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The clinical evaluation of the patient with COVID-19 allows better care, application of safety criteria and preventive measures. The disease progresses from mild to severe and critical. In this work, is evaluated in patients with COVID-19 clinical format to identify moderate to severe stages of the disease. Following a cohort of male and female patients over 18 years of age admitted to the Infectology Service of the General Hospital of Mexico. Each patient is studied using the"COVID-19 Infectology"clinical format and in the first 24 hours of admission, a real-time RT-PCR molecular test is performed for SARS-CoV-2 infection. 65 patients classified as severe COVID-19 were studied, the RT-PCR was positive in 60 patients and negative in 5, clinical data did not differ from the positive ones and the 5 negative were considered false negative cases of the molecular test. There were no differences between positives and negatives with Fisher's test, and no difference in age, comorbidities, or prognostic evaluation with Student's t test. The conclusion is that the clinical format"COVID-19 Infectology"allows to recognize the cases and identify those that are in a severe evolution.Copyright /© 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.
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Background: Patients with cancer are at a higher risk of getting infected with the severe acute respiratory syndrome coronavirus 2 owing to their immunocompromised state. Providing care to these patients amidst the first wave of the coronavirus disease-2019 (COVID-19) pandemic was extremely challenging. Objective(s): This study was aimed at evaluating the clinical profile and disease-related outcomes of pediatric patients with hematological illnesses and cancer. Material(s) and Method(s): This retrospective study was conducted at a tertiary care center in North India during the first wave of the pandemic from March 2020 to December 2020. Children aged up to 18 years, who were treated for a hematological illness or malignancy or underwent hematopoietic stem cell transplantation (HSCT) and tested positive for COVID-19 regardless of symptoms were included in the study. Baseline demographic data related to the age, diagnosis, treatment status, and chemotherapy protocol used were collected. Outcomes including the cure rates, comorbidities, and sequelae were recorded. Result(s): A total of 650 tests for COVID-19 were performed for 181 children;22 patients were found to be COVID-19 positive. The most common diagnosis was acute leukemia (63.6%). None of the patients developed COVID-19 pneumonia. The majority of patients had asymptomatic infection and were managed at home. Among those with a symptomatic infection, the most common symptoms were fever and cough. A total of 3 (13.6%) patients needed oxygen therapy, one developed multisystem inflammatory syndrome of children leading to cardiogenic shock. Three patients required intensive care or respiratory support;all the patients had favorable clinical outcomes. The median time from the onset of COVID-19 to a negative result on the reverse transcription-polymerase chain reaction test was 21.3 days. Cancer treatment was modified in 15 patients (68.2%). Conclusion(s): Our results suggest that children with hemato-oncological illnesses rarely experience severe COVID-19 disease. The impact of the first wave of COVID-19 primarily manifested as disruptions in the logistic planning and administration of essential treatment to these children rather than COVID-19 sequelae.Copyright © 2021 Cancer Research, Statistics, and Treatment Published by Wolters Kluwer - Medknow.
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The aim of this study was;to define the anxiety and anxiety-related factors experienced by children/adolescents during the Covid-19 pandemic on a global scale. Study data were collected between 15.04.2021 and 30.04.2021 by using keywords (child, children, adolescents, adolescents, mental health, anxiety, anxiety and stress) in Turkish and English. The data sources of this study are PubMed, Web of Science, and Google Scholar t. As a result of the evaluations, a total of n=6185 articles were reached from all databases. After the evaluation of the full texts, the study was completed with n=31 articles. Eleven of the articles evaluated in this study were published in China. The anxiety prevalence of children and adolescents varies between 1.84-45.0%. As a result of the evaluated studies;It has been observed that women, those with chronic-psychiatric diseases, those who are older, separated from family members, migrant children and adolescents are more likely to experience anxiety. Some of the anxiety symptoms of children and adolescents are nervousness, irritability, anxiety, and suicidal ideation. In conclusion, anxiety levels and anxiety-related factors of children and adolescents living in various countries of the world during the Covid-19 pandemic were determined. (English) [ FROM AUTHOR] Bu çalışmada amaç;Covid-19 pandemisi sürecinde çocuk/ergenlerin deneyimlediği anksiyete ve anksiyeteyle ilişkili faktörleri küresel boyutta tanımlamaktır. Çalışma verileri 15.04.2021 ve 30.04.2021 tarihleri arasında, anahtar kelimeler (çocuk, çocuklar, ergen, ergenler, adolesanlar, akıl sağlığı, anksiyete, kaygı ve stres/child, children, adolescent, adolescents, adolescents, mental health, anxiety, anxiety and stress) Türkçe ve Íngilizce kullanılarak toplanmıştır. Bu çalışmanın veri kaynakları;PubMed, Web of Science, ve Google Akademiktir. Değerlendirmeler sonucunda tüm veri tabanlarından toplam n=6185 makaleye ulaşılmıştır. Tam metinlerin değerlendirmesinin ardından n=31 makale ile çalışma tamamlanmıştır. Bu çalışmada değerlendirilen makalelerin n=11'i Çin'de yayınlanmıştır. Çocuk ve ergenlerin anksiyete preveransları %1,84-45,0 arasında değişmektedir. Değerlendirilen çalışmalar sonucunda;kadınların, kronik-psikiyatrik hastalığı bulunanların, büyük yaşta olan, aile üyelerinden ayrı kalan, göçmen çocuk ve ergenlerin anksiyete yaşama ihtimallerinin yüksek olduğu görülmüştür. Çocuk ve ergenlerin anksiyete semptomlarının bazıları, gerginlik, sinirlilik, endişe ve intihar düşüncesidir. Bu derleme çalışması sonucunda, Covid-19 pandemisi sürecinde dünyanın çeşitli ülkelerinde yaşayan, çocukergenlerin anksiyete düzeyleri ve anksiyete ile ilişkili faktörler belirlenmiştir. (Turkish) [ FROM AUTHOR] Copyright of Current Approaches in Psychiatry / Psikiyatride Guncel Yaklasimlar is the property of Psikiyatride Guncel Yaklasimlar 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 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 . (Copyright applies to all s.)
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Chronic stress during adolescence increases the susceptibility to many neuropsychiatric diseases in adulthood, including anxiety-like and alcohol drinking behaviors. Social isolation is a particularly profound stressor with increasing human relevance, especially during the COVID-19 pandemic, when millions of adolescents faced prolonged periods of isolation. However, preclinical rodent models of adolescent social stress have produced mixed results that are often sex, species and strain-dependent. Here we examined the effect of intermittent social isolation on alcohol intake and preference during adolescence (PND28-56) and its long-term effects and alcohol drinking on anxiety, irritability, and synaptic transmission in both male and female Wistar rats. To this goal, we developed and utilized a new model of social isolation and alcohol exposure whereby adolescent (PND28) male and female rats were intermittently socially isolated for 24h prior to 2-bottle choice (2BC) access to ethanol (20% v/v, 2h/session, Tues/Thur/Sat) vs. water, for 4 weeks. Two weeks later (young adults), all rats were tested for anxiety in the novelty induced hypophagia test and irritability-like behavior in the bottle brush test, and a subset was used to record spontaneous inhibitory GABAergic postsynaptic currents (sIPSCs) in the central nucleus of the amygdala (CeA). Additionally, we studied genetically selected Marchigian Sardinian alcohol-preferring (msP) rats to compare the effects of social isolation in a rat strain of increased alcohol preference vulnerability and high sensitivity to anxiety. Social isolation increased alcohol preference in both male and female Wistars when compared to the group-housed controls, starting from week 1 and throughout adolescence. All msP rats displayed escalation of drinking during week 1 and 2 and the effect of the isolation was observed starting from week 3 in males only. No isolation effects were observed in female msPs throughout the 4 weeks. Social isolation and alcohol drinking during adolescence increased aggressive-like behavior in male adult Wistar rats, but not females, and did not alter anxiety measures. Baseline frequency of sIPSCs was decreased in socially isolated male Wistar and msP adult rats vs. group-housed, while rise times, amplitudes, and decay times remained unchanged, indicating reduced basal presynaptic GABA release in the CeA. Together, these findings suggest that an intermittent social isolation produces increased alcohol preference in Wistar rats of both sexes and in male msPs, as well as synaptic changes in the CeA.Copyright © 2023
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Purpose of Study: Affective symptoms, such as depression, nervousness, anxiety, and irritability, are common yet complicating aspects for concussion patients, therefore addressing exasperations of these symptoms is essential for injury management. This is an especially important consideration for patient populations increasingly susceptible to affective disorders, such as those in rural regions and adolescents. Increases in adolescent mental health problems during the time of the COVID-19 pandemic pose an additional challenge for clinicians managing affective concussion symptoms in rural adolescents. The aim of this study is to quantify the mental health effects of the pandemic by comparing affective concussion symptoms in groups of adolescents with concussion and without concussion in the Central Oregon region. Methods Used: The study is a secondary data analysis of ImPACT Concussion Test symptom scores from a cohort of non-concussed (Baseline) and concussed (Post-Injury) adolescents between the ages of 12-18, pre-pandemic (January 1, 2015 - March 20, 2020) and pandemic (March 21, 2020 - April 1, 2022). Subjects were excluded from the study if they received special education, had a diagnosis of learning disabilities, ADD, dyslexia, autism, or received treatment for headaches, migraines, epilepsy, brain surgery, meningitis, substance use or psychiatric conditions. Prevalence of symptoms of 'headache', 'trouble falling asleep', 'irritability', 'nervousness', 'sadness', and 'feeling more emotional' were noted for each group during each time period. Summary of Results: A total of pre-pandemic non-concussed (n =2667), pre-pandemic concussed (n=643), pandemic non-concussed (n = 593) and pandemic concussed (n=87) were included in the final analysis. There was a statistically significant increase in the proportions of 'nervousness' (p=0.0209) and 'sadness' (p=0.0117) in pre-pandemic and pandemic non-concussed groups. Furthermore, there were statistically significant increases in the proportions of 'headache' (p=0.0331), 'irritability' (p=0.0006), 'nervousness' (p=0.0135), 'sadness' (p=0.0357) and 'feeling more emotional' (p=0.0039) between pre-pandemic and pandemic concussed adolescents. Conclusion(s): This study demonstrates a significant increase in affective symptoms in both concussed and non-concussed groups during the COVID-19 pandemic consistent with other studies. However, those with concussion during the COVID-19 pandemic showed greater number of affective symptoms as well as somatic symptoms (headache) compared to concussed pre-pandemic adolescents. The results of this study support the broader body of research examining the mental health burden of the COVID-19 pandemic on adolescents, and further encourages a biopsychosocial approach to injury management, in which social and emotional components of a patient's life are considered.
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Background/Purpose: Pediatric Acute Lymphoblastic Leukemia (ALL) affects ~4000 young Americans each year. Steroids are essential to curative ALL treatment yet have significant neuropsychiatric side effects that decrease quality of life for patients and families. However, incidence and predisposing risk factors are not well understood. This review aims to describe the current literature on neuropsychiatric side effects of steroids in Pediatric ALL. Method(s): A precise search in PubMed and Embase was cultivated using controlled vocabulary terms (MeSH, Emtree) and keywords for the following concepts: pediatrics, steroids, side effects, cancer, and neurobehavioral manifestations. Keywords and controlled vocabulary for each subject were arranged logically and combined with other concepts by Boolean Logic, using the Boolean operator AND, resulting in 642 precise results exploring neurobehavioral side effects of steroids in children with cancer. Results (2010 to date of search) were imported into Covidence systematic review software, and reviewed by SB and AM. Result(s): Twenty-three articles met inclusion criteria. There is marked variability in research methodology and no standard measurement of neuropsychiatric symptoms. Commonly reported symptoms include mood swings, irritability, depression, anxiety, aggression, insomnia, mania, and psychosis with prevalence between 5% and 75%. Heterogeneous research methodology and descriptions of psychiatric symptoms make it difficult to determine risk factors, though dexamethasone, family psychiatric history, and younger age are consistently associated with greater risk of behavioral dysregulation. Genetic predisposition (Bcl1 polymorphism, SNPs in GR gene) may increase susceptibility to developing depression during treatment. Data suggest variable efficacy of antipsychotics, benzodiazepines, hydrocortisone, and potassium-chloride. Conclusions and Implications: Existing data about neuropsychiatric side effects of steroids in pediatric ALL is extremely heterogeneous, creating challenges for standardized assessment and treatment. The burden of these symptoms necessitates further research to identify and treat vulnerable patients. Standard measurement of these symptoms could be a first step in eventually alleviating this source of distress.
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The proceedings contain 20 papers. The topics discussed include: the effect of specialty addiction consultation on prescribing medication for opioid use disorder (MOUD) during general hospital admission;mindfulness-based interventions for adolescent drug and alcohol use: a systematic review and meta-analysis;early changes in irritability predict longer-term abstinence from drug use in adults with stimulant use disorder: findings from the stride study;carfentanil, a highly potent opioid responding to high doses of naloxone, what can help?;an inpatient protocol for managing methamphetamine withdrawal;COVID-19 treatment outcome in a cohort of methamphetamine and cannabis users;the impact of COVID-19 on overdose risk and healthcare-seeking behaviors among hospitalized patients with opioid use disorder;and inpatient low dose transitions from full agonist opioids including methadone onto long-acting depot buprenorphine: case series from a multicenter clinical trial.
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Background: After infection with SARS-CoV- 2 is observed short-term and long-term post-acute sequelae of COVID-19 (PASC). A systematic review of 57 studies comprising more than 250 000 survivors of COVID-19 indicates that more than half of COVID-19 survivors experienced PASC 6 months after recovery. The most common PASC involved functional mobility impairments, pulmonary abnormalities, and mental health disorders [Groff D et al]. It has been suggested that co-infection of SARS-CoV- 2 with EBV or other herpes viruses (HSV1 / 2, HHV6, CMV) contributes to both severe COVID-19 and post-COVID symptoms. Method(s): 88 patients with the post-COVID- 19 condition were examined, including 52.3 % female, 47.7 % male, mean age 41.4 +/- 6.7 years. Patients underwent the following studies: anamnestic, clinical, general laboratory, biochemical and immunological analysis. PCR DNA of EBV, HHV6, CMV in blood, saliva, and the posterior pharyngeal mucosa was performed by Rotor-Gene 6000 (Corbett Research, Australia) and EBNA-IgG, VCAEBV-IgG, HHV6-IgG was performed by ELISA. Result(s): There were 2 groups of patients: the first included 68 patients with the post-COVID- 19 condition and active phase of herpesviruses. They were found positive EBV DNA -in 29 (42.6%) patients, positive HHV6 DNA -17 (25.0%) patients, positive EBV DNA, and HHV6 -in 22 (32, 4%) patients;the second group included 20 patients with the post-COVID- 19 condition and latent phase of herpesviruses and negative DNA EBV and/or HHV6 were found. In patients of the first group compared with the second group, patients were found COVID-19 had a severe course, pneumonia was diagnosed more often (77.9% vs. 40.0%), patients needed oxygen support and inpatient treatment lasted longer (16 +/- 7 vs. 10 +/- 4 days). In the first group patients compared with the second group patients were subfebrile temperature, headache, irritability, depression, myalgia, arthralgia, shortness of breath (p < 0.05). In patients of the first group compared with the second group in serum blood, we found elevated ESR, lymphopenia, monocytosis, increased activity of liver enzymes ALT and AST, CRP, D-dimer (p < 0.05) Conclusion(s): 1. Reactivation of herpesvirus infections is common in 72.3% of patients with the post-COVID- 19 condition: the EBV DNA positive were found in 42,6% of patients, the HHV6 DNA positive in 25,0% of patients, and EBV+HHV6 DNA positive in 32,4% of patients. 2. Patients with the post-COVID- 19 condition and reactivation of herpesviruses were characterized by severe COVID-19, manifestations of subfebrile, impaired mobility, mental disorders, and pulmonary abnormalities, as well as changes in laboratory parameters. 3. Our studies confirm the possible participation of reactivated herpesvirus infections (EBV, HHV6) in the formation of post-COVID- 19 conditions, which suggests the need for diagnosis of these infections and specific treatment. (Figure Presented).
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Introduction: The fear and uncertainty in the face of the unknown, as well as the fear of contagion by the virus, was added to the stress that can cause a mandatory isolation that arose due to the COVID-19 pandemic, which generated changes in mental health and eating behaviors. Objective(s): To characterize the impact of COVID-19 isolation on mental health and food consumption behaviors. Method(s): An exploratory cross-sectional research was conducted, with the application of a previously validated online instrument, consisting of 18 multiple-choice questions related to mental health and eating behaviors during COVID-19 isolation. 1305 surveys that were answered with the prior consent of the participants were collected. The statistical package SPSS version 22 was applied to associate the variables of interest and tests of the chi-squared for nominal scale indicators. Result(s): The confinement situation due to COVID-19 caused sleep disturbances (41.4%), irritability (79.6%), anxiety (71%), fear (87.3%), arguments at home (62.7%), with negative effects on changes in diet (p = .000), generating poor nutrition (48%). The problem was mainly found in women (p = 0.000), young people and young adults (p = 0.000), from urban areas, who live in apartments without access to green areas. Conclusion(s): There are emotional alterations as a result of isolation, which have an impact on eating behaviors. For this reason, it is necessary to work on public health policies that propose strategies for managing stress and associated emotions during a situation of isolation.Copyright © 2023, Editorial Ciencias Medicas. All rights reserved.
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Misophonia is a condition in which individuals suffer a wide range of intense emotions in response to sound triggers. Emotions such as anxiety, irritability, and disgust may lead individuals to engage in avoidance behaviors to escape or suppress sound triggers. Transdiagnostic treatment may serve as a practical intervention for misophonia as it addresses a broad scope of emotions and physiological sensations. This paper presents the first reported case example of misophonia treated with a transdiagnostic treatment protocol, the Unified Protocol for Emotional Disorders in Adolescents (UP-A). In this case, the UP-A was efficacious in treating a client with autism spectrum disorder, comorbid misophonia and anxiety symptoms. The client evidenced reliable change in misophonia and related problems. Future research should investigate the efficacy of the UP-A in a larger sample of youth with misophonia, as well as assess mechanisms of change in transdiagnostic treatment of this disorder in youth.Copyright © 2022 Society of Clinical Child & Adolescent Psychology.
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Objective: The objective of this study was to compare the screen time (ST) in pre-COVID and COVID era in children aged 5-15 years and to analyse the ST effect in pre-COVID and COVID era in the children. Method(s): The study was done at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow. Two hundred and seventy-six children aged between 5 and 15 years, attending outpatient department or inpatient department were enrolled in the study. Result(s): It was observed that the ST was significantly increased in post-COVID as compared to pre-COVID time and the difference was statistically significant (p<0.0001*). It was also observed that the screening time was significantly increased in post-COVID as compared to pre-COVID time and the difference was statistically significant (p<0.0001*). Conclusion(s): The present study found that when screening duration was analysed, the screening time during COVID-19 was significantly longer than the screening time before COVID-19 which may be associated with the various health problems reported among children during COVID-19 pandemic.Copyright © 2023 The Authors. Published by Innovare Academic Sciences Pvt Ltd.
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Introduction: Typical manifestations of Coronavirus disease 2019 (COVID-19) include respiratory involvement. Gastrointestinal (GI) symptoms have also been reported as early clinical manifestations. The GI involvement can represent with diarrhea, vomiting, and abdominal pain. The present research aimed to identify dysentery as one of the signs of GI involvement in the novel coronavirus infection in children. Case Presentation: We report twelve patients with COVID-19 and dysentery. All these children had positive reverse transcriptionpolymerase chain reaction (RT-PCR) results. None had underlying illnesses or recent travel history. However, all children had contact with a first-degree relative affected by non-digestive COVID-19. In three patients, obvious dysentery was observed, and in the rest, red and white blood cells were evident in the stool exam. Stool exams were negative for bacterial infections, parasites, and the toxin of Clostridium difficile. Abdominal ultrasonography and echocardiographic evaluations to rule out multisystem inflammatory syndrome in children were normal. Supportive treatment, such as zinc supplementation and probiotics, was prescribed. They also received intravenous fluid therapy based on their dehydration percentage. In the end, they were discharged in good general condition without any complications. No GI complications were found in the follow-up series. Conclusion(s): Dysentery in children can be one of the GI manifestations of COVID-19, which is usually self-limiting. It does not require invasive diagnostic measures and antiviral treatments. This symptom is in contrast to other viral infections of the GI tract.Copyright © 2022, Author(s).
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Introduction: Quality of life is a state of complete physical, mental and social well-being. Due to the COVID-19 pandemic, which led to changes in the daily routine, there was a change in the psychosocial functioning of individuals. Given that laryngectomized patients belong to a vulnerable group that requires psychological support after surgery, specific epidemiological measures during the COVID-19 pandemic could only further increase the fear and reluctance that is especially pronounced after surgery. Aim(s): The aim of this study was to investigate whether there was a link between the quality of life of laryngectomized patients and the COVID-19 pandemic. Method(s): The literature review was performed through the Google Scholar Advanced Search search engine and the Consortium of Libraries of Serbia for Unified Acqusition - KoBSON. Result(s): The first wave of the COVID-19 pandemic significantly disrupted the emotional well-being of patients with head and neck cancer. These patients became even more anxious due to the high mortality from the COVID-19 viral infection, hospital occupancy and missed therapeutic examinations. The need for togetherness, impaired concentration and attention, irritability and fear that family members might suffer from a deadly disease were the most common behavioral problems identified during the COVID-19 pandemic. Conclusion(s): The psychological burden associated with the direct and indirect effects of the COVID-19 pandemic should not be overlooked, given the fact that laryngectomized patients have twice the risk of suicide compared to patients who have undergone other types of cancer. Assessing the quality of life in laryngectomized patients is very important because it enables the timely identification of mental disorders and suggests the necessary support measures.Copyright © 2022 Sciendo. All rights reserved.
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Introduction: Individuals with intellectual disabilities experience greater difficulties compared to the general population in using masks to protect from SARS-CoV-2 due to inability to understand the need to wear masks, hypersalivation, irritability etc. This study aims to identify the challenges faced by these individuals in using masks and their correlation with the severity of intellectual disability. Methodology: 50 individuals aged 6 to 18 years with intellectual disabilities attending NIEPID were recruited after taking informed consent from the caregivers. Socio-demographic details and difficulties faced while using masks and when their family members wear masks were collected using semi-structured proforma. Data was analyzed using MS Excel and SPSS version 25. Result(s): The mean age of participants was 11.06 years. Male: Female ratio was 1.94:1. Majority (92%) of individuals were having mild to moderate intellectual disabilities. 62% wore masks properly. Irritability (24%) and touching the masks repeatedly (54%) were the commonest mood and behavioral changes noted while wearing masks respectively. Soiling of masks as a result of hypersalivation was a concern in 18% of the cases. The strength of significant correlations between the degree of mental retardation and difficulties faced with mask usage was negligible to low. Discussion(s): 88% and 54% of individuals observed their family members while wearing masks and tried to imitate this behaviour respectively. This can be utilized in training to wear masks. Behavioural issues when family members wear masks place them at a higher risk of contracting covid. Improper fitting of masks was an issue in 30% of the study population and requires exercising caution while selecting masks. Conclusion(s): Insights gained into the challenges faced by individuals with intellectual disabilities while using masks help devise appropriate behavioral interventions to enhance compliance with using masks. Mask tolerance training is essential for preparedness for future pandemics.
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Introduction: The COVID-19 pandemic is one of the most stressful events in recent times. Medical professionals, including anesthesiologists-reanimatologists, suffered the main blow in this difficult and stressful environment. Aim(s): This study aimed at identifying the features of anesthesiologists-reanimatologists' emotional states in different COVID-19 pandemic periods. Method(s): The study was conducted through an anonymous questionnaire among anesthesiologists-reanimatologists in two periods. In the First stage - which was carried out in May 2020 (during the first COVID-19 pandemic wave) - 58 anesthesiologists-reanimatologists in the Arkhangelsk region took part. During the Second segment - which took place in October 2020 (in the second COVID-19 pandemic wave) - 43 anesthesiologistsreanimatologists were examined. Repeated questioning was carried out among the same participants. Result(s): In October 2020, compared to May, the number of doctors who noted a high intensity of professional activity increased. Regardless of the study period, one-third of the subjects experienced constant pronounced anxiety. Anesthesiologists-reanimatologists, whose professional activity was directly related to the patients in COVID-19 care, noted a poorer emotional state more frequently in October, accompanied by anxiety, depressed mood, irritability and a high burnout level, which may indicate a depletion of internal resources in this group. Conclusion(s): The study results showed that for anesthesiologists-reanimatologists, a further depletion of emotional resources accompanied the second pandemic wave. The anesthesiologists-reanimatologists' emotional state was mediated by a number of social and gender factors, as well as specific labor organization features.Copyright © 2022 The Authors. Published by Semmelweis University, Institute of Mental Health, Budapest.
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Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.Copyright © The Author(s) 2022.
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Aims and objective: To present a series of 5 cases of Stress Related Disorders in HCWs during the covid second wave where they bounced back and recovered fully, returned to work Methodology: Reporting 5 different cases of psychological trauma in healthcare workers working in the peak of covid pandemic as frontline workers -02 doctors, 02 Nurses, and 01 health assistant who reported symptoms of vague nature arising out of stress during handling of Covid 19 pts. All of them had clear cut psychological symptoms arising in close temporal relation to experiencing the trauma of handling covid patients and the agony and disaster that befell us during the covid second wave from April to Aug 2021. None of them had any past history of psychiatric illness or genetic loading of significance. None of them had any other significant live stressor in personal life or h/o drug abuse. Thus underlying the life threatening nature of Covid exposure as a healthcare worker and it's psychological implications. All of them were referred for vague symptoms like irritable mood, not able to function as before, physical symptoms of headache, marital discord etc. The exposure ranged from personal handling of serious covid patients to handling dead bodies in the mortuary to managing relatives of dying patients. No preventive distressing mechanism was available to them, the need of which is the learning from this study. Also, the remarkable recovery and resumption of functioning and return to duty shown by these frontline healthcare covid warriors with minimal support from the environment is a lesson in bouncing back from psychological trauma, a concept recognized as resilience. The Resilient HCWs ascribed their bouncing back to peer and organizational support during crisis, a sense of duty to care and psychoeducation as their driving force to early recovery, among other things Results: High index of suspicion, early intervention, empathetic handling, psycho education, behavioral modifications and cognitive counseling with a short course of anxiolytics and antitidepressants in few, helped all of them improve completely with return to almost normal functioning. Conclusion(s): The Covid experience has been a life threatening experience for HCWs involved in treatment of serious covid patients during covid pandemic esp the second wave. It has been a never before experienced reality, completely overwhelming and traumatogenic enough to cause psychological decompensation in some of them. For the few diagnosed, there would be many undiagnosed HCWs. The focus should be on high index of suspicion for stress related psychological trauma in HCWs and it's mitigation through early detection and support for complete recovery. The importance of systemic, family and peer support is emphasized.
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Young children who experience trauma and adverse experiences are at an increased risk of developing an insecure attachment style as well as negative physical and mental health problems. These can include internalizing and externalizing behavioral problems, developmental delay, emotional dysregulation, and aggression. Several evidence-based interventions exist to treat young children with symptoms related to trauma, each with different foundational theories. This article presents the case of a 4-year-old boy with posttraumatic stress disorder who was in the middle of a legal fight between caregivers and transitioning between caregivers' homes. Initially, therapy began with Child-Parent Psychotherapy to address caregivers' first concerns. Later, the therapeutical approach was switched to Parent-Child Interaction Therapy due to difficulty with treatment fidelity related to caregivers' symptoms and conflict. This case demonstrates great improvement in treatment fidelity and subsequently problem behaviors after switching to an intervention that allowed to address behavior management shortcomings in a family with ongoing conflict.Copyright © The Author(s) 2022.
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Purpose: To compare the frequency of occurrence of various symptoms of post-covid syndrome (PCS) in groups of patients with rheumatic diseases (RD) of the elderly to young. Material(s) and Method(s): The study involved 89 patients with RD who underwent COVID-19, verified by RT-PCR for SARS-CoV- 2 RNA, for the period from 05/15/2020 to 12/01/2021. Participants in the study, after talking with the research physician, completed questionnaires on past COVID-19 and post-COVID syndrome (PCS). The information was supplemented with data from discharge records after inpatient treatment for COVID-19. Result(s): The data obtained were differentiated depending on the age of the participants: <60 years (group 1), N = 69 and >=60 years (group 2), N = 20. Both groups were dominated by women (82.6% and 85%). The average age in group 1 was 41.9 +/- 11.6 years, in group 2 -68.5 +/- 5.1 years. 33 (47.8%) patients in group 1 and 10 (50%) in group 2 noted the development of PCS. In group 1, the following symptoms of PCS prevailed: memory impairment -in 17 (51.5%) patients, fatigue, weakness -in 14 (42.4%), problems with concentration -in 14 (42.4%), arthralgia -in 12 (36.4%) %, shortness of breath during physical exertion -in 11 (33.3%), drowsiness -in 10 (30.3%), irritability -in 9 (27.3%). In group 2, the most common memory impairment -in 8 (80%) patients, weakness, fatigue -in 7 (70%), arthralgia -in 7 (70%), problems with concentration -in 6 (60%), weight loss -in 5 (50%), irritability -in 5 (50%), sleep disturbance -in 5 (50%). The frequency of occurrence of different manifestations of PCS did not differ significantly between the groups. On average (median), each patient in group 1 noted 4 [2;8], group 2 -10 [8.25;12.5] symptoms of PCS at the same time, but the differences did not reach statistical significance. Conclusion(s): The frequency of occurrence of various clinical manifestations of PCS did not have statistically significant differences between the study groups. In a comparative assessment, the group of elderly patients noted a greater number of symptoms of PCS at the same time.