Learning from telepsychiatry during COVID-19 pandemic in India: Boon for public mental health in low- & middle-income countries.

Novel coronavirus disease (COVID-19) pandemic has affected the mental well-being of the population and posed many challenges in availing mental healthcare. Telepsychiatry has been proven to be an effective route for the delivery of mental healthcare. We share our experience of using the telemedicine approach in providing mental health services at a tertiarycare hospital in India during the COVID-19 pandemic, following the break in routine outpatient services during the national lockdown. The telepsychiatry approach helped in ensuring the maintenance of mental healthcare. The utility of telepsychiatry as an option for such future situations and for its use in routine follow up care in indicated cases, have also been discussed.

Is it a challenging task to work with personal protective equipment in a COVID-19 ICU: Findings from a hospital-based cross-sectional study from north India.

Introduction: Amidst the coronavirus disease 2019 (COVID-19) pandemic, the use of personal protective equipment (PPE) is mandatory for healthcare workers to remain protected against infection. The present study was undertaken to evaluate challenges faced by the healthcare workers while using level 3 PPE. Methods: This hospital-based study was conducted among resident doctors selected by convenience sampling method using a pretested, semi-structured, self-administered questionnaire after getting informed consent from the participants to collect data on the somatic, psychological, and technical problems faced while working in PPE. Bivariate and multivariable logistic regression was done between outcome variables and other independent variables to check for the association. Results: Of the total, 252 resident doctors completed the survey, their age ranged from 22 to 36 years with 140 (55.6%) males and 112 (44.4%) females. One-twenty-nine (51.2%) residents were trained to work in ICU, 73 (29%) participants used PPE ≤10 times and the rest 179 (71%) used PPE more than 10 times. The difficulties faced were as follows: visual impairment (n = 244, 96.8%), headache (n = 226, 89.6%), breathing difficulty (n = 216, 85.7%), hearing impairment (n = 201, 79.8%), sweating (n = 242, 96%), and fear of being infected (n = 156,61.9%). Two-thirty-six (93.6%) participants felt that overall work quality reduced due to PPE. Headache, hunger, urge to micturate, anxiety, sleep disturbances, and need to change the timing of medication or diet were higher with increased duration of work with PPE. Conclusion: A longer duration of work is associated with headache, hunger, anxiety, and sleep disturbances. More research has to be done to improve the PPE to reduce problems like visual impairment, skin irritation, sweating, and breathing difficulty.

Impact of 1918 influenza pandemic on mental asylums in India: An analysis of asylum reports

Introduction: Not much is known about impact of 1918 Influenza on patients confined inside mental asylums of that period. Aim and Methods: The study aimed to assess impact of Influenza pandemic on mentally ill patients in asylums, based on data extracted from provincial asylum reports (1915–1923) from British India. Results: The asylum population in most provinces was impacted both in terms of direct mortality (1918) as well as all-cause morbidity and mortality (1918;1918–1920). Agra and Oudh lost 9.5% of average daily asylum strength directly due to influenza in 1918. All-cause mortality (1918) was highest for mental asylum/s in provinces of Agra and Oudh (16.83%), Punjab (14.83%), and Bombay (14.4%). Isolated outbreaks continued till 1923. Another peculiar finding was markedly reduced sickness and death rates in 1921–1923 compared to 1915–1917, across asylums of all provinces. Conclusion: Findings point to a significant impact of Influenza pandemic in mental asylums across several provinces, and provide historical insights with implications for the current pandemic.

Screen Time beyond Gaming and Social Media: Excessive and Problematic Use of Over the Top (OTT) Platforms among College Students during COVID-19 Pandemic.

There is a gap in existing literature regarding Over the Top (OTT) platform use contributing to the excessive and problematic screen time. We aimed to assess OTT platform use among college students and its associations with increased screen time, mental well-being, COVID-19 related anxiety and personality traits. A total of 1039 students from a college in India were invited to participate in this web-based survey. A majority of participants used OTT platforms regularly. Subscription to paid OTT platforms, poor mental well-being were associated with problematic OTT use; whereas personality trait of conscientiousness seemed to offer protection against problematic OTT use.

Top 100 cited articles in one year of COVID-19 research - A bibliometric analysis.

BACKGROUND: Coronavirus disease (COVID-19)-related scientific publications have increased exponentially during the present pandemic but their influence on biomedical literature is not known. The characteristics of highly cited articles help us to identify important advances and their scientific impact. OBJECTIVES: In the present study, we have identified and analyzed the top 100 most highly-cited articles of COVID-19 research published in the year 2020. METHODS: A cross-sectional bibliometric analysis was using the search terms "severe acute respiratory syndrome-coronavirus-2," "COVID," "nCoV," "Coronavirus," and "HCoV" querying the Google Scholar database using the program "Publish or Perish." The first 100 English language articles with the maximum number of citations were identified and evaluated in detail. RESULTS: The top 100 COVID-19 articles in 2020 had citations ranging from 1147 to 20,440. The median (interquartile range [IQR]) number of citations was 1970 (1456-2939). The number of authors ranged from 1 to 79 (median 10; IQR 5.25-19). The majority of first authors was from China (58%), followed by the United States of America (16%) and the United Kingdom (7%). The top three journals in terms of the number of published articles (37%) were the New England Journal of Medicine, Journal of the American Medical Association, and The Lancet. Most of the top-cited COVID-19 literature were descriptive studies focusing on epidemiology (48%) and clinical course (60%) of COVID-19. CONCLUSION: Clinical course and epidemiology have been the predominant areas of research interest in COVID-19 in 2020. Citation analysis of COVID-19 literature helps us to map out the most important focus for research in this pandemic and to identify gaps in knowledge which would guide further research.

Treatment Needs and Service Delivery for Patients with Dual Disorders During the COVID-19 Pandemic: Findings From the WADD Survey.

OBJECTIVE: The COVID-19 pandemic has posed a great challenge for the existing health systems. The restrictions imposed across countries on the movement of people and the realignment of health care services in response to the pandemic are likely to negatively affect the health status and delivery of mental health services to persons with dual disorders (PWDD). Methods: An online survey was conducted among mental health professionals involved in providing care to PWDD to better understand the problems encountered and identify potential solutions in providing continued treatment for PWDD during the COVID-19 pandemic. Results: The findings confirmed significant disruption in the delivery of treatment services for PWDD during the COVID-19 pandemic. Dissatisfaction with personal protective equipment, inadequate COVID-19 testing services at treatment facility, and lack of guidelines on providing continued treatment services to PWDD by national authorities or professional bodies were identified as the likely reasons for this disruption. Conclusions: These concerns in turn need to be addressed by the policy-makers, hospital management staff, and other stakeholders. Specifically, there should be a focus on developing and disseminating guidelines to assist mental health professionals in setting-up and providing continued treatment services to PWDD via tele-psychiatry and other novel digital strategies.