Resumo: Introdução: A investigação sobre a primeira fase do confinamento devido à COVID-19 em Itália mostrou que se observou um aumento da suscetibilidade a problemas de saúde mental (SM) na população. Na mesma amostra, investigámos as correlações entre as diversas dimensões demográficas, socioeconómicas, historial biológico/clínico e dimensão cognitivo-afetivas e a SM na segunda fase, de “abertura”, do confinamento. Métodos: Foi realizado um questionário online anónimo, com dados recolhidos entre 26 de maio e 4 de julho de 2020, sobre dados demográficos, socioeconómicos, risco percebido, saúde geral, qualidade de vida, preocupação, interferência na vida, satisfação com a vida, felicidade percebida e SM, usando o Inventário de Saúde Mental-5 (MIH-5). Resultados: Embora 300 participantes tenham respondido à secção demográfica e socioeconómica do questionário, apenas 202 responderam à secção de SM neste estudo exploratório. Usando pontuações totais do MHI-5 >52 para baixo distress e >70 para baixa depressão como pontos de corte, mostrámos que a idade avançada estava positivamente associada a melhor SM. Além disso, avaliações positivas mais baixas para a saúde geral e uma maior interferência na vida e na satisfação com a vida foram consideradas preditores de pior SM. Discussão: Durante a segunda fase do confinamento, o impacto das restrições da COVID-19 na SM dependeram da idade do sujeito. Apesar de indivíduos mais velhos apresentarem maior dificuldade no controlo da dor durante o período pandémico, relataram menor preocupação com as despesas diárias e com o futuro e menor interferência das restrições pandémicas na sua atividade laboral e na vida em geral. Independentemente da idade, a saúde mental estava associada à saúde geral autorreportada e à interferência da pandemia na vida e na satisfação com a vida em adultos durante o confinamento devido à COVID-19. Os resultados deste estudo indicam que os indivíduos mais jovens são os mais vulneráveis perante eventos de vida negativos significativos, tais como, a pandemia, e que esta vulnerabilidade aumenta quando os indivíduos têm uma menor capacidade de lidar com a interferência na vida e menor satisfação com a vida devido ao isolamento criado pelo confinamento. Assim, um sistema de saúde pró-ativo que cuide da saúde mental, especialmente entre os jovens, e programas destinados a promover a saúde mental devem ser estabelecidos nas instituições públicas, especialmente nas escolas.

Abstract: Introduction: Research into the first phase of the COVID-19 lockdown in Italy showed an association with an increased susceptibility to adverse mental health (MH) in the general population. We investigated in the same population the correlations between the various demographic, socioeconomic, biological/clinical history and psychological dimensions and MH in the second, “opening-up”, phase of the lockdown. Methods: An anonymous online survey collected data from 26 May to 4 July 2020 on demographic, socioeconomic, perceived risk, general health and quality of life appraisals, worry, interference in life, life satisfaction, perceived happiness and MH by using Mental Health Inventory-5 (MHI-5). Results: Of the 300 participants, only 195 responded to MH questions. Older age was positively associated with better MH (r=.15), as was education (r=.19). A negative correlation with MH, with medium-high effect size, was found with quality of life (r=.40) and health (r=.34) appraisals, and the factors “worry about sustenance” (r=.23) and “interference with life” (r=.32). A positive correlation, with strong effect size, was found between MH and life satisfaction (r=.53) and perception of happiness (r=.64). Discussion: During phase two of the lockdown, rather the real impact of COVID-19 restrictions on employment or economic resources, it was worry about finances that was associated with worse MH. Mental distress was associated with the loss of some positive psychological factors. From a homeostatic and biopsychosocial perspective of MH, life satisfaction and perceived happiness represent important mental resources for counteracting the effects of lockdown on MH.

ABSTRACT Treatment for children and adolescents with pain in Spain: data from a survey on current specialized programs(*) Background: The treatment of children and adolescents with pain has improved considerably in the last 30 years. In Spain, progress is also evident, and specialized units or programs have emerged as part of the care provided for this population. However, there are no studies on the characteristics or activities of these specialized units or programs. This lack of information prevents an adequate evaluation of the current procedures, and hinders an adequate administration and management of these resources. The objective of this work was to study the characteristics of these units and programs for the treatment of children and adolescents with pain in Spain. Methods: A total of 10 specialized units or specific treatment programs for pediatric pain in Spain were identified, and the person responsible was contacted. Through a self-administered online survey, information was collected on the organization of the program, the involvement in relevant fields such as research, training of professionals and the raising of awareness and visibility of the problem, the specialties involved, the type of treatments offered, the evaluation of results and the services provided. Results: Of the ten units or programs contacted, eight answered the survey (80%). Pain programs for children and adolescents proved to be primarily pharmacological, also for chronic pain. They reported to promote awareness about the problem (88%), to contribute to the training of specialists (88%) and to a lesser extent to research and knowledge generation (75%). Conclusions: This survey provides valuable information on the current characteristics of specialized programs and units for the treatment of children and adolescents with pain in Spain, and can be used to propose actions that improve its current management and administration.

RESUMEN Fundamentos: El tratamiento de la población infantojuvenil con dolor ha mejorado considerablemente en los últimos 30 años. En España, el progreso también es evidente, y han surgido unidades o programas especializados como parte de la atención a esta población, aunque no existen estudios sobre las características o la actividad de estas unidades o programas especializados. Esta falta de información impide una evaluación adecuada de los procedimientos vigentes y dificulta una adecuada administración y gestión de estos recursos. El objetivo de este trabajo fue conocer las características de estas unidades y programas para el tratamiento de la población infantojuvenil con dolor en España. Sujetos y métodos: Se identificaron un total de 10 unidades especializadas o programas de tratamiento específicos del dolor infantil en España y se contactó con la persona responsable. A través de una encuesta autoadministrada online se recogió información sobre la organización del programa, su implicación en ámbitos relevantes como la investigación, la formación de los profesionales, la sensibilización y visibilidad del problema en la sociedad y entre los profesionales, las especialidades implicadas, el tipo de tratamientos que se ofrecen, la evaluación de resultados y los servicios prestados. Se han utilizado medias y porcentajes para describir los resultados. Resultados: De las diez unidades o programas contactados, ocho contestaron a la encuesta (80%). Los programas de tratamiento del dolor infantojuvenil demostraron ser fundamentalmente farmacológicos, también en los casos de dolor crónico. Informaban de que se preocupaban por impulsar la sensibilización de los especialistas y la sociedad sobre el problema (88%), de contribuir también a la formación de especialistas (88%) y, en menor medida, de investigar y generar conocimiento (75%). Conclusiones: Esta encuesta proporciona información valiosa sobre las características actuales de los programas y unidades especializadas para el tratamiento de la población infantojuvenil con dolor en España. Puede servir para proponer acciones que mejoren la gestión y administración actual.

ABSTRACT Treatment for children and adolescents with pain in Spain: data from a survey on current specialized programs(*) Background: The treatment of children and adolescents with pain has improved considerably in the last 30 years. In Spain, progress is also evident, and specialized units or programs have emerged as part of the care provided for this population. However, there are no studies on the characteristics or activities of these specialized units or programs. This lack of information prevents an adequate evaluation of the current procedures, and hinders an adequate administration and management of these resources. The objective of this work was to study the characteristics of these units and programs for the treatment of children and adolescents with pain in Spain. Methods: A total of 10 specialized units or specific treatment programs for pediatric pain in Spain were identified, and the person responsible was contacted. Through a self-administered online survey, information was collected on the organization of the program, the involvement in relevant fields such as research, training of professionals and the raising of awareness and visibility of the problem, the specialties involved, the type of treatments offered, the evaluation of results and the services provided. Results: Of the ten units or programs contacted, eight answered the survey (80%). Pain programs for children and adolescents proved to be primarily pharmacological, also for chronic pain. They reported to promote awareness about the problem (88%), to contribute to the training of specialists (88%) and to a lesser extent to research and knowledge generation (75%). Conclusions: This survey provides valuable information on the current characteristics of specialized programs and units for the treatment of children and adolescents with pain in Spain, and can be used to propose actions that improve its current management and administration.

RESUMEN Fundamentos: El tratamiento de la población infantojuvenil con dolor ha mejorado considerablemente en los últimos 30 años. En España, el progreso también es evidente, y han surgido unidades o programas especializados como parte de la atención a esta población, aunque no existen estudios sobre las características o la actividad de estas unidades o programas especializados. Esta falta de información impide una evaluación adecuada de los procedimientos vigentes y dificulta una adecuada administración y gestión de estos recursos. El objetivo de este trabajo fue conocer las características de estas unidades y programas para el tratamiento de la población infantojuvenil con dolor en España. Sujetos y métodos: Se identificaron un total de 10 unidades especializadas o programas de tratamiento específicos del dolor infantil en España y se contactó con la persona responsable. A través de una encuesta autoadministrada online se recogió información sobre la organización del programa, su implicación en ámbitos relevantes como la investigación, la formación de los profesionales, la sensibilización y visibilidad del problema en la sociedad y entre los profesionales, las especialidades implicadas, el tipo de tratamientos que se ofrecen, la evaluación de resultados y los servicios prestados. Se han utilizado medias y porcentajes para describir los resultados. Resultados: De las diez unidades o programas contactados, ocho contestaron a la encuesta (80%). Los programas de tratamiento del dolor infantojuvenil demostraron ser fundamentalmente farmacológicos, también en los casos de dolor crónico. Informaban de que se preocupaban por impulsar la sensibilización de los especialistas y la sociedad sobre el problema (88%), de contribuir también a la formación de especialistas (88%) y, en menor medida, de investigar y generar conocimiento (75%). Conclusiones: Esta encuesta proporciona información valiosa sobre las características actuales de los programas y unidades especializadas para el tratamiento de la población infantojuvenil con dolor en España. Puede servir para proponer acciones que mejoren la gestión y administración actual.