined the association between different clinical correlates of BD and SP according to its current definition in a cohort of patients with BD type I (BDI) and II (BDII). Methods Patients were recruited from a specialized unit and assessed according to the season of relapse and type of episode per season. SP and non‐SP patients were compared looking into sociodemographic and clinical correlates. Significant variables at univariate comparisons were included in multivariate logistic regression with SP as the dependent variable. Results 708 patients were enrolled (503 BDI, 205 BDII), and 117 (16.5%) fulfilled DSM‐5 criteria for SP. The mean age was 45.3 years (SD = 14.18), and 389 were female (54.9%). The logistic regression model included a significant contribution of BDII (OR = 2.23, CI 1.4–3.55), family history of mood disorder (OR = 1.97, CI 1.29–3.01), undetermined predominant polarity (OR = 0.44, CI 0.28–0.70), and aggressive behavior (OR = 0.42, CI 0.23–0.75). Conclusion Our results outline a novel positive association of SP with undetermined predominant polarity, BDII, family history of mood disorder, and with fewer aggressiveness‐related symptoms. Seasonality is associated with a biphasic pattern with similar dominance of (hypo)mania and depression and is more frequent in BDII as compared to BDI. Seasonal episodes may be easier to predict, but difficult to prevent.

Objective This study was aimed at identifying differences in the prodromal symptoms and their duration, risk factors and markers of vulnerability in patients presenting a first episode mania (FEM) or psychosis (FEP) with onset in late adolescence or adulthood in order to guide tailored treatment strategies. Methods Patients with a FEM or FEP underwent a clinical assessment. Prodromes were evaluated with the Bipolar Prodrome Symptom Scale‐Retrospective (BPSS‐R). Chi‐squared tests were conducted to assess specific prodromal symptoms, risk factors or markers of vulnerability between groups. Significant prodromal symptoms were entered in a stepwise forward logistic regression model. The probabilities of a gradual versus rapid onset pattern of the prodromes were computed with logistic regression models. Results The total sample included 108 patients (FEM = 72, FEP = 36). Social isolation was associated with the prodromal stage of a FEP whilst Increased energy or goal‐directed activity with the prodrome to a FEM. Physically slowed down presented the most gradual onset whilst Increased energy presented the most rapid. The presence of obstetric complications and difficulties in writing and reading during childhood were risk factors for FEP. As for markers of vulnerability, impairment in premorbid adjustment was characteristic of FEP patients. No specific risk factor or marker of vulnerability was identified for FEM. Conclusion Early characteristics differentiating FEP from FEM were identified. These findings might help shape early identification and preventive intervention programmes.

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