The COVID-19 pandemic has brought about changes in mental health occupational therapy. Research into these changes and the associated risks of relapse is insufficient. To explore the changes that have taken place in forms of occupational intervention (face-to-face and online) during the pandemic, and to analyze their association with subsequent relapses, a multicenter retrospective cohort study was carried out of 270 patients with mental disorder diagnoses under follow-up in day hospitals during 2020. Our results show that the frequency of face-to-face occupational therapy interventions decreased during lockdown and subsequently recovered. Interventions via telehealth increased during lockdown and have since been continued to a greater extent than before lockdown. Patients who received occupational intervention via telehealth relapsed less in the following six months (10.7% vs. 26.3%; χ² = 10.372; p = 0.001), especially those who received intervention via videoconferencing (4.2% vs. 22%; χ² = 5.718; p = 0.017). In conclusion, lockdown subsequent to the COVID-19 outbreak led to a reduction in face-to-face occupational therapy interventions, putting people with prior mental disorders at risk, while the implementation of telehealth tools helped reduce relapses.

Background: Combination therapies delivered remotely via the internet or mobile devices are increasingly being used to improve and promote the self-management of chronic conditions. However, little is known regarding the long-term effects of these interventions. Objective: The aim of this study is to evaluate the effectiveness of a multimodal intervention program that measures associated variables such as catastrophizing, pain acceptance, and quality of life using a mobile device in people with chronic pain in an outpatient setting. Methods: A randomized controlled clinical trial was performed using parallel treatment groups. A total of 209 patients with chronic musculoskeletal pain were randomly assigned to one of the two study arms. The intervention group received a standard web-based psychosocial therapy-type program of activities through a smartphone for 6 weeks. The control group only had access to the Find out more section of the app, which contained audiovisual material for pain management based on a self-help approach. The primary outcome was catastrophizing measured using the Pain Catastrophizing Scale (PCS). Secondary outcomes were pain acceptance measured using the Chronic Pain Acceptance Questionnaire and health-related quality of life measured using the EuroQol Visual Analogue Scale. Assessments were conducted at baseline (T1), after treatment (T2), and at the 3-month follow-up (T3). The variations between the different phases were assessed using the percentage change rescaled with log base 2. The Cohen d was calculated based on the results of the linear mixed model. The investigators of the study who evaluated the results were not involved in patient recruitment and were blinded to the group assignment. Results: Positive effects were found in the intervention group (T2–T1) in catastrophizing between the baseline and posttreatment phases (P<.001) and in helplessness (−0.72 vs 0.1; P=.002), rumination (−1.59 vs −0.53; P<.001), acceptance (0.38 vs 0.05; P=.001), and quality of life (0.43 vs −0.01; P=.002), although no significant changes were found for magnification (0.2 vs 0.77; P=.14) and satisfaction with health (0.25 vs −0.27; P=.13). Three months after treatment, significant differences were observed in the intervention group for the outcome variable of catastrophizing (PCS; −0.59 vs 0.2; P=.006) and the PCS subscales of helplessness (−0.65 vs 0.01; P=.07), rumination (1.23 vs −0.59; P=.04), and magnification (0.1 vs 0.86; P=.02). Conclusions: The results of our study suggest that app-based mobile multidimensional treatments for adults with chronic pain improve catastrophizing, quality of life, and psychological flexibility immediately after treatment and that the effects are maintained for the primary outcome of catastrophizing for at least 3 months following treatment. Moreover, they promote self-management and can be used to complement face-to-face pain treatments. Trial Registration: ClinicalTrials.gov NCT04509154; https://clinicaltrials.gov/ct2/show/NCT04509154

Background: The use of diverse therapies combined with a multidisciplinary approach and prevention initiatives for patients with chronic non-malignant pain (CNMP) can improve health and have a positive impact on psychotropic drug use and the self-management of pain. Purpose: This purpose of this study has been two-fold: to conduct a literature review with a view to selecting best evidence recommendations for CNMP and to prioritize self-care recommendations using a participatory methodology for the analysis and selection of interventions. Methods: A qualitative, descriptive, and documentary method based on participatory action research was used. Findings: Based on the study results, a multimodal psychosocial intervention program has been designed for CNMP that includes psychoeducational therapy, pharmacological therapy, physical exercise, and health assets. Discussion: The findings are consistent with previous studies underlining the need to invest in resources for the management of CNMP, including strategies for good differential diagnoses and pharmacological treatments combined with non-pharmacological treatments to confer greater well-being for people living with pain who want to participate in their own recovery.

Background: The recovery model assumes that the patient can experience personal growth even while maintaining symptoms of a mental disorder. In order to achieve this recovery, the practices of professionals must also change. However, in our setting, there are limited data on the implementation of practices based on the recovery model and their effect on personal recovery. Objective: To describe the association between professionals’ practices and patients’ personal recovery. Methods: An observational and cross-sectional study in which the Recovery Self-Assessment (RSA) was used to assess the degree of implementation of the different practices and the Recovery Assessment Scale (RAS) was used to assess the personal recovery of 307 patients with severe mental disorders. Results: Patients attended by professionals who followed the recovery model obtained a greater personal recovery (p < 0.001, d = 1.10). The dimension associated with greater recovery was that of working toward life goals. The least implemented dimensions had to do with offering treatment options and patient participation in decision-making. This study was conducted in accordance with STROBE (STrengthening the Reporting of OBservational studies in Epidemiology). Conclusions: Although this is a cross-sectional study that does not allow us to establish causal relationships, it shows that the model with which mental health professionals work is associated with patients’ chances of recovery. We therefore consider that it is important to foster the implementation of practices based on the recovery model within mental health care.

For people with severe mental disorders (SMDs) the COVID-19 pandemic may pose a number of risks. These include the loss of needed care, a higher probability of infection, and the worsening of their mental health. To analyze the pandemic’s impact on care received, relapses, loss of employment, and adherence to preventive guidelines in SMD sufferers, a multicenter retrospective cohort study was carried out comparing 185 patients diagnosed with SMD and 85 with common disorders. The results showed that during lockdown, there was a significant reduction in face-to-face psychotherapeutic, nursing, and occupational therapy interventions. In the same period, telematic interventions were introduced which, although subsequently reduced, now continue to be used to a greater extent than before the pandemic. Employment decreased significantly (13% vs. 9.2%; χ² = 126.228 p < 0.001). The percentage of people with SMD following preventive guidelines was significantly lower for both hand washing (56.2% vs. 75.3%; χ² = 9.360, p = 0.002) and social distancing (47% vs. 63.5; χ² = 6.423 p = 0.011). In conclusion, the COVID-19 pandemic has led to a reduction in the interventions that are needed for the recovery of people with SMDs, together with a significant loss of employment and an increased risk of contagion due to less adherence to preventive guidelines. In the future, appropriate attention to these people’s needs must be guaranteed.

Background: Evidence suggests that different variables associated with the COVID-19 pandemic may increase the risk of relapse in people with Severe Mental Disorders (SMDs). However, no studies have yet looked closely at the different risk factors involved to determine their influence on the worsening of these patients’ illnesses. Objective: To analyze which variables related to the COVID-19 pandemic have increased the risk of relapse in patients with SMDs. Method: A multicenter retrospective cohort study in which data were collected from 270 patients with mental disorders who had been under follow-up in day hospitals during the year 2020. Results: The proportion of full mental health inpatient admissions was significantly higher in those who lost their employment (40.7% vs. 18.1%; p = 0.01), in those who were not receiving psychotherapy interventions (33.9% vs. 16.6%; p = 0.006), and in those who were not receiving occupational therapy (25.7% vs. 13.6%: p = 0.013). Significant associations were detected between urgent mental health consultations, the number of COVID-19 symptoms (B = 0.274; p = 0.02), and the low-income group (1.2424 vs. 0.4583; p = 0.018). Conclusions: COVID-19 symptoms and certain consequences of the pandemic, such as loss of employment, economic hardship, and loss of interventions, have brought about clinical worsening in people with SMDs. Knowledge of these factors is important for health-related decision-making in future outbreaks or pandemics.