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This letter discusses mental health care after the COVID-19 outbreak by presenting preliminary findings from a public general hospital in Madrid. The pandemic caused by the SARS-CoV-2 poses a major challenge for national health systems around the globe. In these situations, healthcare centers are urged to adjust their structures to the demands of the outbreak in order to protect both the users and the workers. However, this emergency has no precedent in the recent history, and entire hospitals and clinics need further adaptations for which there is no previous evidence. This affects mental healthcare teams, which deal with the unknown psychological consequences of an overwhelming, global crisis. La Paz University Hospital is a public general hospital that provides healthcare to a catchment area of more than half a million people in Madrid. So far, more than 2,700 confirmed cases of SARS-CoV-2 have been attended in this hospital, which required a complete restructuring process. A few days after the outbreak, its mental health team managed to develop a COVID-19 intervention protocol that was based on its previous experience during the 2014 Ebola crisis in Madrid and on the reports that were coming from China. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Introduction: Long-term COVID-19 effects has been recently described as persistent and prolonged symptoms after an acute and severe SARS-COV-2 (1). An important concern is that the sequelae of severe COVID-19 may suppose a substantial outpatient's burden for the specialized services in reopening pandemic phase (2). Objective(s): To describe the frequency of mental health service use in COVID-19 hospitalized patients after discharge and to estimate the costs associated to the post- discharge consultations. Method(s): We used a 1-year follow-up cohort of 1455 COVID-19 inpatients hospitalized in La Paz University Hospital of Madrid, Spain between March 16th and April 15th, 2020. Data were retrieved from Psychiatry Service (PS) electronic health records and we described the frequency of mental health reason for consultation. We used information published by the Madrid health Office to estimate the cost of initial and following appointments. Result(s): Our sample consisted of 1,455 patients admitted with a COVID-19 diagnosis between March 16th and April 15th, 2020, and then discharged. Roughly half of them were men (776, 53%), 238 (16%) had a prior history of mental health problems, and 44 (3%) died. 193 participants (13%) visited the mental health department after being discharged. The total cost was estimated in 103,581 USD, of which two-thirds corresponded to patients with prior history of mental health problems. Conclusion(s): Our results indicate that the mental health burden of severe COVID-19 inpatient s after discharge was substantial during the first year of follow-up. This generate important economic impact to mental health providers and society at large.
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Introduction: The use of technological supports in psychotherapeutic interventions has been widespread in recent years. Since the COVID-19 pandemic, the increase has been greater. The feasibility of online group interventions has been proved in previous studies. Research comparing dropout rates in group interventions with clinical population that include mindfulness training is infrequent. Objective(s): To compare the difference in dropout rates between online and face-to-face mindfulness-based group interventions. Method(s): This study was carried out in a Mental Health Unit in Colmenar Viejo (Madrid, Spain). One hundred thirty-five adult patients with anxiety disorders were included in group interventions (74 face-to-face;61 online). The group treatments were Acceptance and Commitment Therapy and a Mindfulness-based Emotional Regulation intervention, during 8 weeks, guided by two Clinical Psychology residents. A descriptive analysis of dropout rates (participants attending 3 or fewer sessions out of the total number of participants starting the intervention) was performed. Result(s): Of the 135 patients included, 8 did not participate in the interventions (5 face-to-face;3 online), which represents a 5.93% rejection rate;6.76% for the face-to-face intervention and 4.92% for the online intervention. Of the remaining sample (127 participants), a total dropout rate of 12.6% was obtained, with 8.69% in the faceto-face intervention versus 17.24% online. Conclusion(s): A higher dropout rate was obtained in online interventions compared to face-to-face, with an increase of almost double. Research on specific factors that may interfere with treatment adherence to online group interventions is needed.
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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. Objective(s): 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). Method(s): 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. Result(s): 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). Conclusion(s): 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.
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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. Objective(s): 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). Method(s): 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. Result(s): 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). Conclusion(s): 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.
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IntroductionPost-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 to explore global cognitive impairment among PICS patients after COVID-19 infection.ObjectivesTo analyse the global cognitive functioning 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).MethodsThis 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 total score 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.ResultsMean total z-score on SCIP-S was -1.08 (S.D. = .82) from the total sample, with 52.9% of cases with significant impairment (mean = -1.74;S.D. = .21).ConclusionsThese preliminary results show the probable presence of mild-moderate global cognitive impairment in a relevant proportion of patients after COVID-19 infection. Longitudinal studies, with larger samples, are needed where the premorbid cognitive level is considered.DisclosureNo significant relationships.
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IntroductionPost-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.ObjectivesTo 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).MethodsThis 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.ResultsMean 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).ConclusionsThese 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.DisclosureNo significant relationships.
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IntroductionPost-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, previous studies describe impairment on verbal learning among PICS patients.ObjectivesTo analyse the immediate 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).MethodsThis 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-Immediate (VLT-I) 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.ResultsMean z-score on VLT-I was -1.08 (S.D. = .80) from the total sample, with 33.3% of cases with significant impairment (mean = -1.81;S.D. = .20).ConclusionsThese preliminary results show the probable presence of mild-moderate impairment on immediate verbal learning in a subgroup 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.DisclosureNo significant relationships.