COVID-19 as a Crisis of Confinement: What We Can Learn From the Lived Experiences of People With Intellectual Disabilities in Care Institutions

While the COVID-19 crisis has affected people all around the world, it has not affected everyone in the same way. Besides glaring international differences, disparities in personal and situational factors have resulted in strikingly dissimilar effects even on people within the same country. Special attention is required in this regard for people with intellectual disabilities (ID) who are vulnerable to marginalization and precarization during crises as concerns over safety and public health are likely to trump consideration for inclusion and care. This article explores the lived experiences during the pandemic of people with ID living in care institutions in the Netherlands. Particular attention is paid to the challenges involved in living through periods of confinement and separation in what may be called "vulnerable spaces.” Drawing from interviews with individuals with a mild ID who have been restricted in seeing family and friends through the closed access of group homes to visits from outsiders, as well as interviews with their relatives and support workers, the article considers the ways in which stakeholders have responded to these spatial policies and negotiated the meaning of living space in times of crisis. © The Author(s) 2023.

Psychiatric emergencies and 15-25 years old during the first year of the health crisis: A descriptive epidemiological study in the largest French psychiatric emergency center

Introduction: Since March 16, 2020, the date of the announcement of the first confinement in France in the context of the COVID-19 pandemic and health crisis, French residents have experienced a brutal and lasting disruption in their rhythms and habits. The health crisis has had a strong impact on the general population and especially on patients suffering from psychiatric disorders. The demand for mental health care has particularly heightened among young people, who seem to be the most affected by this crisis. In the first part of this article, we will describe the impact of the health crisis on the mental health of young people and on the attendance of psychiatric emergencies, with a review of French and international literature. In the second part, we will present a descriptive epidemiological study carried out in the largest French psychiatric emergency center. Methods and objective: Our sample included 9,771 young patients from 15 to 25 years old. The main objective of our study is to highlight the changes in the flow of consultations of patients aged 15 to 25 years during the first year of the health crisis, compared to the three previous years. We calculated and compared the proportion of the target population consulting between the period of the first year of the health crisis (COVID period) and the period encompassing the previous three years (pre-COVID period). We also compared different variables, between the 2,179 young people consulting during the first year of COVID-19 health crisis and the 7,592 young people during the three last years: age, sex, marital status, symptoms, environmental context and CIM-10 diagnoses. Result(s): We observed a significant increase in the proportion of patients aged 15 to 25 during the COVID period (n = 29.4% vs. 27.6%;P < 0,001). The patients during the COVID period were predominantly female. We have seen a significant increase in patients coming for consultations for anxiety (+4.3%;P < 0.001), sleep disorders (+2.8%;P < 0.001) and suicidal thoughts (+2.7%;P = 0.006) during the COVID period. During the first year of the health crisis, the target population consulted less for claustration, withdrawal or odd behavior. Family conflicts, traumatic events and other life events were more frequent. Schizophrenia, schizotypal and delusional disorders were less frequently diagnosed. Conclusion(s): The health crisis has had a considerable impact on the mental health of the youth population. The mental health of young people is a current subject of concern and a major public health issue. Data from the literature warns of the impact of the health crisis on the mental health of this population and the need for early treatment, even as the supply of psychiatric care is decreasing.Copyright © 2022 Elsevier Masson SAS

Progression of dementia symptoms in old patients because of confinement in the COVID-19 pandemic era: challenges for mental health workers and caregivers

Currently, the whole world is experiencing a COVID-19 pandemic. The elderly are one of the populations with a high physical and mental risk of being affected by covid-19. Dementia is a psychiatric disorder that is often experienced by the elderly. We describe two cases of dementia that occurred during the COVID-19 pandemic situation. Both cases explain the condition of dementia patients during quarantine due to the implementation of the PSBB (confinement). Dementia patients have difficulty in understanding and complying with health protocols. The emergence of exacerbation symptoms and education on health protocols are challenging for caregivers during the COVID-19 pandemic. The role of mental health workers is important to help caregivers understand the causes of worsening symptoms of dementia patients because of changes in environmental conditions during the COVID-19 pandemic situation and provide examples for caregivers on how to educate patients with appropriate health protocols. Modification of activities during a pandemic and regular communication with caregivers can be a solution to addressing challenges.Copyright © 2023, Codon Publications. All rights reserved.

Neuropsychiatric complications from COVID-19

IIntroduction: COVID-19 manifests mainly as a respiratory disease, later with the course of the pandemic neurological symptoms were described, but mainly patients developed neurological complications, which manifested with neuropsychiatric symptoms in about 35,6 % of the cases with COVID-19 infection. Aim: to determine neuropsychiatric complications due to COVID-19. Method: a narrative review was carried out to gather information on neuropsychiatric complications due to COVID-19. For this purpose, indexed scientific articles published from 2020 to 2022, in Spanish and English, were consulted using scientific search engines such as PubMed and SciELO. Results: the main neurological symptoms could be the consequence of multiorgan failure, severe infection or brainstem involvement. It has been reported that patients infected by SARS-CoV-2, after 3 weeks, developed altered mental status, encephalopathy, psychosis, neurocognitive syndrome (similar to dementia) and affective disorders. Persistent neurocognitive deficits were identified in patients with delirium even 18 months after discharge. Conclusions: the effect of SARS-CoV-2 at the neuropsychiatric level is manifested as altered mental state, psychosis, depression, anxiety, neurocognitive syndrome, affective disorder, cognitive impairment, dementia, consciousness disorders. Thus, it is suggested that in the presence of risk factors such as critical patients or patients with encephalopathies, contact with persons with the infection should be prevented. © Este es un artículo en acceso abierto,.

Prevalence of SARS-CoV-2, serological study in France in non-confined and confined employees

Objectives: Retrospectively assess the rate of employees, confined (teleworking) and not confined, infected with SARS-CoV-2 from the end of April 2020 to July 2020, after the 1st lockdown (April to May 2020). Method: A serological test for anti-SARS-CoV-2 antibodies, IgG and IgM, with a questionnaire on the symptoms was proposed to 2100 employees of the same company. Results: Among the 786 included employees, serology was positive for: 4.05% in the unconfined, and 6.72%, in the confined (P = NS). Symptoms were present for 86.4% of positives, with no significant difference between confined and non-confined. Among asymptomatic, 1.7% were positives. No symptoms were significantly different between the 2 groups apart from anosmia-ageusia significantly more often observed in the confined group. Symptoms significantly associated with positive serology were anosmia-ageusia, fever-fever sensation -chill, body aches, fatigue and/or malaise, influenza-like illness and respiratory symptoms. This low rate of contamination may be the result of reinforced prevention measures put in place for employees from the end of January 2020, and the regular information meetings with the Occupational Health Doctor about prevention of the risk of contamination in the company. Conclusions: The rate of employees who were infected with SARS-CoV-2 from the end of April 2020 to July 2020 was half the rate reported in the population of Ile de France at the same period, without difference between employees who continued their activity face-to-face compared to those who had been in confinement. © 2023 Objectifs: Évaluer rétrospectivement le taux de salariés, confinés (en télétravail) et non confinés, infectés par le SARS-CoV-2 après le 1er confinement (avril à mai 2020). Méthode: Un dépistage sérologique des anticorps anti-SARS-CoV-2, IgG et IgM, et un questionnaire sur leurs symptômes a été proposé aux 2090 salariés d'une même entreprise. Résultats: La sérologie était positive pour 5,6 % des 786 salariés inclus entre fin avril et juillet 2020: 4,05 % chez les non confinés, et 6,72 %, chez les confinés (p = NS). Parmi les positifs, 86,4 % avaient présenté des symptômes, sans différence significative entre confinés et non confinés. Enfin, 1,7 % des asymptomatiques étaient positifs. Les symptômes n'étaient pas significativement différents entre les 2 groupes sauf pour l'anosmie-agueusie significativement plus fréquente dans le groupe des confinés. Les symptômes significativement associés à une sérologie positive étaient l'anosmie-agueusie, la fièvre-sensation de fièvre-frissons, les courbatures, la fatigue malaise, un syndrome grippal et des symptômes respiratoires. Ce faible taux de contamination peut être le résultat des mesures de prévention renforcées mises en place pour les salariés dès fin janvier 2020 par le médecin du travail pour limiter le risque de contamination au sein des locaux. Conclusion: La prévalence du SARS-CoV-2 dans l'entreprise de fin avril à juillet 2020 était inférieure de moitié au taux rapporté dans la population d'Ile de France à la même période sans différence entre les salariés ayant poursuivi leur activité en présentiel par rapport aux confinés. © 2023

The effects of the Covid-19 crisis and those of the confinement measures on the well-being of children entrusted to the protection of children

From 16 March 2020, the confinement established in France to slow the spread of the COVID-19 pandemic had considerable implications. The host institutions, like all other institutions in The French territory, had to reorganize themselves in this unprecedented sanitary period. The aim of this article is to report the effects of the crisis of covid 19 and, nod. The results of this exploratory study reveal certain common characteristics of the impacts of the pandemic on children entrusted to foster care institutions, and their relational well-being, considering various risk or protective factors. Finally, we discuss the implications of these results for research and practice. Understanding in which confinement has changed practices, and how they have proved beneficial to improve the well-being of protected children, allows identifying the factors or intervention strategies favorable to the mental health of this public with specific needs.

COVID-19: The dual confinement

COVID-19 has highlighted the dramatic inadequacy of staffing in nursing homes, which prevents professionals from genuinely focusing on well-being for all (residents and caregivers) and the preservation of as much autonomy as possible for residents. The issue of the consequences of lockdown and the resulting dual confinement, social and moral, has been raised, especially since confinement is also often the sole strategy used in daily practice as a response to certain behavioural disorders. Other approaches can be put in place, drawing on institutional psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (French) La Covid a revele l'insuffisance dramatique du personnel travaillant dans les Ehpad ne permettant pas a ceux-ci de fonctionner avec une veritable recherche de bien-etre de tous (residents et soignants) et de preservation d'un minimum d'autonomie pour les residents. Les consequences d'un double enfermement, social et moral, ont ete posees, d'autant que c'est souvent le seul recours utilise quotidiennement comme reponse a certains troubles du comportement. D'autres pratiques peuvent etre mises en place inspirees par la psychotherapie institutionnelle. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The impact of confinement on orthopaedic and trauma surgical activity

Introduction: Le 16 mars 2020, devant l’état d'urgence sanitaire décrété en France, le gouvernement a imposé des mesures de confinement dont l'impact sur l'activité de chirurgie orthopédique et traumatologique reste à démontrer. L'hypothèse de cette étude était que le confinement a diminué l'activité chirurgicale orthopédique et traumatologique. L'objectif principal était d’évaluer l'activité chirurgicale d'orthopédie et de traumatologie en période de confinement et de la comparer à l'activité hors confinement. Matériels & méthodes: Il s'agissait d'une étude rétrospective, monocentrique, observationnelle et comparative d'une cohorte continue de patients inclus pendant la période de confinement du 16 mars au 11 mai 2020. Cette cohorte a été comparée à un groupe de patients inclus de manière rétrospective sur la même période hors confinement l'année précédente du 16 mars au 11 mai 2019. Le critère de jugement principal était le taux d'incidence de l'activité chirurgicale en 2020 versus 2019 sur une période identique. Le critère secondaire était l'analyse des traumatismes recensés. Résultats: Le nombre de patients opérés était significativement diminué en période de confinement: 194 patients inclus en 2020 soit une incidence de 57 pour 100 000 habitants contre 772 patients inclus en 2019 soit une incidence de 227 pour 100 000 habitants;p < 0,001. L'activité chirurgicale d'orthopédie programmée passait d'un taux d'incidence de 147 en 2019 à 5 en 2020 pour 100 000 habitants (p < 0,001). L'activité chirurgicale de traumatologie passait d'un taux d'incidence de 80 en 2019 à 50 en 2020 pour 100 000 habitants (p: NS). Nous retrouvions une augmentation significative des patients de plus de 65 ans pendant le confinement, 70 % contre 61 % en 2019;p = 0,04. Le taux de fractures du col du fémur était significativement augmenté pendant le confinement, 48,5 % contre 39,3 % en 2019;p = 0,03. La chirurgie dégénérative était significativement diminuée pendant le confinement (p < 0,001). Discussion: Cette étude montre que l'activité chirurgicale d'orthopédie et de traumatologie a été significativement diminué par le confinement, avec une différence d'incidence de 170 pour 100 000 habitants, confirmant ainsi l'hypothèse des auteurs. Cette diminution est due à la fois à l'arrêt de l'orthopédie programmée et à la diminution de 40 % du nombre de patients traumatisés. En période de confinement, le pourcentage de patients âgés de plus de 65 ans victime d'une fracture a significativement augmenté. Conclusion: Le confinement a eu un impact significatif sur l'activité de chirurgie orthopédique et traumatologique. Niveau de preuve: III;comparative et rétrospective. © 2021 Elsevier Masson SAS

Obesity and Covid-19, a high risk association

Obese patients have a significantly increased risk of COVID-19-related complications. The health measures induced lifestyle disruptions and emotional eating anxiety, which increased weight gain. In some cases, the stigma suffered by obese people has influenced their mental health and weight gain. Medicine, public health, society, and the patients themselves, must learn from these events. © 2021

Emotional impact motivated by Covid-19 in the Spanish millennial population

The objective of this research is to analyze the impact of the confinement decreed as a result of the state of alarm caused by Covid-19 on the emotional state of the Spanish millennial population. This is a cross-sectional, descriptive and correlational research with a quantitative methodology carried out between March 28 and April 26, 2020. 1,137 people aged 19 participated (they turned 20 in the year of the research) and 40 years old. For the analysis of the emotional state, the CES-D questionnaire was used;the resilience scale for the study of resilient protective factors;and for variables of a socio-demographic nature, ad hoc questions were created. As a result, the university millennial population (from 19 to 24 years old) presents higher levels of depressive mood than the millennial population of working age (from 25 to 40 years old). In turn, millennial women, who live in smaller homes and who perceive a worse economic situation, show higher levels of depressive mood. It is concluded that personal strength is shown as a determining dimension in the analysis of depressive mood in a young population (millennial) during confinement in Spain. © 2022, Revista de Ciencias Sociales. All rights reserved

[Impact of the SARS-CoV-2 pandemic on diabetic macular edema and prognostic factors]. / Impact de la pandémie du SARS-CoV-2 sur l'œdème maculaire diabétique et facteurs pronostiques.

PURPOSE: To assess functional and anatomical consequences of the delay in intravitreal injections for diabetic macular edema (DME) patients during the corona virus pandemic lockdown in Morocco as well as to evaluate factors associated with disease progression. PATIENTS AND METHODS: This cross-sectional study included DME patients who did not complete their scheduled intravitreal bevacizumab injections during the Lockdown period (March 20, 2020 to May 20, 2020). Data recorded included age, duration of diabetes, number of previous intravitreal injections, best-corrected visual acuity, and central macular thickness before and after the lockdown. RESULTS: One hundred and fifty four eyes of 104 patients were analyzed. 57.8% were male. The mean age was 59.4±9.04 years. The mean duration of delay of intravitreal injections was 57.3±6.7 days. The mean number of intravitreal bevacizumab injections received before the lockdown was 2.29±2.1. Worsening of visual acuity was noted in 44.8% of patients and was associated with a lower number of intravitreal injections performed prior to the lockdown (P=0.001) and with glycemic imbalance (P=0.04). An increase in central macular thickness was noted in 26.6% of patients and was associated with a lower number of intravitreal injections (P=0.038). CONCLUSION: The delay in intravitreal injections during the lockdown had negative effects on visual acuity and central macular thickness in eyes with DME. Prolonged delay in intravitreal anti-VEGF injections in diabetic patients should be avoided.

Bio-psychosocial study on the impact of the COVID-19 lockdown on depression and anxiety in a sample of 1753 French-speaking subjects.

The aim of this article was to study the impact of the COVID19 lockdown on anxiety and depressive symptoms on the basis of responses to an online survey from 1753 French-speaking subjects, conducted between April 27 and May 11, 2020. METHOD: Using a biopsychosocial model, the effects of socio-demographic characteristics (age, gender at birth, socio-professional category, sexual orientation), lockdown conditions (material factors: urban density of the place of residence, surface area of the place of residence during lockdown), social characteristics: living with a partner during lockdown, presence of children during lockdown) and psychosocial history (attachment styles) on anxiety - evaluated on the GAD7 - and depression - evaluated on the MDI - were investigated. Ordinal regression analyses were conducted. RESULTS: The rates of depression observed (moderate or severe depression: 22.5%) and anxiety (moderate or severe anxiety: 18.4%) were higher than usual but lower than what has been documented in other studies on the effects of lockdown. Women appeared to be more vulnerable than men (Anxiety: AOR=1.647, CI 95%=1.647-2.530; Depression: AOR=1.622, CI 95%=1.274-2.072). Bisexual individuals had an increased likelihood of anxiety symptoms (AOR=1.962, CI 95%=1.544-2.490) and depression (AOR=1.799, CI 95%=1.394-2.317). For homosexuals, only links with depression were observed (AOR=1.757, CI 95%=1.039-2.906). People in a situation of economic vulnerability were more prone to anxiety disorders (e.g. people with no working activity: AOR=1.791, CI 95%=1.147-2.790) or depression (e.g. people with no working activity: AOR=2.581, CI 95%=1.633-4.057). Links with attachment styles were also found. Fearful subjects were particularly vulnerable (anxiety: AOR=2.514, CI 95%=1.985-3.190; depression: AOR=2.521, CI 95%=1.938-3.289), followed by subjects with an anxious attachment style (anxiety: AOR=1.949, CI 95%=1.498-2.540; depression: AOR=1.623, CI 95%=1.207-2.181). The impact of lockdown on avoidant subjects only concerned depression (AOR=1.417, CI 95%=1.034-1.937). Being with a partner during lockdown appeared to have a protective effect against depression (AOR=.693, CI 95%=.555-.866). Neither the presence of children, the surface area of the lockdown residence, nor the population density of the place of residence was associated with anxiety or depression. CONCLUSION: The impact of lockdown on mental health depends on a range of dimensions that need to be apprehended in order to tailor post-lockdown psychological and social support. Management based on a biopsychosocial approach should be favored.