Association of sociodemographic characteristics, mental health, and sleep quality with COVID-19 fear in an elderly Brazilian population

Aim: This study determined whether COVID-19 fear is correlated with sociodemographic characteristics, general health, mental health, and sleep quality in an elderly Brazilians. Methods: Elderly people aged ≥ 60 years replied to an online survey containing questions about their sociodemographic characteristics; general health; levels of stress, anxiety, and depression; sleep quality; and COVID fear. Results: Data were statistically analyzed using descriptive statistics (α = 5%). In total, 705 elderly people with mean age of 66 ± 5 years, and most (82.7%) respondents were women, graduated and from southeastern Brazil. COVID-19 fear correlated positively and moderately with sleep quality and symptoms of depression, anxiety, and stress (all p < 0.001). It was associated with females. Elderly people from northern and northeastern Brazil and diabetics had increased COVID-19 fear (all p < 0.05). Conclusion: The fear of COVID-19 exists among Brazilian female old people, diabetics, increases anxiety and stress symptoms, and worsen sleep quality in elderly people

Understanding Mobile Health and Youth Mental Health: Scoping Review.

BACKGROUND: A total of 75% of people with mental health disorders have an onset of illness between the ages of 12 and 24 years. Many in this age group report substantial obstacles to receiving quality youth-centered mental health care services. With the rapid development of technology and the recent COVID-19 pandemic, mobile health (mHealth) has presented new opportunities for youth mental health research, practice, and policy. OBJECTIVE: The research objectives were to (1) synthesize the current evidence supporting mHealth interventions for youths who experience mental health challenges and (2) identify current gaps in the mHealth field related to youth's access to mental health services and health outcomes. METHODS: Guided by the methods of Arksey and O'Malley, we conducted a scoping review of peer-reviewed studies that used mHealth tools to improve youth mental health (January 2016-February 2022). We searched MEDLINE, PubMed, PsycINFO, and Embase databases using the following key terms: (1) mHealth; (2) youth and young adults; and (3) mental health. The current gaps were analyzed using content analysis. RESULTS: The search produced 4270 records, of which 151 met inclusion criteria. Included articles highlight the comprehensive aspects of youth mHealth intervention resource allocation for targeted conditions, mHealth delivery methods, measurement tools, evaluation of mHealth intervention, and youth engagement. The median age for participants in all studies is 17 (IQR 14-21) years. Only 3 (2%) studies involved participants who reported their sex or gender outside of the binary option. Many studies (68/151, 45%) were published after the onset of the COVID-19 outbreak. Study types and designs varied, with 60 (40%) identified as randomized controlled trials. Notably, 143 out of 151 (95%) studies came from developed countries, suggesting an evidence shortfall on the feasibility of implementing mHealth services in lower-resourced settings. Additionally, the results highlight concerns related to inadequate resources devoted to self-harm and substance uses, weak study design, expert engagement, and the variety of outcome measures selected to capture impact or changes over time. There is also a lack of standardized regulations and guidelines for researching mHealth technologies for youths and the use of non-youth-centered approaches to implementing results. CONCLUSIONS: This study may be used to inform future work as well as the development of youth-centered mHealth tools that can be implemented and sustained over time for diverse types of youths. Implementation science research that prioritizes youths' engagement is needed to advance the current understanding of mHealth implementation. Moreover, core outcome sets may support a youth-centered measurement strategy to capture outcomes in a systematic way that prioritizes equity, diversity, inclusion, and robust measurement science. Finally, this study suggests that future practice and policy research are needed to ensure the risk of mHealth is minimized and that this innovative health care service is meeting the emerging needs of youths over time.

Covid-associated psychosis - A challenge for expert opinion.

Discussed is the case of a 41-year-old pilot with no relevant psychiatric history who presented with headache, fatigue, and lack of drive in the context of a confirmed mild COVID infection. At the same time he suffered from a paranoid symptomatology persisting for several weeks. After remission the patient remained stable also after discontinuation of neuroleptic medication. CCT, NMR, CSF were normal. The interrelationship between COVID and acute psychosis is discussed.Copyright © 2023 Georg Thieme Verlag. All rights reserved.

Prevalence and Factors Associated with Mental Health Problems among Essential and Nonessential Workers during the COVID-19 Pandemic, June 2021, in an Unstable and Developing Country: A Cross-Sectional Study

The two main goals of this research were to assess workers' mental health (anxiety, depression, and job burnout syndrome) and examine factors related to mental health burdens in two groups of workers. The study was conducted as an online cross-sectional study. The target population consists of workers in essential activities who worked during the pandemic (health, defense, trade, finance, and media), as well as a group of workers who were particularly impacted by the protection measures and either worked under a different regime or were unable to work (caterers, musicians). A questionnaire was constructed for the needs of this research and the scales for anxiety, depression, and burnout syndrome were used. In total, 42.2% of non-essential workers and 39.5% of essential workers reported anxiety symptoms, circa 20% of non-essential activity workers and essential activity workers reported depression, and 28.9% of non-essential activity workers and 33.7% of essential activity workers reported burnout. A significant association has been found between certain sociodemographic and health characteristics of respondents, as well as financial stress (worry about losing a job), social stress, media stress, and respondents' trust in competent authorities and COVID-19 prevention measures, and symptoms of anxiety, depression, and burnout syndrome. The findings of this study pointed to mental health issues in other activities and highlighted the need for and importance of examining mental health in the population of non-essential activities. It is indicative of significant points that can be investigated in the future for prevention. © 2023 by the authors.

Utilization of Teleconsultation: Mitigation in Handling Mental Disorders in the COVID-19 Era.

The COVID-19 pandemic has caused many undesirable effects, including death. The COVID-19 outbreak occurred suddenly, and many countries were ill prepared to face it. Community behaviour has been altered due to the pandemic. Uncertainty surrounding the disease triggered panic buying; public panic caused additional worry about limited food supplies, and thus demand increased. World economies have also felt the impacts of the COVID-19 outbreak. Owing to the measures put in place to address the spread of COVID-19, many service providers and industries were closed, resulting in financial losses, and the risk of unemployment was elevated, which inevitably increased negative emotions in individuals. A psychosocial consequence of the COVID-19 pandemic is worldwide fear. Because psychological defence is a supporting factor for the recovery of COVID-19 patients, it is important to encourage prevention of mental stress. Psychotherapy is able to provide counselling services to the community through teleconsultation. Strengthening psychological defences can help countries fight against this disease.

The Impact of COVID-19 Pandemic on Psychiatric Rehabilitation in Residential Facilities: Perspectives of Staff and Residents.

The coronavirus pandemic imposed significant changes in the care of patients in psychiatric residential facilities, especially during lockdown periods. The aim of this study was to assess the impact of the pandemic on patients and staff of psychiatric residential facilities (RFs). This cross-sectional survey was conducted between 30 June and 30 July 2021 and involved 31 RFs located in the province of Verona (Italy). In total, 170 staff members and 272 residents participated in this study. Staff showing clinically significant symptoms of anxiety, depression and burnout were, respectively, 7.7%, 14.2% and 6%. Staff were concerned about the risk that COVID-19 infection might spread among residents (67.6%) and that residents could not receive an acceptable service due to service reconfiguration because of the pandemic (50.3%). Residents found it very unpleasant not to be permitted to attend family members (85.3%), and not to be allowed to engage in outdoor activities due to the restrictions (84%). Both staff and residents agree that the main problematic areas for the residents was the interdiction to meet family members or friends and the interdiction to outdoor activities, whereas problems related to the COVID-19 infection were considered by the staff members as more frequently problematic than reported by residents. The COVID-19 pandemic had a significant impact on the rehabilitation care and recovery journeys of the residents of psychiatric RFs. Therefore, sustained, and careful attention is needed to ensure that the rehabilitation needs of people with severe mental disorders are not neglected in time of pandemics. Supplementary Information: The online version contains supplementary material available at 10.1007/s40737-023-00343-6.

Status of mandatory treatment of mentally ill offenders without criminal responsibility in China: Information from 5,262 mandatory treatment judgments.

Background: To avoid public health risks, all governments ensure monitoring and treatment of mentally ill persons if they offend and assess their level of criminal responsibility. The Criminal Procedure Law of the People's Republic of China (2013) instituted special procedures. However, there are few articles in English which explain the implementation of mandatory treatment procedures in China. Methods: We collected 5,262 qualified documents from 2013 to 2021 from the China Judgments Documents Online. We analyzed social demographic characteristics, trial-related information as well as the mandatory treatment-related content, to investigate the mandatory treatment of China's mentally ill offenders without criminal responsibility, from 2013 to 2021. Simple descriptive statistics and chi-square tests were used to compare differences among several types of documents. Results: There was an overall change trend of the number of documents: increasing year by year from 2013 to 2019 after the implementation of the new law, but with sharp decrease in 2020 and 2021 during covid-19 pandemic. From 2013 to 2021, a total of 3,854 people had applications made for mandatory treatment, of whom 3,747 (97.2%) were given mandatory treatment, 107 (2.8%) had applications rejected. "Schizophrenia and other psychotic disorders" was the most common diagnosis in both groups and all offenders receiving mandatory treatment (3,747, 100.0%) were considered to have no criminal responsibility. A total of 1,294 patients had applications made for relief of mandatory treatment, of whom 827 (63.9%) were subsequently approved for relief, 467 (36.1%) were rejected. A total of 118 patients had applications for relief two or more times, and 56 (47.5%) were finally relieved. Conclusion: Our study presents the Chinese model of a criminal mandatory treatment system to the international community which has been in operation since the implementation of the new law. Legislatory changes and covid-19 pandemic can have effect on the number of mandatory treatment cases. Patients, their close relatives and mandatory treatment institutions have the right to apply for relief from mandatory treatment, but the final decision in China is taken by the court.

Somatic health according to people with severe mental disease.

OBJECTIVES: Patients with schizophrenia have a 15- to 20-year shorter life expectancy compared with the general population. The aim of this study was to explore these patients' perception of their physical health. METHODS: A patient reported outcomes measure (PROM) has been developed by patients with severe mental disease. This survey had to better capture undetected, under-rated and non-prioritized physical domains by traditional routine clinical scales that are important for people who live with mental health disease. These patients have tested the applicability of this PROM with peers with severe mental disease in medical, social and community-based centers from Hauts-de-France. RESULTS: Two and a half years have been required to develop this PROM, to test its applicability to patients with severe mental disease and to analyze the results. The study process has been slowed by the sanitary context induced by the COVID-19 pandemic. Thirty-two questionnaires have been collected by the participants. Despite this low number of data, participants have been satisfied by the results and their experience. The results show that people with severe mental disease consider physical health as a major concern, notably pain and somatic diseases. External factors (such as accessibility to health care and medication) and internal factors (such as self-esteem, cognitive and negative symptoms, sleep, alimentation, and substance use) have been identified as barriers for physical health. CONCLUSIONS: These results support the development of PROMs highlighting personal experience of people with severe mental disease. The data obtained thanks to these measures will allow to build programs to help them to cope with barriers for physical health.

COVID-19 and common mental disorders among university students in South Africa

COVID-19 has had far-reaching economic, social and health consequences, with vulnerable groups disproportionally affected. Even before the COVID-19 pandemic, concern was expressed about university students' mental health, with global data suggesting students are more vulnerable than the general population to mental disorders. Yet, it is unclear what the pandemic's impact has been on the mental health of students in South Africa. We examined the impact of COVID-19 on first-year students at two universities in South Africa by analysing changes in the prevalence and age-of-onset of three common mental disorders (namely major depressive episode, generalised anxiety disorder, and suicidal ideation) before and during the pandemic, and comparing these to changes between 2015 and 2017. Our analysis of cross-sectional survey data collected in 2015, 2017 and 2020 shows no clear or consistent pattern of increases in prevalence of common mental disorders following the start of the pandemic. Lifetime prevalence rates of common mental disorders among students have been steadily increasing since 2015, and where increases before and during COVID-19 were observed, they are not consistently larger than increases between 2015 and 2020. No significant changes were observed in the 12-month prevalence of common mental disorders before and during COVID-19, except for an increase in prevalence of depression at one institution, and a decrease in suicidal ideation at the other. Findings suggest that in the context of ongoing adversity and disruptions on South African university campuses in recent years, COVID-19 may be just one more stressor local students face and that its impact on student mental health may not have been as marked in South Africa compared to other regions. © 2023. The Author(s). Published under a Creative Commons Attribution Licence.

Antecedents of Mental Disorder among Physically Inactive Employees Study of Jordanian Higher Education Institutions: Mediated Moderation of Perceived Threat of Covid-19 and Psychological Capital

This study aimed at identifying the antecedents and explaining the unexplored path of mental disorder among the physically inactive individuals. Grounded in social cognitive theory and social exchange theory, this cross sectional field study with convenient sampling examines stress, anxiety, depression, and mental disorder in 377 survey respondents from Jordanian higher education institutions. Additionally, moderating effect of psychological capital and the mediating effect of perceived COVID-19 threat was assessed. Results from Structural Equation Modelling (SEM) indicate that the direct links between stress, anxiety, depression on mental disorder were significant. Further using PLS mediated moderation analysis the moderating effect of psychological capital and mediating effect of perceived COVID-19 threat was proved in Jordanian sample. The study is incremental to suggest future research directions and policy insights for developing countries and specifically these findings are vital for clinical psychologists and practitioners working in Jordanian setting. © 2023,Pakistan Journal of Life and Social Sciences.All Rights Reserved.

Tracking Population-Level Anxiety Using Search Engine Data: Ecological Study.

BACKGROUND: Anxiety disorders are the most prevalent mental disorders globally, with a substantial impact on quality of life. The prevalence of anxiety disorders has increased substantially following the COVID-19 pandemic, and it is likely to be further affected by a global economic recession. Understanding anxiety themes and how they change over time and across countries is crucial for preventive and treatment strategies. OBJECTIVE: The aim of this study was to track the trends in anxiety themes between 2004 and 2020 in the 50 most populous countries with high volumes of internet search data. This study extends previous research by using a novel search-based methodology and including a longer time span and more countries at different income levels. METHODS: We used a crowdsourced questionnaire, alongside Bing search query data and Google Trends search volume data, to identify themes associated with anxiety disorders across 50 countries from 2004 to 2020. We analyzed themes and their mutual interactions and investigated the associations between countries' socioeconomic attributes and anxiety themes using time-series linear models. This study was approved by the Microsoft Research Institutional Review Board. RESULTS: Query volume for anxiety themes was highly stable in countries from 2004 to 2019 (Spearman r=0.89) and moderately correlated with geography (r=0.49 in 2019). Anxiety themes were predominantly long-term and personal, with "having kids," "pregnancy," and "job" the most voluminous themes in most countries and years. In 2020, "COVID-19" became a dominant theme in 27 countries. Countries with a constant volume of anxiety themes over time had lower fragile state indexes (P=.007) and higher individualism (P=.003). An increase in the volume of the most searched anxiety themes was associated with a reduction in the volume of the remaining themes in 13 countries and an increase in 17 countries, and these 30 countries had a lower prevalence of mental disorders (P<.001) than the countries where no correlations were found. CONCLUSIONS: Internet search data could be a potential source for predicting the country-level prevalence of anxiety disorders, especially in understudied populations or when an in-person survey is not viable.

Suicide and COVID-19: a rapid scoping review.

There is considerable interest in exploring effects of coronavirus disease 2019 (COVID-19) pandemic on mental health. Suicide is one of the leading causes of mortality worldwide and changes in daily life brought by the pandemic may be additional risk factors in people with pre-existing mental disorders. This rapid PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) scoping review aims to identify and analyze current evidence about the relation between COVID-19 pandemic outbreak, along with COVID-19 disease and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection, and suicide in individuals with previously diagnosed mental disorders. First, we conducted a comprehensive review of the literature, then proceeded to discuss findings in a narrative way. Tables were constructed and articles sorted according to the studies' methodologies. 53 papers were eventually identified as eligible, among which 33 are cross-sectional studies, 9 are longitudinal studies, and 11 studies using other methodologies. Despite suffering from a mental disorder is a risk factor for suicidal behavior per se, the advent of COVID-19 pandemic may exacerbate this relation. Nevertheless, data addressing a clear correlation between suicidal behavior and the pandemic outbreak are still controversial. Longitudinal analysis using validated suicide scales and multicenter studies could provide deeper insight and knowledge about this topic.

Community Participation Among Individuals with Severe Mental Disorders During COVID-19 Pandemic.

Utilizing a sample of 286 community-dwelling adults with severe mental disorders (SMDs) in Beijing, this study examined their social and community participation during COVID-19 pandemic. The descriptive results showed that adults with SMDs living in the pandemic Beijing mostly engaged in social activities, followed by productive and leisure/recreational activities. More than two-thirds of the participants indicated that their participation was not sufficient. The multivariate analyses revealed that higher social support and self-esteem predicted more participation days, higher social support and independent usage of Health Kit were linked to more participation items, while higher social support and stronger self-stigma were associated with lower perceived participation sufficiency. Thus, community mental health professionals need to provide more tailored interventions to people with SMDs to enhance their participation performance and perceived participation sufficiency during the pandemic era.

Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study.

Background: The COVID-19 pandemic is commonly believed to have increased common mental disorders (CMD, i.e., depression and anxiety), either directly due to COVID-19 contractions (death of near ones or residual conditions), or indirectly by increasing stress, economic uncertainty, and disruptions in daily life resulting from containment measure. Whereas studies reporting on initial changes in self-reported data frequently have reported increases in CMD, pandemic related changes in CMD related to primary care utilization are less well known. Analyzing time series of routinely and continuously sampled primary healthcare data from Sweden, Norway, Netherlands, and Latvia, we aimed to characterize the impact of the pandemic on CMD recorded prevalence in primary care. Furthermore, by relating these changes to country specific time-trajectories of two classes of containment measures, we evaluated the differential impact of containment strategies on CMD rates. Specifically, we wanted to test whether school restrictions would preferentially affect age groups corresponding to those of school children or their parents. Methods: For the four investigated countries, we collected time-series of monthly counts of unique CMD patients in primary healthcare from the year 2015 (or 2017) until 2021. Using pre-pandemic timepoints to train seasonal Auto Regressive Integrated Moving Average (ARIMA) models, we predicted healthcare utilization during the pandemic. Discrepancies between observed and expected time series were quantified to infer pandemic related changes. To evaluate the effects of COVID-19 measures on CMD related primary care utilization, the predicted time series were related to country specific time series of levels of social distancing and school restrictions. Results: In all countries except Latvia there was an initial (April 2020) decrease in CMD care prevalence, where largest drops were found in Sweden (Prevalence Ratio, PR = 0.85; 95% CI 0.81-0.90), followed by Netherlands (0.86; 95% CI 0.76-1.02) and Norway (0.90; 95% CI 0.83-0.98). Latvia on the other hand experienced increased rates (1.25; 95% CI 1.08-1.49). Whereas PRs in Norway and Netherlands normalized during the latter half of 2020, PRs stayed low in Sweden and elevated in Latvia. The overall changes in PR during the pandemic year 2020 was significantly changed only for Sweden (0.91; 95% CI 0.90-0.93) and Latvia (1.20; 95% CI 1.14-1.26). Overall, the relationship between containment measures and CMD care prevalence were weak and non-significant. In particular, we could not observe any relationship of school restriction to CMD care prevalence for the age groups best corresponding to school children or their parents. Conclusion: Common mental disorders prevalence in primary care decreased during the initial phase of the COVID-19 pandemic in all countries except from Latvia, but normalized in Norway and Netherlands by the latter half of 2020. The onset of the pandemic and the containment strategies were highly correlated within each country, limiting strong conclusions on whether restriction policy had any effects on mental health. Specifically, we found no evidence of associations between school restrictions and CMD care prevalence. Overall, current results lend no support to the common belief that the pandemic severely impacted the mental health of the general population as indicated by healthcare utilization, apart from in Latvia. However, since healthcare utilization is affected by multiple factors in addition to actual need, future studies should combine complementary types of data to better understand the mental health impacts of the pandemic.

Prevalence of post-traumatic stress disorder symptoms among patients with mental disorder during the COVID-19 pandemic.

BACKGROUND: The outbreak of the COVID-19 pandemic has caused extensive public health concerns, posing significant challenges to healthcare services. One particular area of concern is the mental health of patients with mental disorder, who are often a neglected group. The aim of this study was to investigate the prevalence of, and associated factors for symptoms of post-traumatic stress disorder (PTSD) among patients with mental disorder in China during the COVID-19 pandemic. METHODS: Self-reported questionnaires were distributed to patients in four psychiatric hospitals in Beijing, China, between April 28th and May 30th, 2020. Information regarding sociodemographic characteristics, COVID-19 related factors, support, psychosomatic factors, and PTSD symptoms were collected using a series of scales, such as the Impact of Event Scale-Revised, the 7-item Generalized Anxiety Disorder Scale, the 9-item Patient Health Questionnaire depression scale, and so on. Multivariate regression was used to identify factors related to PTSD symptoms. RESULTS: A total of 1,055 patients with mental disorder were included in the final sample. The prevalence of PTSD symptoms was 41.3%. Hierarchical linear regression demonstrated that fear of the pandemic and anxiety were shared associated factors for both symptoms of PTSD and their subscales. Additionally, age was an associated factor for the total PTSD (ß = 0.12, p < 0.01), intrusion (ß = 0.18, p < 0.001), and avoidance (ß = 0.1, p < 0.05) symptoms; depression was an associated factor for the total PTSD (ß = 0.13, p < 0.001), intrusion (ß = 0.11, p < 0.01), and hyperarousal (ß = 0.19, p < 0.001) symptoms. CONCLUSIONS: The prevalence of PTSD symptoms was high among patients with mental disorder during the COVID-19 pandemic in China. This study found that age, fear of the pandemic, anxiety and depression are significant associated factors of PTSD symptoms in patients with mental disorder during the pandemic. We call for higher awareness and introduction of PTSD interventions to relieve the psychological stress in these patients.

A Triple Jeopardy: Inadequate Knowledge about COVID-19 among Older Persons with Psychiatric Diagnosis attending a Geriatric Centre in Southwest Nigeria.

BACKGROUND: Older persons with mental illnesses have been affected by COVID-19 because of reduced access to routine health care, the adverse social impacts of preventive strategies and inadequate knowledge of the COVID-19 pandemic. Adequate knowledge is crucial to ensuring adherence to the right preventive practices. OBJECTIVES: This study evaluates the knowledge gaps about COVID-19 and preventive practices among older persons with psychiatric diagnoses (PD) in comparison with older persons with non-psychiatric diagnosis (nPD). METHODS: A hospital-based comparative study was conducted among older persons attending the sycho-geriatric and Healthy Ageing clinics of the Geriatric Centre, University College Hospital, Ibadan, Nigeria. Data were gathered with a semi-structured interviewer-administered questionnaire, and SPSS version 23 was used to analyse the data. Level of significance was set at 5%. RESULTS: 390 respondents aged 60 and above were sampled in the two groups: 195 with PD and 195 with nPD. Their mean age was PD:72.2 (±7.4) years and nPD:71.0 (±8.0) years. Majority were aware of the ongoing pandemic (PD:95.9%; nPD:96.4%). The use of facemask (PD:89.7%; nPD:86.7%) was the commonest preventive practice. Male gender (OR: 2.09, CI ;1.14-3.86, p = 0.018) and education (OR: 5.10, CI; 1.15-22.67, p=0.032) were predictors of knowledge among PD and nPD respectively. CONCLUSION: Older persons with psychiatric diagnoses have more gaps in their knowledge of COVID-19. Inadequate knowledge about COVID-19 could further put them in jeopardy of contracting the virus with its associated morbidity and mortality, in addition to the risk that old age and mental illness contribute. Health education programs about COVID-19 targeting the older population with mental illnesses would be beneficial.

CONTEXTE: Les personnes âgées atteintes de maladies mentales ont été différemment touchées par la COVID-19 en raison d'un accès réduit aux soins de santé de routine, les impacts sociaux négatifs des stratégies de prévention et la connaissance insuffisante de la pandémie de COVID-19. Des connaissances adéquates sont essentielles pour garantir le respect des bonnes pratiques de prévention, en particulier chez les personnes âgées. OBJECTIFS: Cette étude évalue les lacunes dans les connaissances sur le COVID19 et les pratiques réventives chez les personnes âgées ayant des diagnostics psychiatriques par rapport à ceux avec un diagnostic non psychiatrique. METHODES: Une étude comparative en milieu hospitalier a été menée auprès de personnes âgées fréquentant les cliniques de psychogériatrie et de vieillissement en santé du Centre gériatrique, Hôpital du Collège Universitaire, Ibadan, Nigéria. Les données ont été recueillies à l'aide d'un questionnaire semi-structuré administré par un intervieweur, et SPSS version 23 a été utilisé pour analyser les données. Le seuil de signification a été fixé à 5%. RESULTATS: 390 répondants âgés de 60 ans et plus ont été échantillonnés dans les deux groupes: 195 avec undiagnostic psychiatrique (PD) et 195 avec undiagnostic non psychiatrique (nPD). Leur âge moyen était PD : 72.2 (± 7.4) ans et nPD: 71.0 (±8.0) ans. La majorité était au courant de la pandémie en cours (PD:95.9 %; nPD: 96.4 %). L'utilisation du masque facial (PD:89.7 %; nPD:86.7 %) était la pratique préventive la plus courante. Le sexe masculin (OR:2.09, IC;1.14-3.86, p=0.018) et l'éducation (OR :5.10, IC ;1.15-22.67, p=0.032) étaient des prédicteurs des connaissances chez les PD et les nPD respectivement. CONCLUSION: Les personnes âgées avec des diagnostics psychiatriques ont plus de lacunes dans leurs connaissances sur le COVID-19. Une connaissance insuffisante du COVID-19 pouurait les mettre davantage en danger de contracter le virus et c'est la morbidité et la mortalité associées, en plus du risque que la vieillesse et la maladie mentale contribuent. Des programmes d'éducation sanitaire sur le COVID-19 ciblant la population âgée souffrant de maladies mentales seraient bénéfiques.

Pediatric psychiatric emergency rooms during COVID-19: a multi-center study.

BACKGROUND: The COVID-19 (SARS-CoV-2) pandemic has been a major stressor for the mental health and well-being of children and adolescents. Surveys and reports from hotlines indicate a significant rise in mental health problems. As the psychiatric emergency room (ER) is a first-line free-of-charge facility for psychiatric emergencies, we expected to see a significant increase in visits, specifically of new patients suffering from anxiety, depression, or stress-related disorders. METHODS: Data from two psychiatric hospital ERs and one general hospital were included. All visits of children and adolescents from the computerized files between March and December of 2019 were analyzed anonymously and compared to the same months in 2020, using multilevel linear modeling. RESULTS: There was a significant decline in the total number of visits (p = .017), specifically among those diagnosed as suffering from stress-related, anxiety, and mood disorder groups (p = .017), and an incline in the proportion of visits of severe mental disorders (p = .029). DISCUSSION: The limited use of child and adolescent psychiatric emergency facilities during the pandemic highlights the importance of tele-psychiatry as part of emergency services. It also suggests the importance of the timeline of the emergence of clinically relevant new psychiatric diagnoses related to the pandemic. Future studies are needed to establish the long-term effects of the pandemic and the expeditious use of tele-psychiatry.

Impact of the COVID19 pandemic on patients followed in psychiatry

Introduction: In the literature, some studies consider psychiatric patients to be vulnerable to COVID-19, in contrast to other studies that find them rather protected. Objective(s): To determine the impact of the COVID 19 pandemic on patients undergoing psychiatric care. Method(s): This is a descriptive and cross-sectional study that took place in the psychiatry department A at Razi hospital in Tunisia. We conducted a comparison of patient follow-up between the period of March 2018-2019 and March 2020-2021. For this we used a form including socio demographic data, data concerning the COVID-19 situation, clinical data while comparing the follow-up of patients (hospitalizations, mode of relapses, consultations in the emergency room.) Results: 100 patients were included, 60% were men, mean age 44 years (+/- 11 years) [19-65 years]. Ninety-seven percent of patients had no personal history of COVID-19 infection. Comparing the pre-pandemic year (2018-2019) and the pandemic year (2020-2021), we note an increase in the rate of emergency room visits of (17.5%) as well as a relapse rate requiring hospitalization in our department in 48%, this figure was 30% in 2019. A statistically significant increase was noted for depressive and anxiety relapses (p=0.04;r=0.7). Fear of catching the virus while attending hospital facilities (17.6%), geographical isolation (17.6%), unavailability of treatment (17%) and poor insight (41.2%) were the primary causes of poor adherence. Conclusion(s): The patients followed in our department have presented during this COVID-19 pandemic several relapses of their psychiatric pathologies compared to the previous year.

Adapting DIALOG+ in a School Setting-A Tool to Support Well-being and Resilience in Adolescents Living in Postconflict Areas During the COVID-19 Pandemic: Protocol for a Cluster Randomized Exploratory Study.

BACKGROUND: Colombia has a long history of an armed conflict that has severely affected communities with forced internal displacement and violence. Victims of violence and armed conflicts have higher rates of mental health disorders, and children and adolescents are particularly affected. However, the mental health needs of this population are often overlooked, especially in low- and middle-Income countries, where scarcity of resources exacerbates the problem that has been further compounded by the global COVID-19 pandemic. Thus, special attention should be paid to the development of interventions that target this population. OBJECTIVE: Our research aims to adapt an existing patient-centered digital intervention called DIALOG+ from a clinical setting to an educational setting using stakeholders' (teachers' and students') perspectives. We aim to evaluate the feasibility, acceptability, and estimated effect of implementing this intervention as a tool for the identification and mobilization of personal and social resources to mitigate the impact of social difficulties and to promote mental well-being. METHODS: We will conduct an exploratory mixed methods study in public schools of postconflict areas in Tolima, Colombia. The study consists of 3 phases: adaptation, exploration, and consolidation of the DIALOG+ tool. The adaptation phase will identify possible changes that the intervention requires on the basis of data from focus groups with teachers and students. The exploration phase will be an exploratory cluster randomized trial with teachers and school counselors to assess the acceptability, feasibility, and estimated effect of DIALOG+ for adolescents in school settings. Adolescents' data about mental health symptoms and wellness will be collected before and after DIALOG+ implementation. During this phase, teachers or counselors who were part of the intervention group will share their opinions through the think-aloud method. Lastly, the consolidation phase will consist of 2 focus groups with teachers and students to discuss their experiences and to understand acceptability. RESULTS: Study recruitment was completed in March 2022, and follow-up is anticipated to last through November 2022. CONCLUSIONS: This exploratory study will evaluate the acceptability, feasibility, and estimated effect of DIALOG+ for adolescents in postconflict school settings in Colombia. The use of this technology-supported tool aims to support interactions between teachers or counselors and students and to provide an effective student-centered communication guide. This is an innovative approach in both the school and the postconflict contexts that could help improve the mental health and wellness of adolescents in vulnerable zones in Colombia. Subsequent studies will be needed to evaluate the effectiveness of DIALOG+ in an educational context as a viable option to reduce the gap and inequities of mental health care access. TRIAL REGISTRATION: ISRCTN Registry ISRCTN14396374; https://www.isrctn.com/ISRCTN14396374?q=ISRCTN14396374. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40286.

Brief App-Based Cognitive Behavioral Therapy for Anxiety Symptoms in Psychiatric Inpatients: Feasibility Randomized Controlled Trial.

BACKGROUND: Psychiatric inpatients often have limited access to psychotherapeutic education or skills for managing anxiety, a common transdiagnostic concern in severe and acute mental illness. COVID-19-related restrictions further limited access to therapy groups on inpatient psychiatric units. App-based interventions may improve access, but evidence supporting the feasibility of their use, acceptability, and effectiveness in psychiatric inpatient settings is limited. MindShift CBT is a free app based on cognitive behavioral therapy principles with evidence for alleviating anxiety symptoms in the outpatient setting. OBJECTIVE: We aimed to recruit 24 participants from an acute general psychiatric inpatient ward to a 1-month randomized control study assessing the feasibility and acceptability of providing patients with severe and acute mental illness access to the MindShift CBT app for help with managing anxiety symptoms. METHODS: Recruitment, data collection, analysis, and interpretation were completed collaboratively by clinician and peer researchers. Inpatients were randomized to two conditions: treatment as usual (TAU) versus TAU plus use of the MindShift CBT app over 6 days. We collected demographic and quantitative data on acceptability and usability of the intervention. Symptoms of depression, anxiety, and psychological distress were measured in pre- and poststudy surveys for preliminary signals of efficacy. We conducted individual semistructured interviews with participants in the MindShift CBT app group at the end of their trial period, which were interpreted using a standardized protocol for thematic analysis. RESULTS: Over 4 weeks, 33 inpatients were referred to the study, 24 consented to participate, 20 were randomized, and 11 completed the study. Of the 9 randomized participants who did not complete the study, 7 were withdrawn because they were discharged or transferred prior to study completion, with a similar distribution among both conditions. Among the enrolled patients, 65% (13/20) were admitted for a psychotic disorder and no patient was admitted primarily for an anxiety disorder. The average length of stay was 20 days (SD 4.4; range 3-21) and 35% (7/20) of patients were involuntarily admitted to hospital. Small sample sizes limited accurate interpretation of the efficacy data. Themes emerging from qualitative interviews included acceptability and usability of the app, and patient agency associated with voluntary participation in research while admitted to hospital. CONCLUSIONS: Our study benefitted from collaboration between peer and clinician researchers. Due to rapid patient turnover in the acute inpatient setting, additional flexibility in recruitment and enrollment is needed to determine the efficacy of using app-based psychotherapy on an acute psychiatric ward. Despite the limited sample size, our study suggests that similar interventions may be feasible and acceptable for acutely unwell inpatients. Further study is needed to compare the efficacy of psychotherapeutic apps with existing standards of care in this setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT04841603; https://clinicaltrials.gov/ct2/show/NCT04841603.