Changes in substance use and engagement in gaming/gambling in persons with severe mental illness during the COVID-19 pandemic and earthquakes: a community study in two points

Sara Medved; Irena Rojnić Palavra; Josefina Gerlach; Sarah Levaj; Laura Shields-Zeeman; Felix Bolinski; Zoran Bradaš; Zoran Madžarac; Igor Filipčić; Martina Rojnić Kuzman

doi:10.3389/fpsyt.2023.1264875

Changes in substance use and engagement in gaming/gambling in persons with severe mental illness during the COVID-19 pandemic and earthquakes: a community study in two points

Front Psychiatry. 2023 Dec 15:14:1264875. doi: 10.3389/fpsyt.2023.1264875. eCollection 2023.

Authors

Affiliations

¹ Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
² University Psychiatric Hospital Sveti Ivan, Zagreb, Croatia.
³ Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, Netherlands.
⁴ Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
⁵ School of Medicine, University of Zagreb, Zagreb, Croatia.

Abstract

Introduction: External stressors, such as COVID-19 pandemic and earthquake, can cause an increase in substance use and addictive behavior in persons with severe mental illnesses (SMI). We analyzed the changes and predictors of substance use and addictive behavior in SMI during these double disasters in Croatia.

Methods: Questionnaires exploring the presence of substance or behavior addiction disorder, mental ill health [Depression Anxiety Stress Scales-21 (DASS-21), Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), Obsessive-Compulsive Inventory-Revised], coping mechanisms, and perceived social support [Multidimensional Scale of Perceived Social Support (MSPSS)] were administered among 90 participants with SMI included in the RECOVER-E study in May/June 2020 (first COVID-19 wave, Zagreb earthquake) and in December 2020/January 2021 (second COVID-19 wave, Petrinja earthquake).

Results: In both time points, a major increase was observed in tobacco smoking (25.0%; 28.6%, respectively) predicted by discontinuation of antidepressants and higher DASS-21 score. Increased sedative use was observed (24.4%; 23.8%, respectively) predicted by higher PSS and ISI scores, lower MSPSS scores, antipsychotic discontinuation and not receiving community mental health team (CMHT) service.

Discussion: In persons with SMI during a double disaster special attention needs to be given to reducing mental-ill health and stress, providing social support and continuity of psychiatric care, through medications and CMHTs.

Keywords: (CMHT); COVID-19 pandemic; addiction; community mental health team; earthquake; severe mental illness.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 779362, RECOVER-E “Large-scale implementation of community based mental health care for people with severe and enduring mental ill health in Europe.”