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Aims: to investigate if mental disorders and cognitive performance are associated with interpersonal behaviours and negative emotions among youth during the COVID-19 pandemic. Method(s): This work is part of the Brazilian High-Risk Cohort for Mental Conditions (BHRC), which included 6-12 years-old children at baseline (Year 2010) who participated in an online COVID-19 wave (N = 1.144). Outcomes were factor socres from specifc sections of the international Coronavirus Health and Impact Survey (relationship changes, stress, and concerns related to COVID-19). A structured interview (DAWBA, DSM-IV) assessed externalizing and internalizing disorders. Cognitive predictors were IQ and executive function assessed at baseline. We used Generalized Linear Models adjusting for sex and socioeconomic variables. First, higher IQ (B = 0.0032;t = 2.714;p = .006) and any internalizing disorder prior to the pandemic (B = 0.0902;t = 2.228;p = .026) were associated with higher perceived stress during the pandemic. Second, any externalizing disorder (B = -0.1449;t = -2.066;p = .039) was linked with lower levels of COVID-19-related worries, whilst higher performance in executive function tasks was associated with higher levels (B = 0.1803;t = 4.796;p = .001). Third, higher IQ was linked with negative changes in interpersonal relationships (B = -0.0007;t = -3.371;p = .0007). Conclusion(s): This study showed that lifetime externalizing and internalizing disorders, in addition to cognitive variables at lifetime externalizing and internalizing disorders, in addition to cognitive variables at an early age, were associated with distinct mental health outcomes during the COVID-19 pandemic.
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Outcomes: 1. Define the factors contributing to increased PTSD incidence due to COVID-19 among hospice and palliative medicine professionals. 2. Implement measures to screen and proactively mitigate workplace related factors associated with increased risk of PTSD in pandemic- and potentially non-pandemic-related situations. The COVID-19 pandemic has affected more than 557 million people globally. In order to assess its psychological effect on healthcare workers in hospice and palliative medicine, a survey was solicited to AAHPM members. Participation was voluntary and anonymous, with all responses kept in confidence. The survey consisted of three parts: demographics, attitudes/sentiments relating to COVID-19, and the DSM-IV-TR Post-Traumatic Stress Disorder (PTSD) Checklist-Specific (PCL-S). The PCL-S has clinical and research utility to screen for PTSD in response to a specific stressor, in this case COVID-19. A total of 323 AAHPM members participated, of which 290 (89.8%) completed the PCL-S. Utilizing the most conservative and reliable scoring method for the PCL-S, 16.6% (48/290) met diagnostic criteria for symptomatic PTSD. Demographic factors including age, relationship status, child status, years of experience, geographical location, and gender did not affect odds of PTSD symptomology, yet non-male gender was associated with higher PCL-S scores (3.2 +/- 1.5;p = 0.38). Attitudes surrounding the use and perceived efficacy of telemedicine did not impact the incidence of PTSD. Those providing critical care services (33/156;21.2%) were at greater risk of symptomatic PTSD than those not providing critical care services to COVID-19 patients (15/135;11.1%;RR = 1.9[1.08-3.35];p=0.026). Furthermore, PCL-S scores increased as a function of the number of patients where critical care (but not non-critical care) was provided (p=0.0006). Increased workload (p=0.009) and having to perform new job duties (p=0.004) as a result of COVID-19 were also associated with symptomatic PTSD. Personal stress was also a contributory factor;the risk of symptomatic PTSD was higher among respondents reporting a friend, family member, or colleague's death from COVID-19 (23.8% vs. 13.1%;RR = 1.82[1.08-3.05]). As COVID-19 continues to impact us all, understanding factors affecting the mental health of an integral part of the healthcare workforce is crucial.Copyright © 2023
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Aim: In this study, we aimed to investigate anxiety, depression, and sleep problems in healthcare professionals during the pandemic. Material(s) and Method(s): This descriptive and cross-sectional study was conducted with the staff of Diyarbakir Gazi Yasargil Training and Research Hospital. A total of 170 people were reached for the research. The data collected by the on-line survey method consisted of demographic questions, questions about behavior change due to COVID-19, Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), and Insomnia Severity Index (ISI). Result(s): It was found that 72.9% of the healthcare professionals had anxiety, 83.5% had depression, and 87.1% had sleep problems. The total score of the GAD-7 scale was found to be significantly higher in those who used personal protective equipment (p=0.021) and those who received infection training (p<0.001). The PHQ-9 scale total score was higher in those 35 years of age and older (p=0.019) and college graduates (p=0.023). The total score of the insomnia severity scale (ISI) was significantly higher in individuals aged 35 years and older (p=0.040), in college graduates (p=0.049), and single/divorced (p=0.009). A significant difference was found between gender, occupation, smoking, fear of infection, burnout status, and total scores on all three scales (p<0.05). Discussion(s): Healthcare professionals were found to have high levels of anxiety, depression, and sleep problems. Anxiety, depression, and insomnia problems were higher in women, health technicians, smokers, those with fear of infection, and those with burnout.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Introduction: According to WHO, there are more than 300,000,000 people worldwide suffering from depression. It is the world's leading cause of disability and contributes significantly to the overall global burden of disease. 30% of the patients are refractory, being possible candidates for surgical treatment by means of Deep Brain Stimulation (DBS). We present the follow up at 22 months of a patient with Treatment Refractory Depression (TRD) operated on with a new combination of targets. Materials / Methods: The diagnostic criteria used are those established by Mayberg et al: DSM IV-TR criteria for major depressive disorder with a major depressive episode of at least 1 year duration, with a minimum score of 20 on the 17-item Hamilton Depression Scale (HAM-D). Result(s): 55-year-old male. HAM-D: 26-point. It was decided to simultaneously implant Area 25 (SCG/Cg 25) and the Inferior Thalamic Peduncle (ITP) in order to contemplate the synergistic effect of stimulation of both structures. On December 5, 2018, it was successfully implanted, with previously published techniques, using a deep brain micro register system and stereotactic planning to define the coordinates of each selected target for the implantation of the four tetrapolar electrodes, model 6145 (Abbott) for Area 25 and model 6149 for ITP (Abbott). The electrode implanted in Area 25 was kept lit for 3 months, then only the corresponding to the ITP for an additional 3 months, and finally the four electrodes simultaneously maintaining the stimulation parameters reported in the literature. Post-surgical HAM-D scales were performed, with the following results: * Exclusively Area 25 (21/03/19) = 10 points * Exclusively ITP (13/06/19) = 9 points * Area 25 + ITP (08/08/19) = 14 points. * Area 25 + ITP (19/12/19) = 5 points. * Area 25 + ITP (08/10/20) = 5 points. Discussion(s): The possibility of multiple targets is technically possible and appropriate in very well selected cases. Conclusion(s): The patient showed a statistically significant improvement. Despite maintaining a rating of 5, it is worth mentioning that the patient refers feeling "better" than the previous year considering the time of year (spring), and the burden of the COVID-19 pandemic. This confirms some reports that mention the maintenance of the effect in the long term, even at 8 years, or even an improvement after almost two years can be seen. We consider that the synergism obtained by simultaneous stimulation of both targets could be more effective in terms of control of the depressive state at the long term. Supplemental Data: none. Learning Objectives: 1- To present a new therapeutic modality of multitargeting DBS for major depression. 2- To demonstrate that the combination of surgical targets is a possible option in carefully selected patients. 3- To demonstrate that the therapeutic effect is maintained over the time. Keywords: depression, deep brain stimulation, Area 25, inferior thalamic peduncle, multitargeting Copyright © 2022
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Remote cognitive and behavioral therapy (CBT) via videoconference has been garnering attention as a means of improving access to CBT for depression, in particular during the coronavirus disease 2019 pandemic. However, there is a lack of evidence supporting its implementation in Japanese clinical settings. This case series aimed to establish preliminary evidence of whether remote CBT can be an effective therapy for major depression in Japanese clinical settings. Five patients who met the diagnostic criteria for major depressive disorder were enrolled and underwent remote CBT via videoconference and face-to-face assessment interviews. The results showed that remote CBT via videoconference improved depressive symptoms, enabling a relatively high level of patient satisfaction and working alliance. Moreover, detailed feedback from our patients showed that continuous monitoring was preferable for increasing treatment engagement. Further research is warranted to test the efficacy and acceptability of remote CBT via videoconference for treating major depression.
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Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of internet-based cognitive behavioural therapy for preventing postnatal depression.
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Background: This 13-month prospective study aimed to investigate the impact of employees’ worry about workplace measures against COVID-19 on the onset of major depressive episode (MDE) during repeated COVID-19 outbreaks in Japan. Methods: Data were collected by using online questionnaires from full-time employees at baseline (May 2020) and the 7th survey (June 2021). The onset of MDE during the follow-up was retrospectively measured at the 7th survey, with a self-report scale developed based on the Mini-International Neuropsychiatric Interview (M.I.N.I.): according to the DSM-IV/DSM-5 criteria. Participants were asked to report the number of workplace measures against COVID-19 in their companies/organizations and their worry about these measures. Multiple logistic regression was conducted of MDE on the number of workplace measures and worry about these, adjusting for demographic and work-related covariates and psychological distress at baseline. Results: Among 968 respondents employed in May 2020, 827 completed the 7th survey in June 2021 (80%). We excluded 75 respondents who reported they had MDE in May 2020 or earlier. Worry about workplace measures was significantly associated with the onset of MDE after adjusting for the covariates (OR, 2.18;95%CI, 1.12-4.25, p=0.022). No significant association was found between the number of the workplace measures and the onset of MDE. Conclusions: Worrying about insufficient workplace measures taken by company/organization may be a risk factor for the onset of MDE among full-time employees during the COVID-19 epidemic.
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Introduction: The Optimal Health Program (OHP) is a collaborative self-management program that promotes clients to be actively involved in their own healthcare and overall wellbeing. Program Kesihatan Optimum (SANUBARI) is a Malay version of the OHP after a translational process and cultural adaptation by psychiatrists, clinical psychologist and family medicine specialists in 2017. The program is of a low intensity, patient-centred program, advocating self-health management to improve health literacy by enhancing self-efficacy, building strengths and values, and initiating change and planning, ultimately enhancing wellbeing of people. The programme can be used as a form of early psychosocial intervention during the current pandemic in maintaining the general mental wellbeing of COVID-19 patients. Methods: This is an open labelled interventional study of a virtual brief psychosocial intervention, called SANUBARI. The program was conducted among COVID-19 patients hospitalized in the COVID-19 wards of two centres from May 2020 until August 2020. Inclusion criteria include patients aged eighteen years and above, diagnosed with COVID-19, medically stable, speaking and reading Bahasa Melayu or English. All study subjects attended two sessions on OHP via telecommunication method and answered questionnaires (General Self-Efficacy (GSE) Scale, Patient Health Questionnaire and Generalized Anxiety Disorder Questionnaire) via computer-assisted self-interview. Data collection was done before the start of the intervention, at the end of the intervention and a month post-intervention. Results: A total of 37 patients were recruited and more than half of the subjects were males (62.2%), single (75.5%) and from the Malay ethnicity (78.4%). Seventy-three per cent of subjects had received tertiary education, and most of them were students reflecting a higher unemployment status (73%). Most subjects have no comorbid chronic medical illness (89.2%), and none has a comorbid psychiatric illness. Comparison of the GSE score across 3-time points (pre-intervention, immediate post-intervention and a month post-intervention) showed statistically significant improvement in the mean total GSE score immediate and a month post-intervention as compared to the pre-intervention;from mean total GSE score of 29.78 pre-intervention to 34.73 (mean difference 4.946, 95% Confidence Interval 95%CI: 3.361, 6.531) immediate post-intervention and 33.08 (mean difference 3.297, 95%CI: 1.211, 5.348) a month post-intervention. There was no significant association between the socio-demographic or clinical data, depressive and anxiety symptoms, and changes in GSE scores over three time points. Conclusion: COVID-19 patients improved their self-efficacy levels after the virtual brief OHP intervention, and it maintained a month post-intervention, protecting them from psychological stress and ultimately enhances wellbeing during this coronavirus pandemic.
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BACKGROUND: The COVID-19 pandemic has had a detrimental effect on the mental health of older adults living in nursing homes. Very few studies have examined the effects of Internet-based Cognitive Behavioral Therapy (ICBT) on older adults living in nursing homes during the pandemic. We conducted a feasibility study using a single-group design, to explore the effectiveness of ICBT on psychological distress in 137 older adults (without cognitive impairment) from 8 nursing homes in 4 southeast cities in China, between January and March 2020. METHODS: Symptoms of depression, anxiety, general psychological distress, and functional disability were measured at baseline, post-treatment (5 weeks) and at a 1-month follow-up. Mixed-effects model was used to assess the effects of ICBT. RESULTS: Statistically significant changes with large effect sizes were observed from pre- to post-treatment on the PHQ-9 (p < .001, Cohen's d = 1.74), GAD-7 (p < .001, d = 1.71), GDS (p < .001, d = 1.30), K-10 (p < .001, d = 1.93), and SDS (p < .001, d = 2.03). Furthermore, improvements in treatment outcomes were sustained at 1-month follow-up, and high levels of adherence and satisfaction were indicated. CONCLUSION: ICBT was effective in reducing psychological distress in older adults without cognitive impairments living in nursing homes during the COVID-19 pandemic. Thus, it could be applied in improving the mental health of this vulnerable group during the pandemic.
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BACKGROUND: On March 2020, World Health Organization (WHO) declared COVID-19 to be a pandemic disease. Interactions between allergy-related inflammatory and psychiatric disorders including depression, anxiety, and post-traumatic stress disorder (PTSD) have been documented. Therefore, those who have pre-existing allergic conditions may have an increased psychiatric reaction to the stresses of the COVID-19 pandemic. OBJECTIVE: Identify the psychological impact of COVID-19 in patients with allergic diseases and determine if these individuals have a greater risk of presenting with post-traumatic stress disorder (PTSD). METHODS: It is a cross-sectional, survey-based study designed to assess the degree of symptoms of depression and the risk of PTSD using the Patient Health Questionnaire (PHQ-9) and the Impact of Event Scale-Revised (IES-R), respectively, in allergic patients. RESULTS: A total of 4106 surveys were evaluated; 1656 (40.3%) were patients with allergic disease, and 2450 (59.7%) were non-allergic (control) individuals. Of those with allergies, 76.6% had respiratory allergic disease including asthma and allergic rhinitis. Individuals with allergic disease reported higher scores regarding symptoms of PTSD on the IES-R scale (p = 0.052, OR 1.24 CI 0.99-1.55) as well as a higher depression risk score in the PHQ-9 questionnaire (mean 6.82 vs. 5.28) p = 0.000 z = -8.76.The allergy group presented a higher score in the IES-R questionnaire (mean 25.42 vs. 20.59), being more susceptible to presenting PTSD (p = 0.000, z = -7.774).The individuals with allergic conditions were further divided into subgroups of those with respiratory allergies such as allergic rhinitis and asthma vs those with non-respiratory allergies such as drug and food allergy, urticaria and atopic dermatitis. This subgroup analysis compares respiratory versus non-respiratory allergic patients, with similar results on the IES-R (mean 25.87 vs 23.9) p = 0.0124, z = -1.539. There was no significant difference on intrusion (p = 0.061, z = -1.873) and avoidance (p = 0.767, z = -0.297), but in the hyperarousal subscale, patients with respiratory allergy had higher scores (mean 1.15 vs. 0.99) p = 0.013 z = -2.486. CONCLUSIONS: Psychological consequences such as depression and reported PTSD are present during the COVID-19 pandemic causing an impact particularly in individuals with allergic diseases. If we acknowledge the impact and how it is affecting our patients, we are able to implement interventions, follow up, and contribute to their overall well-being.