ADHD in a patient with eating disorder. Case report

Introduction: 15-year-old female referred to outpatient unit after COVID lockdown for binge eating and purging with depressive symptoms and anxiety. Objective(s): To show the importance of a correct diagnosis in an impulsive patient with eating disorder Methods: case report and literature review Results: The patient presents emotional instability with interpersonal difficulties with high fear of rejection. She suffered from fear of gaining weight and desires to lose weight with rejection of her body image. Fluoxetine and lorazepam are started together with low doses of olanzapine. During the follow up she presented a worsening of mood, onset of self-injuries and an episode of suicidal attempt. A biographical examination was performed, expressing a feeling of academic failure with difficulty concentrating and performing simple tasks. As a child she is described as impulsive, with frequent arguments with classmates. CPT III was performed with a high probability of ADHD. Treatment was started with lisdexamfetamine up to 50 mg with good tolerance. From the beginning of the treatment the patient expressed a feeling of improvement in the control of emotions as well as in the management of her impulsivity. There was an improvement in her academic performance with a decrease in self-injury episodes. The patient was able to express improvement in the sense of incapacity she felt. Conclusion(s): This case shows how marked emotional dysregulation and impulsive symptoms improves after diagnosis and subsequent treatment of ADHD, also improving eating symptoms. ADHD is present in eating disorders, especially in those with impulse dyscontrol such as binge eating disorder or bulimia nervosa.

Descriptive Study of an Emotional Support Program for Relatives of Patients Hospitalized with COVID-19 in the Puerta de Hierro Hospital in Madrid

The first wave of the COVID-19 crisis dramatically affected the global population. Madrid was one of the most severely affected regions in Spain. For public health reasons, family visits to hospitalized patients were restricted, preventing relatives from accompanying them. This article details the descriptive study that we carried out on the emotional support program offered to relatives of patients admitted during the first wave at Hospital Puerta de Hierro. A total of 456 relatives (mostly female, usually spouses or sons or daughters of patients) were contacted. Relatives of ICU patients and female relatives required broader levels of support. Increasing the perception of care through an emotional support program can be important for family members. Nevertheless, we consider additional studies to be necessary to explore the specific psychological benefits that these interventions provide.

Descriptive study on psychological first aid for COVID-19 patients’ relatives

IntroductionThe presence of psychological impact on relatives of patients admitted for Covid-19 has been described. The effectiveness of psychological first aid in critical situations has also been described. The first psychological aid describes a human response supporting another person who is suffering. This intervention is indicated for those affected by a traumatic event.ObjectivesTo present a theoretical review about psychological first aid and to describe data about it on relatives of patients admitted for Covid-19.MethodsLiterature review about psychological first aid and data description of telephone intervention carried out by mental health professionals on family members of patients admitted for Covid-19.ResultsFrom an initial pool of 77 Covid-19 patients, 50 were selected as telephone contact with relatives was possible. Mean age was 68.9 years, 13 were female and 37 male. 90% were admitted in internal medicine department and 10% in intensive care unit. First telephone intervention in all cases was to introduce the psychiatrist in charge of the follow-up and provide contact number of psychiatry department. In 13 relatives` support, emotional ventilation and active listening was provided and 2 of them also received therapeutic guidelines. Further phone contact was required in 12 relatives. In follow-up phone calls, all relatives received therapeutic guidelines and 3 was referred to our outpatient clinic.ConclusionsFamily members of patients admitted for covid-19 may present emotional symptoms, many of them normal reactions in context of a crisis situation. A large percentage do not require a structured psychotherapeutic intervention but can benefit from a first psychological help.DisclosureNo significant relationships.

Effects of the pandemic on the mental health of children and adolescents. review and current scientific evidence of the SARS-COV2 pandemic

IntroductionThe coronavirus crisis has had an impact on the mental health of children and adolescentsObjectivesDetermine how it has affected this population and what mental pathologies are occurringMethodsLiterature bibliographic reviewResultsSchool closures and lockdown have been seen to have produced higher levels of anxiety, anger, and sleep and appetite disruption. On the one hand, the children had more anxiety and regressive behaviors, and the adolescents had more isolation, depressive symptoms and even autolytic ideation. The economic crisis and lockdown have affected the family environment, having reported greater situations of domestic violence and substance use among parents. Studies show a prevalence up to 28-34% of post-traumatic stress symptoms among adolescents. In Spain it has been determined that ¼ children present anxiety and / or depression. Their parents noticed in them greater irritability, less concentration and greater feelings of loneliness There has been an increase in addiction to new technologies. This is partly a method of maintaining social relationships, but prolonged use is associated with higher levels of anxiety and depression. Regarding to patients with mental pathology, they have presented greater tantrums, especially ADHD and ASD, due to the loss of structure and routine.ConclusionsConfinement and fear of COVID have affected mental health of children and adolescents, with anxiety and depression occurring more frequently. Is highlighted the presence of feelings of loneliness among adolescents and the increase in the use of screens. Finally close to 80% of patients who had mental health conditions referred that this crisis had worsed their symtponms