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BackgroundThis study was aimed to investigate whether patients with epilepsy (PWE) have higher depression and anxiety levels than the normal population in low-risk areas for coronavirus disease 2019 (COVID-19) in the northern part of Guizhou Province, China, during the COVID-19 epidemic, to evaluate their knowledge on COVID-19, and to analyze related factors for the psychological distress of PWE at this special time.MethodsThe survey was conducted online from February 28, 2020 to March 7, 2020 via a questionnaire. PWE from the outpatient clinic of epilepsy of the Affiliated Hospital of Zunyi Medical University, and healthy people matched for age and sex, participated in this study. Mental health was assessed via a generalized anxiety self-rating scale (GAD-7) and the self-rating depression scale (PHQ-9). The knowledge of COVID-19 in both groups was investigated.ResultsThere were no significant differences in the general demographics between the PWE and healthy control groups. The scores of PHQ-9 (P < 0.01) and GAD-7 (P < 0.001) were higher in the PWE group than in the healthy group. There was a significant difference in the proportions of respondents with different severities of depression and anxiety, between the two groups, which revealed significantly higher degree of depression and anxiety in PWE than in healthy people (P = 0, P = 0). Overwhelming awareness and stressful concerns for the pandemic and female patients with epilepsy were key factors that affect the level of anxiety and depression in PWE. Further, the PWE had less accurate knowledge of COVID-19 than healthy people (P < 0.001). There was no statistically significant difference between the two groups in the knowledge of virus transmission route, incubation period, susceptible population, transmission speed, clinical characteristics, and isolation measures on COVID-19 (P > 0.05). PWE knew less about some of the prevention and control measures of COVID-19 than healthy people.ConclusionsDuring the COVID-19 epidemic, excessive attention to the epidemic and the female sex are factors associated with anxiety and depression in PWE, even in low-risk areas.
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This article will summarize the current knowledge and scientific evidence regarding cannabidiol as a possible pharmacological tool for anxiety disorders. Although the use of this substance in medical practice is gaining momentum, gaps can still be found in the current knowledge regarding its molecular targets, drug-to-drug interactions, efficacy in different populations, adequate dosage, duration of treatment, and correct formulation. Moreover, current evidence is still preliminary, lacking robust, blinded, and placebo-controlled clinical trials in many areas of investigation. After reading this article, readers should have a thorough understanding of the current scientific evidence regarding the use of CBD as an anxiolytic drug. [Psychiatr Ann. 2023;53(6):242–246.]
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BackgroundThe COVID-19 pandemic had a substantial influence on the mental health of healthcare workers. This study investigated general health status, the prevalence, and the severity of depressive spectrum and anxiety-related disorders. It evaluated the association between various factors and depression, anxiety, and stress among healthcare workers in the Khatam-Alanbia Hospital in Iran, after 2 years since the corona virus disease 2019 (COVID-19) pandemic.ResultsIn this online cross-sectional study, 409 participants were selected and given a questionnaire about demographic, personal, and clinical characteristics as well as stressors related to COVID-19. The participants completed the General Health Questionnaire (GHQ-28) and the 42-item Depression, Anxiety, and Stress Scale (DASS-42) to report depression, anxiety, and stress/tension levels. We found that the overall incidence of depression, anxiety and stress among health care workers during the COVID-19 pandemic was 44.25%, 50.62%, and 43.76%, respectively. Participants with severe to very severe depression, anxiety and stress accounted for 19.2%, 26.6%, and 18.2% of the sample, respectively. Being female was associated with higher odds of depression, anxiety, and stress.ConclusionsTwo years after the COVID-19 outbreak, health workers are still showing a significant level of depression, anxiety, stress, and remarkable signs of psychological distress. The situation of a health care worker is worrying. The long-term psychological implications of infectious diseases should not be ignored. Mental health services could play an essential role in rehabilitation.
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BackgroundA widely held belief is that "Medical student syndrome” is frequently experienced by young medical students, that is, they experience the symptoms of the diseases they are studying or fear of having such illness. A hypothesis is that because medical students constantly learn about life-threatening conditions and diseases, they experience persistent fear and stress regarding having a severe medical condition, an anxiety-related illness called nosophobia.ResultsAlthough medical students scored an average of 14.14 on a scale measuring potential nosophobia a, the difference between their scores and those of non-medical students, who scored an average of 0.11, is significantly higher (p 0.001). According to the presented analysis, non-medical and medical students exhibit distinct levels of nosophobia. The analysis of responses to hypochondriacal behaviors revealed that students from non-medical faculties scored an average of 1.43 points. By contrast, the average score for medical students was 7.87, which is significantly higher than that of the non-medical students (p 0.001).ConclusionsMedical students are at higher risk for health anxiety and hypochondrial attitudes than non-medical students are.
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The transgender population has higher rates of psychiatric disorders and stigma within medical settings. Literature suggests that gender-affirming care is the standard when working with such patients. There are limited studies regarding treating these patients with severe mental illness (SMI). This article explores how to treat SMI that impacts patients' reality to the point where their assigned sex cannot be acknowledged. The case presented is that of a transgender woman, where clarification of her natal sex was crucial to treatment. The patient denied her natal sex, endorsing a history of miscarriage. Studies on treatment of transgender SMI patients are limited. Gender-affirming treatment is the standard of care for these patients. Training how to ask pertinent questions and communicate effectively is necessary to prevent misdiagnosis, unnecessary treatment, and agitation. [Psychiatr Ann. 2023;53(5):221–223.]
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[...]rates of depression and anxiety have remained lower for older adults compared with younger adults (File & Marlay, 2021), perhaps demonstrating adaptability and the ability to draw on past experiences to survive current challenges. [...]the consideration of alternate therapies has the potential to enhance the process of wise decision-making. Mary "Molly" Camp Mary "Molly" Camp is a Geriatric Psychiatrist and Associate Professor of Psychiatry at the University of Texas Southwestern Medical Center. Metonymy in medical student reflective writing (Teaching and Learning in Medicine, 2020), and Current educational practices for major neurocognitive disorders in psychiatry: A scoping review (Academic Psychiatry, 2021).
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Objective. This study aims to explore the mediation role of perceived stress between nonrestorative sleep (NRS) and emotional distress, as well as the moderation role of resilience among NRS, perceived stress, and emotional distress in university students. Method. We recruited 851 students from the Be Resilient to Nursing Career program (BRNC, registration number: NFYKDX002) in June 2022. Nonrestorative sleep scale (NRSS), 10-item perceived stress scale (PSS-10), 10-item Kessler psychological distress scale (K10), and 10-item Connor–Davidson resilience scale (CD-RISC-10) were administered through a paper questionnaire. Latent profile analysis and moderated mediation analysis were performed. Results. Three profiles of perceived stress were identified: high ability-low stress (24.5%), middle ability-high stress (65.0%), and low ability-middle stress (10.5%). The mediation role of perceived stress between NRS and emotional distress was significant (SE = 0.025;95% confidence interval = −0.369, −0.269). The moderation role of resilience among NRS, perceived stress, and emotional distress was not significant. Conclusion. Heterogeneity exists in freshmen students' perceived stress. Perceived stress plays a significant mediating role between NRS and emotional distress, while resilience cannot significantly moderate the associations among NRS, perceived stress, and emotional distress. The trial is registered with ChiCTR2000038693.
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During the coronavirus (COVID-19) pandemic, antidepressant prescriptions increased by 18.6%, clearly leading to proportionally increased chances of side effects due to medication exposure. Catatonia is a complex and heterogeneous neuropsychiatric syndrome manifesting up to 40 different signs and symptoms that were categorized into 4 groups, including pure motor, volition disturbance, disinhibited complex motor activities, and autonomic instability. The prevalence of catatonia ranges from 7.6% to 38% in patients presenting with acute psychiatric symptomatology. Though most often associated with psychiatric disorders, it is critical to rule out other medical etiologies. The literature reveals catatonia may manifest in several medical conditions and medications have been implicated in the pathophysiology of catatonia. We present a case of possible vortioxetine-induced catatonia in a patient with a history of schizoaffective disorder bipolar type. [Psychiatr Ann. 2023;53(5):224–227.]
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BackgroundSocial isolation can be defined as the absence of social interactions, contacts, and relationships with family, friends, and neighbors. According to some studies, social isolation was associated with depressive symptoms. At least one out of every five teenagers suffer from a diagnosable mental health problem that impairs their function. Saudi Arabia has a significant adolescent population;however, there are few studies conducted in Saudi Arabia to assess social isolation and its psychological impact among adolescents. This research is intended to study the prevalence of social isolation among adolescents in Riyadh and its association with depression symptoms.MethodsA cross-sectional study was conducted among 483 adolescents living in Riyadh, Saudi Arabia. An online self-administered questionnaire was used, and it was composed of three sections which are sociodemographic characteristics, assessment of social isolation, and assessment of depression symptoms.ResultsThe study reported the prevalence of social isolation among adolescents was 10.14%. The prevalence of depression symptoms among adolescents was high (31.68%). There was a significant association between social isolation and symptoms of depression among the studied sample (χ2 = 12.3, p = 0.002). It was found that being a male, living with both parents, and having low income are significant predictors of social isolation among adolescents;with r2 = 0.08 and p-value < .0001. It was also found that low-income level had a more impact on social isolation among adolescents than other factors (estimate = 1.6).ConclusionsA total of 10% of adolescents in Riyadh are socially isolated. There is a significant association between social isolation and symptoms of depression among the studied adolescents. Symptoms of depression can be predicted by social isolation. RecommendationsThe Ministry of Health and the Ministry of Education in Saudi Arabia should work together to conduct educational intervention programs for adolescents about mental health, the importance of social interaction, and the drawbacks of social isolation. These topics should also be involved in the curriculum of secondary schools.
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The novel coronavirus disease (COVID-19) has infected more than 10 million people globally, and it caused more than 500 thousand deaths. Researchers have highlighted the need for early detection and intervention for psychological ill effect of the pandemic on various population subgroups. Women may be more vulnerable in such a crisis phase. This review addresses the mental health needs of women and the kind of interventions needed to cater to their various psychological issues. All existing literature was searched using PubMed, Google Scholar, and Medline databases for articles published on mental health aspects of women during COVID-19 pandemic. Only English language articles published till June 15, 2020, were considered for the review. Data were extracted by the authors from the selected articles, and the findings were synthesized in a narrative format. From the available literature, following themes were identified for further discussion: sexual health and contraception, pregnancy, lactation, domestic abuse, female healthcare workers, women with pre-existing mental illness, women with substance use disorders, homeless women, refugees, and professional sex workers. Studies have reported a higher burden of mental health issues in females than male counterparts and an increase in domestic violence and crises for those at-risk (such as refugees and women with pre-existing illnesses). Women mental health is compromised in many aspects due to COVID-19 pandemic. Findings stress upon the increased need for early detection and prompt intervention for women in the community to alleviate the long-term psychological consequences of this pandemic.
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The internet, especially in the form of social media, provides an avenue for dissemination of unusual and fixed ideas. Recently, the role of conspiracy theories (CTs) in perpetuating myths about the Coronavirus disease (COVID-19) has attracted the attention of mental health practitioners. While extreme CTs may carry some similarities to delusions and may occur in similar socioeconomic groups, some distinctions can be made in the clinical setting. There is little evidence that social media use or gaming with virtual-reality tools on the internet cause psychotic illness, although the internet does promote CTs. Nevertheless, individuals with psychotic illness are overrepresented among internet users and this may allow for greater exposure to unusual beliefs. Future immersive experiences on the internet such as virtual reality and the metaverse may present challenges for people at risk of developing fixed beliefs, but research will be needed on this subject. [Psychiatr Ann. 2023;53(4):171–174.]
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Background: The 11th revision of the International Classification of Diseases (ICD-11) aims to provide a new definition of adjustment disorder (AjD), which is one of the most frequently diagnosed disorders. Coronavirus disease (COVID-19) pandemic has affected the mental health of people and the associated stressors could lead to AjD. The study aimed to investigate the AjD symptoms during COVID-19 pandemic based on the ICD-11 concept on a clinical sample. Methodology: A cross-sectional observational study was conducted between June 10, 2020, and August 9, 2020, among patients visiting the outpatient department of the authors' institute. Prevalence rates of stressors due to COVID-19 and AjD were estimated using scale of the International AjD Questionnaire (IADQ). Results: The study enrolled 723 subjects and 638 subjects endorsed at least one psychological stressor. The IADQ algorithm showed that 25.24% (161) of subjects were suffering from AjD due to the COVID-19 pandemic with a mean score of 20.29 (standard deviation = 4.26) among them. The most common stressors were related to financial problems (81.03%), work problem (63.17%), and personal health problems (27.43%). Conclusion: The high proportion of AjD during COVID-19 in this study may reflect a need for specific interventions. Provision for health-care services for such individuals is essential to avoid other mental disorders in the future.
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BackgroundThe value of the unpaid labor performed by caregivers is estimated to be at least $306 billion annually, nearly double the combined costs of home health care ($43 billion) and nursing home care ($115 billion). However, studies show caregivers are at risk of developing high levels of physical, emotional, and mental strain, which can negatively impact their role, quality of life, and increase medical costs.PurposeThe project aims to determine if giving informal caregivers non-pharmacological interventions such as self-guided bibliotherapy, stress reduction interventions, and improving health literacy will reduce the role strain of informal adult caregivers and improve their quality of life.MethodThis project employed a mix-method design focusing on the role strain and quality of life of relatives and friends assisting individuals with neurocognitive or mental health disorders. The subjects engaged in weekly self-guided activities for 8 weeks, and responded to survey questions regarding demographics, depression, anxiety, and stress levels. Personal health information (PHI) was not obtained. The subjects were required to answer qualifying questions. A $5 Amazon gift card was given to participants who completed the project.ResultsSeven people enrolled in the project, but only four participated. All participants were female. Two were African Americans, one Caucasian, and one Hispanic. All four participants completed the pre-test, demographic surveys, and intervention. However, only two completed the post-test survey. One participant completed the pre-test and post-test on the same day at the end of the project.Descriptive statistics were employed for the data analysis due to the small sample size. A non-parametric 2-independent sample test was used because of the small sample size. The test did not show any statistical significance between the variables in the pre-and post-test DASS-21 after the intervention. Subjects reported the project intervention was "helpful.” Another participant said she could not fully engage in the interventions because of family obligations. Still, she enjoyed the resources, such as the weekly NAMI family support group meetings given by the SI. The pre-test DASS-21 mean score for N=3 was 26 and standard deviation was 15.62.DiscussionThe current COVID-19 has led to an increase in mental health issues. Because of the overwhelming increase in mental health cases, many individuals with mental health problems are being turned away. The decrease in the availability of mental health providers has led to an increased need for informal caregivers. However, studies show stress from caregiving can negatively affect the health of caregivers and result in loss of work productivity. However, specialized support for caregivers is frequently limited. Brown et al. (2016) said nonpharmacological self-help interventions such as bibliotherapy, stress-reduction techniques, and health literacy training could improve caregivers' health. Therefore, lawmakers and healthcare professionals need to come up with interventions to help caregivers.FundingNo Funding
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Background and Aims: Coronavirus has resulted in unique challenges to the healthcare professionals. The pandemic has affected the mental health of healthcare professionals, which may impact their ability to provide care to patients. We aimed to assess anxiety among healthcare professionals, and its relation to selected parameters. Methods: This online questionnaire-based study recruited Indian healthcare workers through convenience sampling. Anxiety was measured using the Generalized Anxiety Disorder 7 scale. The reasons of emotional distress were also ascertained. Results: The sample comprised of 677 healthcare professionals including resident doctors, consultants, interns, nursing personnel, and others. Moderate/severe anxiety was present in 24.4% of the respondents. Moderate/severe anxiety was more likely to occur among those who had a friend or family member affected by COVID-19 (odds ratio [OR] 2.74, 95% confidence intervals [CI] 1.61–4.69), or who themselves had a psychiatric disorder in the past (OR 2.44, 95% CI 1.36–4.38). Those who reported long working hours and inadequate sleep, fear of being infected by the virus, concerns about transmitting the virus to a family member, mob violence against doctors, and shortage of personal protective equipment had significantly higher odds of moderate/severe anxiety. Conclusion: A considerable proportion of healthcare professionals suffering from anxiety suggests the need for addressing their mental health concerns.
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Infections of the central nervous system (CNS) infections are critical problems for public health. They are caused by several different organisms, including the respiratory coronaviruses (CoVs). CoVs usually infect the upper respiratory tract causing the common cold. However, in infants, and in elderly and immunocompromised persons, they can also affect the lower respiratory tract causing pneumonia and various syndromes of respiratory distress. CoVs also have neuroinvasive capabilities because they can spread from the respiratory tract to the CNS. Once infection begins in the CNS cells, it can cause various CNS problems such as status epilepticus, encephalitis, and long‐term neurological disease. This neuroinvasive properties of CoVs may damage the CNS as a result of misdirected host immune response, which could be associated with autoimmunity in susceptible individuals (virus‐induced neuro‐immunopathology) or associated with viral replication directly causing damage to the CNS cells (virus‐induced neuropathology). In December 2019, a new disease named COVID‐19 emerged which is caused by CoVs. The significant clinical symptoms of COVID‐19 are related to the respiratory system, but they can also affect the CNS, causing acute cerebrovascular and intracranial infections. We describe the possible invasion routes of coronavirus in this review article, and look for the most recent findings associated with the neurological complications in the recently published literature.
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CPD credits: 0.5 Podcast Coping, resilience and surviving trauma In this podcast Dr Raj Persaud talks to Dr Vajrin Malin about the immediate psychological impact of a sudden physical trauma, the importance of having goals and a sense of purpose when faced with challenges and how trainee doctors who may be struggling to cope with stress or trauma can be supported.
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The global economy and public health are currently under enormous pressure since the outbreak of COVID-19. Apart from respiratory discomfort, a subpopulation of COVID-19 patients exhibits neurological symptoms such as headache, myalgia, and loss of smell. Some have even shown encephalitis and necrotizing hemorrhagic encephalopathy. The cytoskeleton of nerve cells changes drastically in these pathologies, indicating that the cytoskeleton and its related proteins are closely related to the pathogenesis of nervous system diseases. In this review, we present the up-to-date association between host cytoskeleton and coronavirus infection in the context of the nervous system. We systematically summarize cytoskeleton-related pathogen-host interactions in both the peripheral and central nervous systems, hoping to contribute to the development of clinical treatment in COVID-19 patients.
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To date, only a few cases of intracranial infection related to severe acute respiratory syndrome‐coronavirus‐2 (SARS‐CoV‐2) were reported. Here we describe a case of coronavirus disease 2019 (COVID‐19) that was comorbid with purulent meningitis. A 62‐year‐old male patient was diagnosed with moderate COVID‐19 and had no fever or cough after treatment. However, he suffered from a head injury and experienced headache and fever immediately after the accident. Computed tomography (CT) of the brain showed bilateral frontal lobe contusion, subdural hematoma, and subarachnoid hemorrhage. In the following days, the patient suffered from recurrent fever, although chest CT did not show evidence of worsening of infection. Several lumbar punctures were made, confirming increased cerebrospinal fluid (CSF) pressure and karyocyte count. SARS‐CoV‐2 nucleic acid was not detected in CSF but revealed the presence of Escherichia coli. Thus, the patient was diagnosed with purulent meningitis, presumably caused by brain trauma or the immunologic dysfunction caused by COVID‐19, which was supported by the significant reduction of all kinds of immune cells. Since immunologic dysfunction is commonly presented in COVID‐19 patients, comorbidity with meningitis should be considered when a COVID‐19 patient presents with headache and fever. Lumbar punctures and CSF cultures may help in the diagnosis.
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Purpose. This study aimed to investigate nurses' perceptions of spirituality and spiritual care and perceived professional benefits in China and reveal the relationship between them. Design and Methods. In this study, 372 nurses (response rate: 93.47%) from a number of hospitals across China were surveyed using convenience sampling. The data were collected through online questionnaires, including a sociodemographic characteristics form, the Chinese version of the Spiritual Care-Giving Scale (C-SCGS), and the Nurses' Perceived Professional Benefits Questionnaire (NPPBQ). Findings. The total score of the NPPBQ was 136.88 ± 20.13. A statistically significant relationship was found between the total score and subscale score of the C-SCGS and the total score and subscale score of the NPPBQ (R = 0.217–0.475, P < 0.01). Practice Implications. Nursing managers and educators should pay attention to improving nurses' perceptions of spirituality and spiritual care in order to help nurses gain more perceived professional benefits.