High morbidity and mortality risk due to COVID-19 by smoked drug users.

ABSTRACT: In much of the West, including Brazil, drug use has increased since social distancing began due to the pandemic. Use of smoked and modified drugs, and their impacts on health, may contribute to aggravate the pandemic. However, studies on the relationship between use of smoked drug and the new coronavirus are still scarce and have not received enough attention in global health recommendations. This paper aimed to briefly review the relationship between use of smoked drugs and acute respiratory syndrome coronavirus 2 [SARS-CoV-2]. Recent studies also suggest that drug consumption increases the risk of contamination by SARS-CoV-2 and leads to worse prognosis, particularly drugs that affect lung functions. Use of smoked drugs, especially tobacco, is strongly associated with lung diseases that are risk factors for contamination by SARS-CoV-2. It is essential to develop strategies based on specific characteristics of drug users and for mental health professionals to be part of strategic teams. It is also necessary to invest in information campaigns regarding risks and prevention of harm caused by smoked drugs, as well as to design strategies that facilitate access to psychosocial treatment during the pandemic.

Obsessive-compulsive disorder reinforcement during the COVID-19 pandemic

The COVID-19 pandemic is unquestionably impacting on the mental health of the population worldwide. Fear of contamination can both increase levels of stress in healthy individuals and intensify psychiatric symptoms in patients with pre-existing conditions, especially obsessive-compulsive disorder (OCD). During the COVID-19 pandemic, the imminent risk of contamination creates a logical need for self-surveillance and hygiene habits. However, this kind of information can have drastic implications for subjects with OCD, since cognitive distortions and compensatory strategies (cleansing rituals) are no longer irrational or oversized-rather, these ideas become legitimate and socially accepted, generating plausible validation for the intensification of compulsive cleaning rituals. Patients who presented remission of OCD symptoms would be more likely to have a relapse, and subclinical patients may scale up and ultimately be diagnosed with OCD due to the reinforcement of their habits, emotions and thoughts. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Problematic consumption of online pornography during the COVID-19 pandemic: Clinical recommendations

The coronavirus disease (COVID-19) pandemic is one of the greatest contemporary challenges. Feelings of fear and uncertainty triggered by this pandemic have had noxious effects on people's mental health. This seems to have increased during quarantine and there is evidence of an intensification of reward- directed behavior. Nevertheless, there are few studies dealing with pornography consumption during this period. The aim of this manuscript is to contextualize this phenomenon during the pandemic and suggest some clinical recommendations on the matter. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Well-being at work, productivity and coping with stress during the COVID-19 pandemic.

AIMS: This study aims to analyze the mechanisms through which the Covid-19 pandemic impacts on well-being at work and productivity. The secondary objective is to identify stress management strategies in the work environment during the pandemic time. METHODS: This is an integrative review. Phase 1 consisted of a search for 2020 papers regarding mental health, work and the pandemics in free access electronic databases (MEDLINE, SCIELO, Bireme and LILACS). Phase 2 consisted of literature indicated by specialists in occupational psychiatry and positive psychology. These materials were read and critically analyzed. RESULTS: As a result of the literature review, 40 references were included. The articles reviewed were divided in the following categories: articles concerning work relationships in Brazil, articles describing the impact of pandemics on mental health and work, articles focusing on the work of health professionals during pandemics, articles about well-being at work, and papers proposing strategies to improve well-being and productivity and promote mental health. DISCUSSION: The Covid-19 pandemic can cause a significant impact on workers' mental health and productivity. Most professionals face the need to adapt to changes, which can decrease the feeling of well-being. Consequently, strategies to promote well-being and mental health at the work environment should be a priority. CONCLUSION: The work routines were modified after the installation of the Covid-19 pandemic and assessing these changes is essential to maintain workers' mental health. In this way, it is possible to achieve the promotion of general well-being, the reduction of stress, and the post-traumatic growth.

Differential impact in suicide mortality during the COVID-19 pandemic in Brazil.

AIM: To compare the suicide rates observed in Brazil after the onset of the COVID-19 pandemic with the estimated number based on suicide deaths between 2010 and 2020, and to identify sociodemographic variables associated with this outcome. METHODS: An ecological time-series study. Data were obtained from DATASUS, with the structural break of the data set in March 2020. The number of observed suicides and the number of the expected, if there were no COVID-19 pandemic, were analyzed through Bayesian Models of structural time series. RESULTS: There was stability in Brazil's overall incidence of suicides after the beginning COVID-19 pandemic, compared to what would be expected. However, there was a significant increase in death in women (6.9%) and in the elderly (9.1%). The analysis according to the macro-region showed a significant increase in death in the Central West (7.4%), Northeast (5.7%), and Southeast (10%). Stratified analyzes revealed differences according to the group assessed considering particularities such as age, sex, schooling, and skin color. CONCLUSIONS: Despite the general stability in the number of suicides, this occurs heterogeneously among population groups in different regions of Brazil. There is an increase in populations with a history of poor access to health, which may have been more severely impacted by the pandemic.

The next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological study.

BACKGROUND: Studies have reported the worsening of psychiatric symptoms during the COVID-19 pandemic. However, few studies have evaluated the impact on the access to mental health services during COVID-19. Our aim was to analyze temporal trends and prediction of appointments held in Brazil's public health system, to compare the observed and expected number of mental healthcare appointments during the COVID-19 pandemics. METHODS: An ecological time-series study was performed, analyzing mental health appointments before and during the pandemic (from 2016 and 2020) from the Brazilian governmental database. The structural break in the data series was assessed using the Chow test, with the break considered in March 2020. Bayesian structural time-series models were used to estimate current average appointments and the predicted expectation if there was no pandemic. FINDINGS: Compared to the expected, between March and August 2020 about 28% less outpatient appointments in mental health were observed, totaling 471,448 individuals with suspended assistance. Group appointments and psychiatric hospitalizations were also severely impacted by the pandemic (decreased of 68% and 33%, respectively). On the other hand, mental health emergency consultations and home care increased during this period (36% and 52%, respectively). INTERPRETATION: Our findings demonstrate a dramatic change in mental health assistance during the COVID-19 pandemic, which corroborates a recent WHO survey. This phenomenon can aggravate the mental health crisis and generate a parallel pandemic that may last for a longer time than the COVID-19 pandemic. FUNDING: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

Problematic consumption of online pornography during the COVID-19 pandemic: clinical recommendations.

The coronavirus disease (COVID-19) pandemic is one of the greatest contemporary challenges. Feelings of fear and uncertainty triggered by this pandemic have had noxious effects on people's mental health. This seems to have increased during quarantine and there is evidence of an intensification of rewarddirected behavior. Nevertheless, there are few studies dealing with pornography consumption during this period. The aim of this manuscript is to contextualize this phenomenon during the pandemic and suggest some clinical recommendations on the matter.

The hidden stigma of aging and COVID-19: aggravating factors and strategies to mitigate the impact of the pandemic in older adults, a text mining analysis.

OBJECTIVE: To identify factors associated with mental health of older adults during the pandemic and to provide strategies to mitigate their psychosocial impact in the elderly. METHOD: An integrative text mining analysis in Medline was performed to identify studies on the mental health of older adults during the pandemic. Subsequently, statistical topic modeling was performed to identify the most prevalent terms and topics discussed in included studies. RESULTS: A total of 29 studies were retrieved until July 1st 2020, including a majority of letters (12 studies) and commentaries (8 studies). The most frequent terms overall were: loneliness (n = 137), support (n = 132), home (n = 102), suicide (n = 96) and help (n = 94). The most prevalent terms were then divided in five topics: home (33%), suicide (32%), apps (15%), loneliness (12%) and physical activity (9%). Additionally, a section focused on low- and middle-income countries was included. A summary of strategies to mitigate the effects of pandemic in mental health of older adults was also provided. CONCLUSION: These factors demonstrate the importance of developing strategies for psychosocial support that take into consideration the particularities of the elderly. Different levels of care are immediately necessary to diminish the devastating impact of the pandemic in the mental health of older adults.

The Sum of Fears in Cancer Patients Inside the Context of the COVID-19.

The pandemic resulting from COVID-19 has led to the collapse of the health system in dozens of countries. Parallel to clinical risk, the appearance or intensification of psychiatric symptoms has also been documented. The identification of groups at risk is essential for the establishment of preventive and therapeutic strategies. Cancer patients appear to be especially vulnerable both from a clinical and psychiatric perspective. Problems related to contamination and the cancer treatments themselves are intertwined, causing a sum of patients' fears to arise, which can cause mental effects. This study aims to review and investigate the impact of COVID-19 on the mental health of cancer patients and indicate possible support strategies.

Clinical vulnerability for severity and mortality by COVID-19 among users of alcohol and other substances.

The COVID-19 pandemic is a public health emergency. Individuals with substance use disorder have a higher risk of infection and may suffer from more severe forms of the disease. Our goal is to investigate the prevalence of risk factors for COVID-19 severity in individuals with different substance use and explore whether specific types of substance are potentially associated with more clinical risk factors which could increase morbimortality in this population. The sample included 821 men hospitalized at an inpatient Addiction unit (305 alcohol users, 233 cocaine/crack users, and 283 multiusers). Data were collected using the Addiction Severity Index version 6. The most prevalent risk factors for COVID-19 severity observed in our sample were: smoking (82.5%), arterial hypertension (26.6%), respiratory problems (23.4%), and history of homelessness (25.1%). Arterial hypertension and cirrhosis occurred more frequently among alcohol users. Multiusers lived in the streets longer and had a higher prevalence of HIV than alcohol users. Overall, 28% of the sample had three or more risk factors. The frequency of risk factors was high and this scenario suggests that these individuals could be more susceptible to worse COVID-19 prognosis. Therefore, prevention strategies directed at specific characteristics of substance users merit attention during the pandemic.

Multiple clinical risks for cannabis users during the COVID-19 pandemic.

The pandemic caused by Sars-CoV-2 (COVID-19) has been a great concern for public and mental health systems worldwide. The identification of risk groups is essential for the establishment of preventive and therapeutic strategies, as for substance users. During COVID-19 pandemic, there was an increase in the use of psychoactive substances during the lockdown, including cannabis. This commentary reviews relevant findings and discusses scientific evidence on the risks of worse clinical and psychiatric complications due to coronavirus disease COVID-19 in subjects who use cannabis. Although they are not included as a risk group in the health recommendations for that disease, they may have a more vulnerable respiratory system to viral diseases. There are certain similarities between the harmful cardiovascular and respiratory effects of cannabis use and those of smoking. Due to the different modes of smoking, cannabis chemicals are retained in the body for longe and may also contain other toxic substances such as tar, a substance found in tobacco and which has been associated with the development of lung cancer, bronchitis and pulmonary emphysema. Therefore, we discuss if individuals who use cannabis regularly might be more vulnerable to COVID-19 infection. This population deserves more clinical attention worldwide and this manuscript can help clinicians become more aware of cannabis risks during pandemics and develop specific intervention strategies.

Obsessive-compulsive disorder reinforcement during the COVID-19 pandemic.

The COVID-19 pandemic is unquestionably impacting on the mental health of the population worldwide. Fear of contamination can both increase levels of stress in healthy individuals and intensify psychiatric symptoms in patients with pre-existing conditions, especially obsessive-compulsive disorder (OCD). During the COVID-19 pandemic, the imminent risk of contamination creates a logical need for self-surveillance and hygiene habits. However, this kind of information can have drastic implications for subjects with OCD, since cognitive distortions and compensatory strategies (cleansing rituals) are no longer irrational or oversized - rather, these ideas become legitimate and socially accepted, generating plausible validation for the intensification of compulsive cleaning rituals. Patients who presented remission of OCD symptoms would be more likely to have a relapse, and subclinical patients may scale up and ultimately be diagnosed with OCD due to the reinforcement of their habits, emotions and thoughts.

The COVID-19 pandemic and its impact on substance use: Implications for prevention and treatment.

The COVID-19 pandemic has brought major challenges to healthcare systems and public health policies globally, as it requires novel treatment and prevention strategies to adapt for the impact of the pandemic. Individuals with substance user disorders (SUD) are at risk population for contamination due to multiple factors-attributable to their clinical, psychological and psychosocial conditions. Moreover, social and economic changes caused by the pandemic, along with the traditional difficulties regarding treatment access and adherence-will certainly worsen during this period, therefore aggravate their condition. In addition, this population are potential vectors of transmission. In that sense, specific strategies for prevention and treatment must be discussed. health care professionals dealing with SUD must be aware of the risks and challenges they will meet during and after the COVID-19 outbreak. Addiction care must be reinforced, instead of postponed, in order to avoid complications of both SUD and COVID-19 and to prevent the transmission of coronavirus.