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1.
Asian J Psychiatr ; 75: 103207, 2022 09.
Article in English | MEDLINE | ID: covidwho-2014783
2.
Journal of neurosciences in rural practice ; 13(2):236-245, 2022.
Article in English | EuropePMC | ID: covidwho-1888153

ABSTRACT

Background  The literature on presence of cognitive deficits in patients recovered from coronavirus disease 2019 (COVID-19) infection is emerging. However, the data on whether cognitive deficits have its onset during the acute phase of illness has not been evaluated extensively. Aim  This article estimates the level of cognitive functioning of patients with COVID-19 while they were admitted to COVID-designated wards. Secondary objectives were to assess the influence of medical comorbidities, severity of COVID-19 infection, and depressive and anxiety symptoms on cognitive functioning in patients with COVID-19 infection. Methods  Sixty-six clinically stable patients with COVID-19 infection were evaluated during their inpatient stay on Hindi Montreal Cognitive Assessment scale (H-MoCA), Hindi Mini-Mental State Examination (HMSE) scale, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Questionnaire -7. Results  The mean age of the study participants was 39.85 (standard deviation [SD] 16.89) years and the participants were evaluated after 9.34 (SD 4.98;median 9.0) days of being diagnosed with COVID-19 infection. About one-fourth (28.8%;n  = 19) of the participants had cognitive impairment on HMSE and about two-fifths ( n  = 26;39.39%) had cognitive impairment as per the cutoff used for H-MoCA. A higher level of cognitive deficits were seen among participants who were older, diagnosed with diabetes mellitus, and those who required oxygen support during their hospital stay prior to assessment. Conclusion  Low cognitive score was found in one-fourth (28.8%) to two-fifths (39.9%) of the persons, depending on the assessment scale among those with acute COVID-19 infection. Low cognitive score was more prevalent among the elderly, those with diabetes mellitus, and those who required oxygen support prior to the assessment.

3.
Indian journal of psychiatry ; 64(Suppl 3):S556-S556, 2022.
Article in English | EuropePMC | ID: covidwho-1871596

ABSTRACT

Background: The COVID-19 pandemic has led to expansion of telepsychiatry services and formulation of telemedicine guidelines. However, the telemedicine guidelines are not very clear about psychiatric emergencies, such as suicidal behaviour, resulting in psychiatrists facing dilemma about handling such situations. Aim: To evaluate the prevalence of suicidal behaviour in new patients presenting to the Telepsychiatry services in a Tertiary Care centre and how patients with suicidal behaviour were handled during the initial consultation. Methods: All new adult patients (aged >18 years) registered with telepsychiatry services during 19th July to 20th of Sept 2021 were assessed for suicidal behaviour, in the form of death wishes, suicidal ideations, plans, attempts (lifetime/recent) and non-suicidal self-injurious behaviour (NSSI) (lifetime/recent). Results: The study included 1065 adult patients (aged≥18 years). In terms of suicidal behaviour, in the last few weeks prior to assessment 14.4% ofthe patients had death wishes, 2.4% had thoughts of killing themselves, 0.9% had attempted suicide in the lifetime and 0.6% in thelast few weeks, 1.1% had active suicidal ideations at the time of assessment, 0.6% had active suicidal plan, 1.3% had history of non-suicidal self-injurious behaviour (NSSI) in the lifetime and0.5% had NSSI behaviour in the last few weeks. Based on the suicidality, 1% of thepatients were asked to report to the emergency immediately, 1.4% were given an appointment within 72 hours for follow-up and 3.6% were explained high risk management. Conclusions: Suicidal behaviour, especially active suicidal ideations and suicidal plan is not very prevalent in patients seeking telepsychiatry consultation.

4.
Indian journal of psychiatry ; 64(Suppl 3):S528-S528, 2022.
Article in English | EuropePMC | ID: covidwho-1871437

ABSTRACT

Background: During the Covid-19 pandemic, telepsychiatry has become normalised in multiple institutes across India as the primary method of care delivery. However, not much evidence is available regarding the experience of a tele-psychiatry consultation for both the care-providing clinician as well as the recipient. Objective: This study aims to assess the experience and satisfaction of the clinician and the patients/their caregiver during a telepsychiatry consultation. Methods: Clinicians scored their experience of providing the consultation to patients over a call(video/audio) in a detailed Google form based questionnaire on a 6 point Likert scale, ranging from very dissatisfied to very satisfied. Patient’s sociodemographic details were collected in a standard manner. Patients were sent a modified version of the Google form questionnaire on their registered mobile number to report their degree of satisfaction, after the call ended. Results: 371 consecutive teleconsultations between April to June 2021 were assessed by 3 clinicians, of which 132 patients/caregivers responded back. The patients had a mean age of 43.5 years, were mostly male, married, educated beyond matric, employed and belonged to urban nuclear families. The average distance of their location from the hospital was 178 km and more than 80% of the patients were accompanied by their relatives in the teleconsultation. 53.6% of the consultations did not face any technological problems, while 24% had connectivity issues from the patient side. Overall, ~66.8% clinicians and 62% of the patients reported being satisfied to a large extent. 66% of the clinicians felt teleconsultation experience was same as an in-person consultation. Conclusions: Teleconsultation in psychiatric patients might not be as difficult as intuitively thought and needs to be explored further as an opportunity to reach out to a larger population, beyond the urban educated sociodemographic group who are the primary beneficiaries in the current scenario.

5.
Asian J Psychiatr ; 74: 103152, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1821103

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to expansion of telepsychiatry services and formulation of telemedicine guidelines. However, the telemedicine guidelines are not very clear about psychiatric emergencies, such as suicidal behaviour, resulting in psychiatrists facing dilemma about handling such situations. AIM: To evaluate the prevalence of suicidal behaviour in new patients presenting to the Telepsychiatry services in a Tertiary Care centre. METHODS: 1065 new adult patients (aged > 18 years) registered with telepsychiatry services were assessed for suicidal behaviour, in the form of death wishes, suicidal ideations, plans, attempts (lifetime/recent) and non-suicidal self-injurious behaviour (NSSI) (lifetime/recent). RESULTS: In terms of suicidal behaviour, in the last few weeks prior to assessment 14.4% of the patients had death wishes, 2.4% had thoughts of killing themselves, 0.9% had attempted suicide in the lifetime and 0.6% in the last few weeks, 1.1% had active suicidal ideations at the time of assessment, 0.6% had active suicidal plan, 1.3% had history of NSSI in the lifetime and 0.5% had NSSI behaviour in the last few weeks. Based on the current suicidal behaviour, 1.3% of the patients were asked to report to the emergency immediately, 0.5% were given an appointment within 72 h for follow-up, and 14.4% were explained high risk management. CONCLUSIONS: Overall prevalence of suicidal behavior is relatively low in new patients seeking psychiatric help through telepsychiatry services.


Subject(s)
Mental Disorders , Mental Health Services , Suicidal Ideation , Telemedicine , Adult , COVID-19/epidemiology , Humans , Mental Disorders/therapy , Mental Health Services/organization & administration , Pandemics , Telemedicine/organization & administration , Tertiary Care Centers
6.
Indian J Psychiatry ; 64(Suppl 2): S499-S508, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1776460
7.
Indian J Psychiatry ; 64(1): 93-97, 2022.
Article in English | MEDLINE | ID: covidwho-1766052

ABSTRACT

Context: Telepsychiatry is being practiced in India for many years but was formalized only in 2020. It has many advantages and disadvantages. Aims: This study aimed to understand the perceived advantages and disadvantages of telepsychiatry practices in India. Settings and Design: An online survey with ethics approval by the Indian Psychiatric Society (IPS) Ethics Review Board. All psychiatrists who are members of the IPS and whose email address was available with the society were sent the survey link by email. Methodology: Information about existing telepsychiatry consultation practices in India and perception of advantages and disadvantages by the practitioners were collected between June and July 2020. Statistical Analysis: Frequency, percentages, mean, and standard deviation were calculated. Results: Responses by 340 responders were analyzed. Majority of the responders felt that telepsychiatry would provide easy accessibility to mental health services (n = 283, 83.24%) and would lead to less exposure to infections (n = 222, 65.29%). Half of the responders (n = 177, 52.06%) felt that there would be an increased doctor shopping resulting in poor care and nearly three-fourth (n = 245, 72.06%) felt that mental health professionals would fall into a problem while dealing with a suicidal or a homicidal patient. Some expressed that the inability to do physical and central nervous system examinations could lead to missing out comorbidities. About one-third (n = 117, 36.56%) felt that the patient recording the consultation would be a legal issue. Conclusions: This online survey showed that psychiatrists perceive many advantages and some disadvantages in practicing telepsychiatry.

8.
J Neurosci Rural Pract ; 13(2): 236-245, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1747129

ABSTRACT

Background The literature on presence of cognitive deficits in patients recovered from coronavirus disease 2019 (COVID-19) infection is emerging. However, the data on whether cognitive deficits have its onset during the acute phase of illness has not been evaluated extensively. Aim This article estimates the level of cognitive functioning of patients with COVID-19 while they were admitted to COVID-designated wards. Secondary objectives were to assess the influence of medical comorbidities, severity of COVID-19 infection, and depressive and anxiety symptoms on cognitive functioning in patients with COVID-19 infection. Methods Sixty-six clinically stable patients with COVID-19 infection were evaluated during their inpatient stay on Hindi Montreal Cognitive Assessment scale (H-MoCA), Hindi Mini-Mental State Examination (HMSE) scale, Patient Health Questionnaire-9, and Generalized Anxiety Disorder Questionnaire -7. Results The mean age of the study participants was 39.85 (standard deviation [SD] 16.89) years and the participants were evaluated after 9.34 (SD 4.98; median 9.0) days of being diagnosed with COVID-19 infection. About one-fourth (28.8%; n = 19) of the participants had cognitive impairment on HMSE and about two-fifths ( n = 26; 39.39%) had cognitive impairment as per the cutoff used for H-MoCA. A higher level of cognitive deficits were seen among participants who were older, diagnosed with diabetes mellitus, and those who required oxygen support during their hospital stay prior to assessment. Conclusion Low cognitive score was found in one-fourth (28.8%) to two-fifths (39.9%) of the persons, depending on the assessment scale among those with acute COVID-19 infection. Low cognitive score was more prevalent among the elderly, those with diabetes mellitus, and those who required oxygen support prior to the assessment.

9.
Indian J Crit Care Med ; 26(2): 174-178, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1675046

ABSTRACT

Background: The coronavirus disease-2019 (COVID-19) pandemic has led to a significant disruption in healthcare delivery and poses a unique long-term stressor among frontline nurses. Hence, the investigators planned to explore the adverse mental health outcomes and the resilience of frontline nurses caring for COVID-19 patients admitted in intensive care units (ICUs). Materials and methods: A cross-sectional online survey using Google form consisted of questionnaires on perceived stress scale (PSS-10), generalized anxiety disorder scale (GAD-7), Fear Scale for Healthcare Professionals regarding the COVID-19 pandemic, insomnia severity index, and the Connor-Davidson Resilience Scale-10 (CD-RISC) were administered among the nurses working in COVID ICUs of a tertiary care center in North India. Results: A considerable number of subjects in the study reported symptoms of distress (68.5%), anxiety (54.7%), fear (44%), and insomnia (31%). Resilience among the frontline nurses demonstrated a moderate to a high level with a mean percentage score of 77.5 (31.23 ± 4.68). A negative correlation was found between resilience and adverse mental outcomes; hence, resilience is a reliable tool to mitigate the adverse psychological consequences of the COVID-19 pandemic. Conclusion: Emphasizing the well-being of the nurses caring for critical COVID-19 patients during the pandemic is necessary to enable them to provide high-quality nursing care. How to cite this article: Jose S, Cyriac MC, Dhandapani M, Mehra A, Sharma N. Mental Health Outcomes of Perceived Stress, Anxiety, Fear and Insomnia, and the Resilience among Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Indian J Crit Care Med 2022;26(2):174-178.

11.
Prim Care Companion CNS Disord ; 23(6)2021 Dec 02.
Article in English | MEDLINE | ID: covidwho-1551702

ABSTRACT

Objective: To evaluate the demographic and clinical profiles of patients admitted to the psychiatry ward during the coronavirus disease 2019 (COVID-19) pandemic and compare with profiles of patients admitted 1 year before the onset of the pandemic (ie, before the lockdown announcement in India). An additional objective was to evaluate the incidence of COVID-19 infection in the psychiatry inpatient unit and discuss the measures taken to run the unit during the pandemic, including the measures taken if any patient or staff member was detected to have COVID-19 infection.Methods: This retrospective study was conducted in a tertiary care hospital in North India. Data of patients admitted to the inpatient unit from March 24, 2019, to March 23, 2020, were compared with data from March 24, 2020, to March 23, 2021. The data were extracted from the inpatient registry.Results: Compared to the pre-pandemic period, fewer patients were admitted during the pandemic, and the patients admitted had more severe illness. During the ongoing pandemic, the incidence of COVID-19 infection among the residents was 5%, nursing staff was 4.7%, and support staff was 6.66%. The incidence rate of COVID-19 among the patients was 3.2%. Patients were not found to be the primary source of infection; on the other hand, COVID-positive status among the health care professionals was responsible for patients becoming infected.Conclusions: During the ongoing COVID-19 pandemic, psychiatry inpatient facility can be managed with reduced capacity and by following COVD-19 protocol.


Subject(s)
COVID-19 , Psychiatry , Communicable Disease Control , Humans , Inpatients , Pandemics , Retrospective Studies , SARS-CoV-2
12.
Brain Behav Immun Health ; 18: 100345, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1427574

ABSTRACT

There is a sudden upsurge in the use of steroids due to the ongoing COVID-19 pandemic, especially in patients with severe or critical COVID-19 infection. There are reports of excessive use of steroids, both in terms of use in patients who do not require the same and use in doses higher than the recommended. There are reports of the emergence of different adverse outcomes of excessive steroid use in the form of diabetes mellitus and a higher incidence of mucormycosis. However, little attention has been paid to the mental health impact of the use of steroids. This review attempts to evaluate the existing data in terms of incidence of psychiatric side effects of steroids, and the risk factors for steroid associated psychiatric manifestations. Additionally, an attempt is made to discuss the pathogenesis of steroid-associated psychiatric side effects and why it is likely that the incidence of psychiatric side effects may be more in patients with COVID-19 infection. There is a need to improve the awareness about the psychiatric side effects of steroids, both among the physicians and mental health professionals, as in any patient presenting with new-onset psychiatric symptoms while having COVID-19 infection or during the post-COVID-19 infection phase, a possibility of steroid associated side effect needs to be considered.

13.
Asian J Psychiatr ; 64: 102815, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1363856

ABSTRACT

BACKGROUND: Few studies have highlighted multiple psychosocial and physical outcomes in patients with COVID-19 infection after recovery. However, the data from developing countries is limited. AIM: To evaluate psychological morbidity, post-traumatic stress disorder (PTSD), fatigue, and perceived stigma among patients with COVID-19 after recovery from the acute phase of COVID-19 infection. METHODS: In a cross-sectional online survey, 206 adult patients (age>18 years), recovered from COVID-19 infection completed the Patient Health Questionnaire-4 (PHQ-4), the Impact of Events Scale-Revised (IES-R), Fatigue Severity Scale (FSS), 4 items self-designed questionnaire evaluating cognitive deficits and self-designed questionnaire to evaluate perceived stigma. Additionally, they completed the information about demographic and clinical information. RESULTS: The prevalence of anxiety, depressive symptoms, and PTSD in the study sample was 24.8 %, 23.8 %, and 30 % respectively. About three-fifths of the participants (61.2 %) had at least one fatigue symptom as per the FSS with the mean FSS score being 32.10 ± 15.28. About one-fourth of the participants (23.7 %) reported "feeling confused and always feeling mentally foggy", and 38 % of patients reported experiencing at least one cognitive problem. The level of felt stigma related to self was seen in 31.1 %, 20 % reported stigma related to family, and 50 % reported stigma in relation to neighbors and society. Those reporting higher PTSD scores had higher anxiety and depressive scores, reported more fatigue and stigma, and had a higher level of cognitive deficits. A higher fatigue score was also associated with higher anxiety, depression, and cognitive deficits. CONCLUSIONS: Our study reveals that a significant proportion of patients after recovery from COVID-19 experience psychological morbidities, fatigue, cognitive problems, and stigma. Efforts should be made to take care of these issues in routine post-COVID follow-up care.


Subject(s)
COVID-19 , Adolescent , Adult , Anxiety , Cognition , Cross-Sectional Studies , Depression/epidemiology , Fatigue/epidemiology , Humans , Prevalence , SARS-CoV-2 , Self Report
17.
Journal of Indian Association for Child & Adolescent Mental Health ; 17(3):127-142, 2021.
Article in English | Academic Search Complete | ID: covidwho-1292395

ABSTRACT

Aim: To assess the impact of online classes (started in view of COVID-19 pandemic) on the physical and psycho-behavioural parameters of children as perceived by their parents. Methodology: A cross-sectional web-based survey was carried out among the parents of children attending the online classes due to the ongoing pandemic. Results: 289 parents (either mother/father, or any other relative;67.8% - mothers) responded to the survey. The majority of the responders perceived online classes to be less comfortable, less satisfactory;and reported that their children had poor attention and concentration, had a lower level of learning in the theoretical and practical aspect of the subject. Most parents reported their child gets distracted and engages in surfing the internet or participating in online competitions. About half of the parents reported an increase in irritability (45.0%), the increased demand to go to school (45.0%), and a reduction in self-hygiene/care (43.3%). The other common behavioural problems as reported were stubbornness (36.3%), demanding behaviour (30.0%), tantrums (27.3%), and manipulativeness (27.0%). Conclusion: These preliminary findings suggest that the level of learning with in-person school-based classes is far superior to the online classes. The online classes might have a negative impact on the behaviour and physical health of the children. [ABSTRACT FROM AUTHOR] Copyright of Journal of Indian Association for Child & Adolescent Mental Health is the property of Indian Association for Child & Adolescent Mental Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

18.
Indian J Psychiatry ; 63(3): 222-227, 2021.
Article in English | MEDLINE | ID: covidwho-1296031

ABSTRACT

BACKGROUND: Little information is available from India about the psychological impact of COVID-19 on helath-care workers. AIM: The current study aimed to evaluate the psychological issues among the health-care workers (HCW) during the COVID-19 pandemic. MATERIALS AND METHODS: An online survey using Survey Monkey® platform was carried out to evaluate depression (using Patient Health Questionnaire-9), anxiety (using Generalized Anxiety Disorder Questionnaire-7), and other psychological issues (using a self-designed questionnaire). RESULTS: The study sample comprised 303 participants with a mean age of 41.2 (standard deviation: 11.1) years. A majority of them were male (69%) and married (79.9%). Nearly half (46.2%) of the participants had either anxiety disorder or depression or both and 12.9% of HCW had suicidal behavior. Higher level of anxiety and depression scores were associated with being female, having undergone quarantine, directly involved in the care of COVID-19 patients, and younger age (<30 years). Higher prevalence of depression and anxiety disorder was seen in younger (<30 years) age group, being a doctor (compared to paramedics). In addition, higher prevalence of depression was seen in those who were directly involved in the care of patients with COVID-19 infection. CONCLUSION: About half of the HCWs are suffering from psychiatric morbidity, specifically anxiety, in the wake of the COVID-19 pandemic. There is a need to assess all the HCWs for psychiatric morbidity and provide them with psychological support.

20.
Indian J Psychiatry ; 63(2): 134-141, 2021.
Article in English | MEDLINE | ID: covidwho-1210071

ABSTRACT

AIM: This study aimed to evaluate the impact of lockdown on sexual functioning in India. In addition, impact of lockdown on relationship with the partner and mental health was evaluated. MATERIALS AND METHODS: An online survey was conducted using changes in sexual functioning questionnaire, Patient Health Questionnaire-4, and a self-designed questionnaire. RESULTS: The mean age of the participants was 41.5 (standard deviation: 11.2; range: 22-77; median: 39.5) years, with the majority being males 385 (85.6%). The participants reported that lockdown led to reduction in the frequency of sexual intercourse and also touching the partner (fondling, caressing, touching, or kissing) when not indulging in sexual intercourse. Majority of the participants reported improvement in the overall relationship, communication with the partner, and interpersonal conflicts. About two-fifths of the participants reported engaging in sexual intercourse more than twice a week or more. About one-fifth screened positive for psychiatric morbidity, with 14.2% screened positive for anxiety, 14.8% screened positive for depression and 8.7% screened positive for both. In both genders, presence of depression and anxiety were associated with lower sexual functioning in all the domains. CONCLUSION: Lockdown led to a reduction in the frequency of sexual intercourse, and reduction in the frequency of intimacy in the form of fondling, caressing, touching, or kissing partner when not doing sexual intercourse. However, lockdown led to the improvement in overall relationship and communication with the partners and a reduction in interpersonal conflicts.

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