bluuebunny/crossref_metadata_2025 huggingface dataset:
Dissociative disorder following preeclampsia: A case report
Authors: Palomo A. Giménez , Imaz M.L. , Pacchiarotti I. , Roca A. , Solé E. , Garcia-Esteve L.
Published: February 2022

Introduction

Preeclampsia is a new-onset hypertension with new-onset proteinuria after 20 weeks gestation. Scarce evidence regarding psychiatric effects of preeclampsia is available.

Objectives

To describe a case of a pregnant 24 year-old patient with a premature cesarean section in context of severe preeclampsia and dissociative symptoms.

Methods

Patient referred to a third-level hospital for cesarean section due to a severe preeclampsia at week 32, in whom magnesium sulfate, labetalol perfusion and betamethasone are started. In the puerperium period only labetalol up to 300 mg/6h is maintained.

Results

Due to the appearance of pulsating headache and photophobia, a computerized tomography is conducted, showing bilateral insular and occipital hypodensity related to vasogenic edema. High blood pressure is maintained (177/121 mmHg) despite antihypertensive treatment. A magnetic resonance imaging and an ophthalmologic exam do not show significant abnormalities and blood pressure is stabilized with treatment. However, the patient refers new-onset auditory imperative hallucinations and suicide thoughts, being referred to our Acute Psychiatric Ward for clinical assessment and intervention. Treatment with risperidone 2 mg is started. The day after her admission, she does not refer psychotic symptoms, explaining depersonalization symptoms in the previous 5 days, seeing herself having to choose a knife to commit suicide. After discharge, she maintains reiterative dreams in which she falls down from a building, not presenting dissociative symptoms during the day.

Conclusions

Further evidence regarding psychiatric effects of preeclampsia is needed in order to study the consequences of edema and pharmacological treatment. Blood pressure and psychiatric symptoms monitoring after preeclampsia should also be considered.

Disclosure

No significant relationships.
Toothache
Authors: Vázquez E. Rodríguez , Meseguer C. Capella , Cerejeira J. Gonçalves , Carrasco I. Santos , Valera G. Guerra , De Llano De La Viuda M. Queipo , Ramírez A. Gonzaga , Adame C. Vallecillo , Aparicio T. Jiménez , Lobo C. De Andrés , Escudero A. Pérez
Published: February 2022

Introduction

Mental retardation (RM) is defined as by a deficient intellectual capacity as well as by alterations of the adaptive capacity that are externalized in two or more functional areas (Personal autonomy, Communication, Orientation in the environment, Work and Free time).

Objectives

Present a patient with a severe behavioural disturbance with an associated intellectual deficit, who remained hospitalized for 2 months and after observing an oral alteration her symptoms improved.

Methods

A descriptive study of a clinical case

Results

54-year-old woman, single. You have a moderate intellectual disability. In January 2019, she began mental health consultations with a diagnosis of adjustment disorder, on treatment with aripiprazole 5 mg/day, mirtazapine 15 mg/day, lorazepam 0.5 mg/day and dipotassium clorazepate 10 mg/day. Went to the emergency room with mutism, hyporesponsiveness and refuse to intake, having lost 25 kg in 6 months. Abdominal and thoracic CT and upper gastrointestinal endoscopy without significant findings. Consultation with otorhinolaryngology, dermatology, traumatology without significant findings. Odontostomatology consultation: Deep cavities are observed, so it is necessary to carry out extractions of the pieces in poor condition. After this intervention, the patient returns to accept oral intake.

Conclusions

People with intellectual disabilities have a wide range of medical problems that in many cases are directly associated with the underlying disease or syndrome and, in others, with poor physical health due to problems in basic self-care skills or the ability to express verbally. Usually, the first manifestation of pain is an alteration in behaviour, which must be taken into account when making a differential diagnosis.

Disclosure

No significant relationships.
Medical consultations for the patients with severe mental illness: An evaluation in psychiatry inpatient service
Authors: Karaman İ.G. Yılmaz , Ağrıdağ E. , Demircan F.
Published: February 2022

Introduction

Patients with severe mental illness die 10-20 younger from general population. In addition to suicide, preventable physical diseases cause most deaths. The mental illness itself and stigma keep the patients from adequate treatment for physical ilnesses.

Objectives

We aimed to investigate medical consultations for inpatients with severe mental illnes.

Methods

We retrospectively evaluated medical records of patients diagnosed by schizophrenia, schizoaffective disorders, bipolar disorder, and depression between 1st Februrary 2018 and 30th January 2020. We excluded routine consultations before electroconvulsive treatment. Local ethichs committee approved the study.

Results

Among total 475 consultations, %41.3 (n=196) was for male, and %58.7 (n=279) was for female patients. Mean age and standart deviation were 48.9 ± 13.9 for male, and 50.1 ± 13.7 for female (p>0.05). Comparing sexes oin terms of primer psychiatric diagnoses, the higher proportion was psychotic disorders for male, and for female it was mood disorders (p<0.05). The most consulted departments with percentage and number were: internal medicine %44.0 (n=209), neurology and neurosurgery %15.2 (n=72), physical medicine and rehabilitation %8.2 (n=39), dermatology %7.8 (n=37), cardiology %6.7 (n=32). We compared the proportions of consulted department between male and female. Male patients were consulted to dermatology more than female, and female patient were consulted to gynecology or urology more than male (p<0.05).

Conclusions

Awareness about physical diseases in paients with severe mental illness between healthcare workers, carries the potential to increase the patients’ quality of life and lifespan. For future interventions the focus should involve healthcare worker in internal medicine and neurology, as well as in psychiatry.

Disclosure

No significant relationships.
When years of many different diagnosis may turn into one – a case of munchausen syndrome
Authors: Lobo M.I. , Amorim A. , Cruz M.D.C.
Published: February 2022

Introduction

The term Munchausen syndrome was first used in 1951 after Baron von Münchhausen, a German nobleman known for his exaggerated storytelling. DSM-5 refers to it as factitious disorder imposed on self: “falsification of physical or psychological signs or symptoms, or induction of injury or disease, (…) in the absence of obvious external rewards”.

Objectives

To report a case of Munchausen syndrome and highlight the impact on its physical and psychiatric approaches.

Methods

Description of a clinical case based on medical records and a brief review on Munchausen syndrome.

Results

A 57-year-old female, with no previous psychiatric history, was evaluated by Psychiatry for complaints of depression with suicidal ideation. She reported family conflicts and a list of medical conditions and surgical interventions. According to the patient she was waiting for a cardiac transplant and said she had type 1 diabetes, myasthenia gravis, hepatic steatoses, dyslipidemia, hyperuricemia, mitral valve prolapse and was submitted to a thymectomy and cervical herniated disc surgery. She was on many different prescription pills. Even though she had blocked the access to her clinical records in other institutions, at our hospital she had multiple admissions to the emergency room, numerous follow-up appointments of different specialties and several allergies documented. She displayed many incoherencies throughout the interview, had a circumstantial speech and exuberant appearance.

Conclusions

Munchausen syndrome remains a challenging diagnosis to physicians. This condition is not only associated with significant morbidity and mortality, but also with unnecessary tests and procedures, iatrogenesis, prolonged hospitalizations and increased health costs.

Disclosure

No significant relationships.
Perceived stress among suspected patients during the COVID-19 outbreak in Tunisia
Authors: Zouari A. , Thabet J. Ben , Guermazi A. , Aloulou J. , Hammami R. , Ayed H. Ben , Sallemi A. , Marrekchi C. , Hdiji S. , Gargouri I. , Kassis M. , Turki M. , Kammoun S. , Masmoudi M.L.
Published: February 2022

Introduction

Widespread outbreaks of infectious disease, such as COVID-19, are associated with psychological distress and symptoms of mental illness especially for patients with suggestive symptoms.

Objectives

Predict the prevalence of perceived stress and study associated factors among patients with suspected COVID-19 infection.

Methods

A cross sectional study was conducted between April and May 2020. Patients consulting the sorting box at the Hedi Chaker Hospital of Sfax and declared suspect to be infected by COVID-19 were invited to participate in our study after given their cosent. Perceived Stress Scale-10 was used to evaluate prevalence of perceived stress.

Results

In total, 149 participants participated. The mean age was 38.8±15.39 years. Medical or surgical history and psychiatric history were identified respectively in 30,2% and 12.1% of participants. Among all respondents, 74.5% took a nasopharyngeal swab to look for COVID-19 and only 6.4% had a positive test. Close contact with someone with a positive COVID-19 infection was found in 8.05%. Several participants (79,2%) expressed fear of transmitting the disease to their family members. The mean of the PSS-10 score was 11.97±9.83. Moderate to severe perceived stress was found in 44.3% of patients. Significantly higher scores were observed among participants with a positive pharyngeal swab for COVID-19 as well as those who perceived worry of transmetting the disease. No significant differences in perceived stress’ scores according to socio-demographic data.

Conclusions

Perceived stress was high among patients with suspected COVID-19 infection. Perceiving worry of transmetting the disease and having a positive pharyngeal swab for COVID-19 were the principal risk factors.

Disclosure

No significant relationships.
Mental health and online learning among medical students during COVID-19 pandemic
Authors: Aljhani S. , Alateeq D. , Alwabili A. , Alamro A.
Published: February 2022

Introduction

Medical students’ well-being is a concern that drawn interest.On March, 2020, WHO declared COVID-19 as a pandemic.Strict isolation measures and closing schools expected to influence the mental health of students.Online education introduced to adjust to new realities.These un-precedented circumstances create significant stress and challenges may lead to unfavorable effects on learning and the overall psychological health of students.

Objectives

To explore the perception of stress and anxiety level among medical students in Saudi Arabia. To determine factors influencing perception of stress and anxiety among medical students in Saudi Arabia. To explore the association between perception of stress, anxiety and on-line learning.

Methods

An online survey will be distributed through students representatives targeting medical students from different levels. The survey will have 4 components: 1) Demographic data that will include: age, gender, level of education and region of residence. 2) Questions concerned the experience of online learning. 3) Perceived stress scale by sheldon cohen. The perceived stress scale (PSS) is a 10-question tool will be used to measure a person’s perception of stress over the past month and scored as low, moderate and high perceived stress. 4)Generalized Anxiety Disorder 7 (GAD-7) which is also a valid tool in detecting anxiety in the last two weeks by 7 items with Likert scale answers which scored as minimal, mild, moderate and severe

Results

Currently under analysis

Conclusions

To be attached later

Disclosure

No significant relationships.
Psychosis secondary to indomethacin. A case report
Authors: González S. Santiago , Sánchez-Lafuente C. Gómez , Rico A. Martinez , Molina J. Hurtado
Published: February 2022

Introduction

Indomethacin, a non-steroidal anti-inflammatory treatment used in various inflammatory diseases, is one of the drugs that has been related to the appearance of psychotic symptoms as a side effect.

Objectives

Point out the importance of knowing the possible psychiatric symptoms that some drugs can cause as a side effect.

Methods

Description of a clinical case and bibliography review.

Results

We present the case of a 71-year-old woman, with no previous mental health history, who is referred by her primary care physician due to the presence of auditory hallucinations and self-referential ideas. As a somatic history, the patient presented Rheumatoid Arthritis under control by rheumatology and acoustic neuroma, under control by neurosurgery. Treatment with Risperidone was started, up to 2 mg, which helped control her symptoms. After an exhaustive study of her situation, the possibility that her symptoms were a side effect of her usual treatment was raised. It was evidenced that the patient had taken a higher dose of Indomethacin than prescribed by the rheumatologist, reason why its daily intake was suspended, and subsequently an improvement and even suppression of symptoms was seen. Later, due to a misunderstanding, the drug was reintroduced, and symptoms appeared again.

Conclusions

The appearance of psychotic symptoms has been related to the intake of various drugs, including Indomethacin. It is essential to carry out a differential diagnosis if psychotic symptoms appear in the subject.

Disclosure

No significant relationships.
Attention deficit hyperactivity disorder (ADHD) & COVID-19: Attention deficit hyperactivity disorder: Consequences of the 1st wave
Authors: Insa I. , Alda J.A.
Published: February 2022

Introduction

In times of pandemic as Covid-19, as in disaster situations, there is an increased risk of Post-Traumatic Stress Disorder, Depression, and Anxiety (Kaufman et al., 1997; Douglas, Douglas, Harrigan, & Douglas, 2009; Guessoum et al., 2020). The measures taken have affected individual freedoms for the benefit of community health by seeking to reduce the spread of the virus, although the side effects can cause profound damage to society, especially in those most vulnerable populations such as children and adolescents with ADHD.

Objectives

This study aims to assess the psychopathological state and possible consequences of the first wave of the Covid-19 pandemic.

Methods

This study is part of the Kids Corona, an institutional research project of the Hospital de Sant Joan de Déu and the Fundació de Sant Joan de Déu to provide a social and research response to the Covid-19 Pandemic. To assess the impact of Covid on children and adolescents with ADHD a cross-sectional study was conducted between 20 and 30 July 2020 with a battery of questionnaires. The Child Behavior Checklist (CBCL), the Sleep Disturbance Scale for Children (SDSC), the Screen for Child Anxiety Related Disorders (SCARED), the Children’s Depression Inventory (CDI) were used.

Results

70% of children and adolescents aged 7 to 12 years with ADHD had sleep disorders, the 54% had anxiety symptoms and 9% had a depressive disorder.

Conclusions

Children and adolescents with ADHD are a vulnerable population to the effects of Covid, with anxiety, depression, and sleep disorders.

Disclosure

No significant relationships.
Differences in psycho-social impact of COVID-19 in albania, india and iran; a cross-section online study
Authors: Dashi E. , Ransing R. , Vahdani B. , Alikaj V.
Published: February 2022

Introduction

After the outbreak of a new coronavirus infection (COVID-19) on 31 December 2019 in Wuhan (China), an increasing amount of information and concerns are impacting global mental health. It is already evident that apart from physical suffering, the direct and indirect psychological and social effects of COVID-19 pandemic are pervasive and could affect mental health now and in the future.

Objectives

The central aim of our study was to investigate the prevalence of common mental disorders in populations during Covid-19 outbreak. The study was done in 3 different countries (Albania, India, Iran) which gave us the opportunity to compare our findings and to have a bigger view of the impact of COVID-19 in individuals.

Methods

A Cross-sectional online survey was done across countries. We used demographic questions and different scales: Corona Anxiety Scale (CAS), The Obsession with COVID-19 Scale (OCS), Insomnia Severity Index (ISI) to evaluate psycho-social impact during covid.

Results

We collected 469 responses in Albania, 442 responses in India and 402 responses in Iran. According to the data we found that symptoms of anxiety related with corona and obsession with corona were higher in Iran compared with the two other countries. Insomnia problems were also more frequent in Iran were only 16,66% of participants reported no insomnia, compared with 42,0% in Albania and 63,12% in India.

Conclusions

The emergence of mental health (MH) problems during a pandemic is extremely common, though difficult to address due to the complexities of pandemics.

Disclosure

No significant relationships.
On phonological verbal fluency. Descriptive study in post-intensive care syndrome patients after COVID-19 infection in a functional rehabilitation unit in Spain. A pilot study
Authors: Maldonado-Belmonte M.J. , Fernández-Jiménez E. , De Pablo-Brühlmann S.
Published: February 2022

Introduction

Post-Intensive Care Syndrome (PICS) is a physical, cognitive, emotional and functional condition resulting from prolonged stays in ICU (Intensive Care Unit). In pathologies with clinical characteristics similar to SARS-CoV-2 pneumonia, most patients showed cognitive deficits after discharge from ICU. Further studies are needed on verbal fluency impairment among PICS patients.

Objectives

To analyse the phonological verbal fluency in patients with PICS after COVID-19 infection in a Functional Rehabilitation Unit in Madrid (Spain) using the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S).

Methods

This study was conducted in the Hospital Central de la Cruz Roja, in Madrid (Spain). A sample of 17 PICS adult patients was included, with age ranging from 56 to 74 years old (mean = 68.35 years; 13 males). Patients were assessed around three weeks after referral from their reference hospital. The Verbal Fluency Test (VFT) of the SCIP-S was used as outcome. Descriptive analyses were conducted (mean and standard deviation) on standardized scores (z) based on age-adjusted general population norms. Significant impairment was set at z < -1.5.

Results

Mean z-score on VFT was -.53 (S.D. = .74) from the total sample, with 11.8% of cases with significant impairment (mean = -1.60; S.D. = .00).

Conclusions

These preliminary results show low probable presence of impairment on phonological verbal fluency among PICS patients after COVID-19 infection, which is in accordance with previous empirical studies. Longitudinal studies, with larger samples, are needed where the premorbid cognitive level is considered.

Disclosure

No significant relationships.
On delayed verbal learning. Descriptive study in post-intensive care syndrome patients after COVID-19 infection in a functional rehabilitation unit in Spain. A pilot study
Authors: Maldonado-Belmonte M.J. , Fernández-Jiménez E. , Vázquez-Sasot A.
Published: February 2022

Introduction

Post-Intensive Care Syndrome (PICS) is a physical, cognitive, emotional and functional condition resulting from prolonged stays in ICU (Intensive Care Unit). In pathologies with clinical characteristics similar to SARS-CoV-2 pneumonia, most patients showed cognitive deficits after discharge from ICU. In particular, earlier studies describe impairment on verbal learning among PICS patients.

Objectives

To analyse the delayed verbal-learning performance in patients with PICS after COVID-19 infection in a Functional Rehabilitation Unit in Madrid (Spain) using the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S).

Methods

This study was conducted in the Hospital Central de la Cruz Roja, in Madrid (Spain). A sample of 17 PICS adult patients was included, with age ranging from 56 to 74 years old (mean = 68.35 years; 13 males). Patients were assessed around three weeks after referral from their reference hospital. The Verbal Learning Test-Delayed (VLT-D) of the SCIP-S was used as outcome. Descriptive analyses were conducted (mean and standard deviation) on standardized scores (z) based on age-adjusted general population norms. Significant impairment was set at z < -1.5.

Results

Mean z-score on VLT-D was -1.02 (S.D. = .96) from the total sample, with 41.2% of cases with significant impairment (mean = -1.97; S.D. = .23).

Conclusions

These preliminary results show the probable presence of mild-moderate impairment on delayed verbal learning in a relevant proportion of patients, which was already observed in PICS patients with other medical conditions. Longitudinal studies, with larger samples, are needed where the premorbid cognitive level is considered.

Disclosure

No significant relationships.
On verbal working memory. Descriptive study in post-intensive care syndrome patients after COVID-19 infection in a functional rehabilitation unit in Spain. A pilot study
Authors: Maldonado-Belmonte M.J. , Fernández-Jiménez E. , Sánchez-Polo M.T.
Published: February 2022

Introduction

Post-Intensive Care Syndrome (PICS) is a physical, cognitive, emotional and functional condition resulting from prolonged stays in ICU (Intensive Care Unit). In pathologies with clinical characteristics similar to SARS-CoV-2 pneumonia, most patients showed cognitive deficits after discharge from ICU. Further studies are needed on verbal working memory among PICS patients.

Objectives

To analyse the verbal working-memory performance among patients with PICS after COVID-19 infection in a Functional Rehabilitation Unit in Madrid (Spain) using the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S).

Methods

This study was conducted in the Hospital Central de la Cruz Roja, in Madrid (Spain). A sample of 17 PICS adult patients was included, with age ranging from 56 to 74 years old (mean = 68.35 years; 13 males). Patients were assessed around three weeks after referral from their reference hospital. The Working Memory Test (WMT) of the SCIP-S was used as outcome. Descriptive analyses were conducted (mean and standard deviation) on standardized scores (z) based on age-adjusted general population norms. Significant impairment was set at z < -1.5.

Results

Mean z-score on WMT was -.64 (S.D. = .60) from the total sample, with 5.9% of cases with significant impairment (mean = -1.53).

Conclusions

These preliminary results show low probable presence of impairment on verbal working memory among PICS patients after COVID-19 infection. Longitudinal studies, with larger samples, are needed where the premorbid cognitive level is considered.

Disclosure

No significant relationships.
Attitudes of preoperative cardiac surgery patients toward COVID-19: A cause for concern
Authors: Nikolaeva O. , Nikolaev E. , Zakharova A. , Maksimova N. , Litvinova E. , Dulina G.
Published: February 2022

Introduction

During the pandemic, many surveys studied people’s attitude to COVID-19. However, less information is available about the peculiarities of such attitude of the most vulnerable groups including chronic somatic patients who are in need of operative treatment.

Objectives

To identify the specificity of preoperative cardiac surgery patients’ attitudes toward COVID-19 as compared to that of healthy people.

Methods

We used the Attitudes towards COVID-19 questionnaire (Nikolaev E.) to survey 60 preoperative cardiac patients and 327 healthy university students. Difference validity was assessed with significance level of p<0.05.

Results

Cardiac patients are more likely to trust the government measures to fight COVID-19 (t=3.131; p=.002), and their COVID-19-related fears for their life are higher (t=2.793; p=.005). As compared to healthy people, patients are less likely to think that pandemic broke their customary way of life (t=-2.793; p=.005) and plans for the future (t=-3.337; p=.000). Credibly more often than healthy people, cardiac surgery patients consider that it is useless to wear a mask and limit contacts, as any person will eventually catch the virus (t=2.401; p=.017). We did not reveal any more evidently expressed COVID-19-related anxiety in preoperative cardiac surgery patients.

Conclusions

Attitudes of cardiac surgery patients toward COVID-19 manifest in an adequate assessment of threat to their personal health, trust in the government measures, and readiness to change their daily plans. It is latent fatalistic ideas about ultimate uselessness of restrictive measures that pose threat to people’s own health and the health of the people around them, which health professionals should remember in their preventive actions.

Disclosure

No significant relationships.
The de Clérambault syndrome: More than just a delusional disorder?
Authors: Fiorillo A.
Published: February 2022

The de Clèrambault syndrome is a psychiatric condition characterized by the presence of a delusion in which the patient is convinced that another person has fallen in love with him or her. Patients usually believe that their lover is a person belonging to a higher social and economic class, or is already married, or even is imaginary or deceased person. In the majority of cases, the patients do not seek for psychiatric help, but usually is referred to the mental health care system due to behavioural consequences associated with the syndrome, including stalking behaviours (repetitive calling, unexpected visits or continuous attempts to send gifts or letters to the loved person). The name of the syndrome derives from the French psychiatrist Gaetan Gatian de Clerambault, who systematically described this syndrome in a series of patients. According to the modern classification systems, the syndrome is conceptualized as erotomanic subtype of the delusional disorder. However, the presence of delusions is not the only clinical feature of the syndrome. In fact, specific affective features are usually present, such as grandiosity, hypersexuality and promiscuity. Therefore, it has been argued that De Clèrambault syndrome should be considered as lying on the continuum of the spectrum of bipolar disorders. Those diagnostic uncertainties highlight the difficulties for clinicians to properly manage this syndrome and should represent a valid reason for rediscovering this almost neglected psychiatric syndrome.

Disclosure

No significant relationships.
The new role of telemedicine in child psychiatry in the period of pandemic caused by spreading of the COVID-19
Authors: Baranskaya L.
Published: February 2022

Introduction

In the period of Covid-19 both adults and children have a great number of the most varied negative social and psychological factors.

Objectives

The study of the necessity of telemedicine technologies for child and teenage psychiatric service.

Methods

During two month, parents of 128 children, aged 3-18, have applied for consultative help to the Department of Psychiatry, Psychotherapy and Narcology of the Ural State Medical University.

Results

In total, the number of consultations has grown by 23% compared to the same period of the previous year. The greatest number was connecting with emotional and behavioral disturbances that usually begin in childhood – 23.0%, neurotic connected with stress and somatoform disorder – 21.1%, and affective disorders –14.1%. The least amount of cases were of children and teenagers with psychiatric diagnoses: disorders of a schizophrenic character – 7% and the mentally retarded – 6.2%. These data points that the limitation of the possibility of receiving a psychiatric consultation in person did not lessen the number of instances when parents of children and teenagers applied for help. On the contrary, this period showed a growth of the number of parents who applied for help, mainly due to the increase in the proportion of anxiety and phobia disturbances, plus behavioral disruptions. At this, the number of neurotic cases connected with stress and somatoform disturbances in children increased by 92.0%, whereas emotional and behavioral disturbances that usually begin in childhood increased by 45.0%.

Conclusions

Thus, telemedicine technologies in child psychiatry have proved to be an effective and necessary means.

Disclosure

No significant relationships.
Protocol to maintain ECT in COVID-19 pandemic
Authors: Martínez-Roig M. , Arilla-Aguilella J. , Arriola-Segura A. , Rolando-Martinez R.
Published: February 2022

Introduction

Electroconvulsive therapy is a highly effective treatment for severe psychopharmacological resistant patients but it is also a procedure that involves open airway management and has been considered as an aerosol generating procedure. The COVID-19 pandemic, has resulted in reduction in ECT services internationally. The COVID-19 pandemic has dramatically and rapidly transformed hospitals in heavily affected areas, decreasing mental health services. The need to locate critical patients in spaces intended for anesthesia, where we usually administered ECT, has forced us to decrease the number of procedures and be highly selective. In the same way, continuation and maintenance ECT (m-ECT) have also been dramatically reduced. The risk of contagion urged us to develop a protocol involving other areas of the hospital

Objectives

To create a safe circuit from admission to the hospital to the ECT including emergency room and psychiatric Ward

Methods

Review of the tliterature and published protocols Workshops with Preventive Medicine, Anaesthesia and Emergency Service to elaborate a protocol Submission of the protocol to Management of the Hospital

Results

The protocol (Figure 1) began with the screening for COVID-19 in every patient. If the PCR was (+) the patient was not excluded. We moved treatment from the PACU into the OR and if a patient tested positive It was determined that the ECT was administered in the OR

That was provided with negative pressure. Circuits were established within the Psychiatric Ward and in the areas of the hospital involved to reduce risks and patients remained isolated until negative test was confirmed The number of persons present in the treatment room was kept to the absolute minimum required and appropriate personal protective equipment was used, as prescribed by the WHO

Conclusions

We must keep in mind treating the most vulnerable of our patients. ECT should be seen as an essential medical procedure and made available

Disclosure

No significant relationships.
Social medias in increasing anxiety around COVID-19 in Morocco
Authors: Hanine I. , Chtibi M. , Bensalah Y. , Belbachir S. , Ouanass A.
Published: February 2022

Introduction

Discovered in December 2019, COVID has affected the entire planet, through direct exposure to its virus; SARS-COV-2, or indirectly through the media, Indeed, on January 20, 2020, the World Health Organization declared COVID-19 to be “a public health emergency of international concern.” Along with other public health crises and other collective trauma (terrorism, H1N1 epidemic or SARS-COV), exposure to publicized information on this virus generates psychiatric disorders, in particular anxiety and absence of well-being. Objective: To link exposure to information about this pandemic through social media and anxiety and lack of well-being.

Objectives

Explore the relationship between anxiety, well-being and exposure to social medias

Methods

Use of a questionnaire consisting of three sections, individual status and conditions, the French versions of the GAD-7 scale for anxiety (Generalized anxiety scale of 7items) and the WHO-5 (five well-being index). This questionnaire is dedicated to the general population who have not been in direct contact with the virus, but through the media.

Results

We were able to collect 209 participants, they were essentially females with a mean age of 28yo, 17,7% had psychiatric history of anxiety and depression, the median use of social medias was 5.7 hours per day. And they were essentially getting their information about the pandemic from Instagram, Facebook, the Moroccan ministry of health’s website and electronic newspapers. 31,1% of our participants had anxiety which was above a Chinese study, and had a poor well-being.

Conclusions

The use of social media to get information about the pandemic had an impact on well-being and anxiety.

Disclosure

No significant relationships.
Experiences and perceptions from non-internal medicine clinicians deployed to COVID-19 units
Authors: Tauber J. , Tingley J. , Rabbanifar S. , Bitners A. , Shrivastava A. , Skae C.
Published: February 2022

Introduction

When New York City became an epicenter of the COVID-19 pandemic, healthcare workers from an array of specialties were deployed to work on general medicine units with limited time for clinical retraining.

Objectives

This study assesses the subjective experience and perceived preparedness of a cohort of non-internal medicine clinicians who were deployed to assist with inpatient management of patients with COVID-19 in the Spring of 2020.

Methods

An online survey was distributed to clinicians (residents, fellows, attendings, nurse practitioners, and physician assistants) who cared for patients in roles outside their usual specialties during the pandemic at the Montefiore Health System in the Bronx, NY.

Results

85/169 (50.3%) clinicians responded. 16.5% reported strong feelings of preparedness prior to deployment (≥7/10 Likert scale). ‘Access to appropriate and efficient review materials prior to deployment’ was ranked as 6/10, overall level of stress as 8/10 and concern for contracting COVID-19 while deployed as 8/10. Responses regarding ‘general feelings of preparedness’ had a weak negative association with ‘feelings of frustration about one’s circumstance’ (r= -0.39, p<0.001). Weak negative associations were found between feelings of ‘access to adequate review materials’ and ‘overall stress levels’ (r= -0.31, p<0.001). A moderate positive association was found between ‘feelings of access to adequate review materials’ and ‘feeling on top of one’s work responsibilities’ (r= 0.40, p< 0.001).

Conclusions

The majority of respondents did not feel adequately prepared to care for patients with COVID-19 prior to deployment and had both high stress levels and fear of contracting COVID-19 in the first wave of the pandemic.

Disclosure

No significant relationships.
SARS – CoV 2 imapct’s on menthal health. Case study, psychiatric hospitals “Ali Mihali”, Vlorë
Authors: Shaska E.
Published: February 2022

Introduction

The aim of this paper is to analyse the impact of SARS – CoV 2 on Menthal Health. Based on the studies pacients infected with COVID-19 manifest severe menthal health problems during or after infection.

Objectives

How do different people face the acute phase of SARS-CoV-2 infection? How do menthal health problems influence the disease’s trajectory? What kind of the menthal health disorder occur in people status post Covid?

Methods

We have used a regular, clinical strategy involving adults aged 21-61 years infected with SARS-CoV-2. The research was conducted over the period July-December 2020, in 5 patients (3 males and 2 females) hospitalized in the Psychiatric Hospital “Ali Mihali” Vlora. The assessment on the diagnosis was made conforming to the diagnostic criteria of DSM-5 based on structured clinical interview (information from family, friends, etc.) and examination of mental status

Results

According to the studies SARS CoV2 affects with serious problems the Menthal Health. Some of them are: Sleep disorder. Anxiety disorder. Major Depressive Disorder. Bipolar disorder Psychotic disorder

Conclusions

Patients infected with SARS-CoV-2 must be provided with a family physician psychological evaluation during the acute and post-COVID-19 phase. All individs status post COVID-19 who have lost their daily functioning and pose a risk to themselves and others must be recommended to CMHC for multidisciplinary treatment All COVID hospitals and wards must be equipped with multidisciplinary teams (psychiatrist, psychologist, social worker, mental health nurse) and each clinical record must have current mental status assessment and follow-up in case dynamics.

Disclosure

No significant relationships.
Prodromal services for at-risk youth and their integration with existing programs: A “modular integration” model
Authors: Savic A. , Ostojic D. , Jendricko T. , Brecic P. , Vukojevic J.
Published: February 2022

Prodromal symptoms may precede onset of the psychotic disorders by years, and while we have instruments for identification of clinical high-risk (CHR), existing predictive models yield low specificity and fail in successfuly predicting transition to psychosis. This, along with the fact that we see a notable decline in transition rates, and the ever-looming lack of resources, means CHR work is still often relegated to research settings. First-episode psychosis (FEP) unit of our institution offers both inpatient and outpatient programs, and while it is common having CHR services emerge from FEP frameworks, there is an inherent risk in drowning the diverse CHR population into very specific FEP interventions and settings, risking additional burden of stigma. Model our institution introduced includes: ⇒Non-dependence on research funding; ⇒Flexible integration in available resources (e.g., FEP interventions, anxiety disorders interventions, substance-use programs); ⇒Dimensional approach with interdisciplinary assessment of capacities/needs non-reliant on supposed diagnosis; ⇒Embedded coordinating clinician ensuring “coordination” of CHR population “dispersed” among different programs; ⇒Collaboration with child psychiatrists allowing smoother transfer of at-risk youth; ⇒Recruitment through sensitized general practitioners and counseling services. No model of care, especially in area lacking conclusive predictive models, can be generalized to different health care systems, as practices and resources vary significantly. Nevertheless, the model presented makes a contribution to the care of CHR population, utilizing/integrating available resources, focusing on dimensional formulation of needs, and avoiding possible stigmatization. Furthermore, widely available CHR services, congruent with any research initiatives, might help us reach the necessary critical mass of data and experience needed for the final push towards clearer prediction models and treatment algorithms.

Disclosure

No significant relationships.
Group therapy for health care workers in a general hospital during the COVID-19 pandemic
Authors: De Miguel-Gimeno S. , Martínez-Roig M. , Margolles-Gareta S.
Published: February 2022

Introduction

A considerable percentage of Health Care Workers (HCW) have experienced psychological distress during the COVID-19 pandemic. Data from previous pandemics suggest that HCW might develop psychiatric disorders. Psychosocial and workplace measures can improve mental wellbeing of the MHW. As part of the program of the Hospital to give support to the HCW, five support weekly open dynamic groups have been carried out with HCW from the COVID Areas of our Hospital including the ICU

Objectives

Identify recurrent contents in the group that express areas ofconcern Identify HCW in risk of develop a psuchiatric disorder and refer them to their apropiate level o

Methods

The sessions were carried out in a freely open group and the contents expressed in the sessions were recorded and analyzed ina narrative way. Special attention was given to the the more stresfull activities identified, to Signs of overload and to the ability to seek relief, as well as signs of disruption of personal life outside of work. Four sessions of 90 minutes, with staff of the same area were established and after these four sessions booster sessions was offered through continuity groups to members with need of more long term care as well as individual care.

Results

The recurrent areas identified were Concern about inadequite Personal Protective Equipment Concern about spreading the infection in their own families Need for relief and avoid double turn Uncertainty about the course of the illness Exposure to patients suffering and dying

Conclusions

HCW need nor only psychological support but also pragmatic measures

Disclosure

No significant relationships.
Predictors of the perceived risk of COVID-19 and adherence to confinement guidelines in the context of the COVID-19 pandemic
Authors: Jarego M. , Rodríguez E. , Ciaramella A. , Miró J. , Pais-Ribeiro J.
Published: February 2022

Introduction

Complete adherence to public health guidelines is essential to reduce the spread of COVID-19. Studies on the factors associated with increased/decreased adherence to these measures have the potential to inform public policies directed at increasing adherence, and thus helping to control the spread of the current pandemic.

Objectives

This study aimed at assessing the demographic and psychosocial predictors of the perceived risk of the COVID-19 and adherence to confinement guidelines during the first mandatory lockdown in Portugal.

Methods

A convenience sample of 430 adults living in Portugal between March 19th and May 2nd, 2020 completed an online survey asking participants about the perceived risk of the COVID-19 and adherence to confinement guidelines. Participants also completed a sociodemographic questionnaire and measures of psychological function. Multiple regression analysis was performed.

Results

Teleworking and Risk and COVID-19 controllability were significant predictors of the perceived risk of COVID-19 as measured by the perceived risk of being infected with COVID-19. Teleworking participants and those perceiving COVID-19 as less controllable reported a higher perceived risk of being infected with COVID-19 than those who were not in telework and perceived COVID-19 as a controllable condition. Adherence to confinement guidelines was predicted by the mental health status and perceived risk of COVID-19. Participants who reported worse mental health status, who perceived COVID-19 as a dangerous condition, and who trusted the public health system reported greater adherence to confinement guidelines.

Conclusions

The results of this study will be discussed considering their implications to public health policymaking to promote adherence to public health policies.

Disclosure

No significant relationships.
Neutropenia in patients under treatment with clozapine and COVID-19 infection
Authors: Bonaccorso S. , Ricciardi A. , Ouabbou S. , Theleritis C. , Ross-Michaelides A. , Metastasio A. , Stewart N. , Mohammed M. , Schifano F.
Published: February 2022

Introduction

Clozapine is among the most effective antipsychotics used for treatment resistant schizophrenia. Adverse reactions to clozapine include neutropenia. Case series report that clozapine-treated patients with COVID-19 have no documented neutropenia.

Objectives

We sought to investigate the potential adverse effect of coronavirus disease (COVID-19) in patients taking clozapine.

Methods

We retrospectively inspected data of 13 consecutive patients on clozapine, admitted to Highgate Mental Health Centre -Camden & Islington NHS Foundation Trust between March and June 2020. Selection was based on their COVID-19 symptoms presentation and/or COVID-19 positive test. We used a linear regression model with COVID status as independent variable and absolute neutrophil count (ANC) as dependent variable to inform about a correlation between COVID-19 status and neutrophil count. STATA was used for statistics.

Results

We collected data on thirteen patients of which nine were male. The median age was of 41.97 years; six subjects were Black, three were Asian and four were White Caucasian. Ten subjects tested positive to COVID-19 and 3 were suspected cases -these latter were excluded from stastical analysis. During COVID-19 infection, neutrophils count (ANC) dropped significantly to 4.215 from a baseline value of 5.337. The beta values of 0.83 shows that ANC declined significantly during COVID-19 infection (p =<.0001, R2 = 95%). In three of thirteen patients, ANC drop was significant and changed the patients’ monitoring status from green to amber and required frequent blood tests.

Conclusions

Clinicians should bear in mind that a significant drop in neutrophils count may occur in COVID-19 -infected patients taking clozapine.

Disclosure

No significant relationships.
COVID-19 turned upside down: A psychological perspective
Authors: Gairola V.
Published: February 2022

Introduction

Only little is known about COVID-19 which is now playing its engulfing function in terms of devouring global health, resulting in a crisis that is as novel as the novel Coronavirus strain itself. Both, the structure and function of COVID-19 have been documented and further research is in progress to fill the lacuna. With significant levels of globalization, COVID-19 spreads rapidly around the globe.

Objectives

Masses are hoping for a vaccine as their ultimate object of liberation. People are talking about crashing economy, but what about the crash of humans from their being? Here, a biological, psychological, and psychoanalytic understanding of COVID-19 is investigated. The impact of physical isolation has been documented, but mental isolation remains an uncharted space. The psychological trace—the paleontological psychic trauma of experiencing a pandemic as a witnessing subject is not much talked about. This effort is to open the paths to understanding COVID-19 which may seem pathless at first.

Methods

Primary sources are used along with an intradisciplinary and interdisciplinary unison of psychiatry, psychology, psychoanalysis, yoga, and meditation.

Results

Yoga and meditation for strengthening both physical and psychological immunity along with facilitating the acceptance of psychological impact which is unregistered in the minds of a large population is elucidated.

Conclusions

It is in the interdisciplinary and intradisciplinary unison that preparedness for future pandemics could be curated.

Disclosure

No significant relationships.
The impact of new psychosocial stresssors on the mental health of young people: Results from a national multicentric study in italy
Authors: Sampogna G.
Published: February 2022

The COVID-19 pandemic and its related containment measures, such as lockdown, is affecting mental health of the general population worldwide. This is an unprecedented event, which is influencing the health care, political, economic, and social welfare systems. Among Western countries, Italy has been one of the first severely hit by the pandemic in terms of number of cases and mortality rates. Therefore, on March 8, 2020, the Italian Prime Minister issued restrictive measures in order to limit the spread of the disease. During this period known as “Phase one” of the national health emergency, all not necessary activities have been closed, more than 29,000 people have died and almost 100,000 people have been home-isolated, with strict lockdown measures. The COvid Mental hEalth Trial (COMET) network, including ten university Italian sites and the National Institute of Health, has promoted a national online survey in order to evaluate the impact of lockdown measures on the mental health of the Italian general population. The COMET survey reports data from a large sample of more than 20.000 people from Italian general population, showing that lockdown has had a detrimental impact on mental health, in terms of worsening of anxiety, depressive and stress symptoms. Findings from this study can be useful to inform national and international associations, policy makers and stakeholders on the importance to provide adequate support to the mental health of the general population.

Disclosure

No significant relationships.