ABSTRACT
Aims: Trauma is particularly prevalent amongst Early Intervention (EI) patients and is associated with adverse clinical and prognostic outcomes. To determine the feasibility of a large-scale randomized controlled trial (RCT) of an 'EMDR for psychosis' intervention for trauma survivors with active psychotic symptoms supported by EI services, we conducted a single-blind RCT comparing 16 sessions of EMDRp + TAU versus TAU only. Method(s): EMDRp therapy and trial assessments were completed both in-person and remotely during the COVID-19 pandemic, and key feasibility outcomes (recruitment & retention, therapy attendance/ engagement, adherence to EMPRp treatment protocol, and the 'promise of efficacy' of EMDRp on relevant clinical outcomes) were examined at 6- and 12-month post-randomization assessments. Results and Conclusion(s): 60 participants (100% of the recruitment target) received TAU or EMDR + TAU. The feasibility criteria examined in this trial were fully met, and EMDRp was associated with promising signals of efficacy on a range of valuable post-treatment outcomes, including improved psychotic symptoms (PANSS), subjective recovery (QPR), post-traumatic symptoms (PCL-5;ITQ), depression (PHQ-9), anxiety (GAD-7) and general health status (EQ-5D-VAS) at the 6-month assessment. Signals of efficacy at 12-month were less pronounced, but remained robust for trauma symptoms and general health status. The findings will be discussed with relevance to future clinical trials of trauma-focused therapy in clients with early psychosis, and the provision of more tailored trauma therapies for EI service users.
ABSTRACT
Background: The outbreak of the COVID-19 pandemic, the constant transformation of the SARS-COV-2 virus form, exposure to substantial psychosocial stress, environmental change, and isolation have led to the inference that the overall population's mental health could be affected, resulting in an increase in cases of psychosis. Objective(s): We initiated a systematic review to determine the impact of the SARS-COV-2 virus and its long-term effects-in both symptomatic and asymptomatic cases-on people with or without psychosis. We envisioned that this would give us an insight into effective clinical intervention methods for patients with psychosis during and after the pandemic. Method(s): We selected fifteen papers that met our inclusion criteria, i.e., those that considered participants with or without psychiatric illness and exposed to SARS-COV-2 infection, for this review and were retrieved via Google, Google Scholar, MEDLINE, PubMed, and PsychINFO Database. Key Gap: There is a dearth of research in understanding how COVID-19 affects people with or without a prior personal history of psychosis. Result(s): The systematic review summary provides insight into the state of knowledge. Insights from the systematic review have also been reviewed from the salutogenesis model's perspec-tive. There is moderate evidence of new-onset psychosis during the COVID-19 pandemic in which some antipsychotics treated the psychotic symptoms of patients while treating for COVID-19. Suggestions and recommendations are made for preventive and promotive public health strategies. Conclusion(s): The Salutogenesis model and Positive Psychology Interventions (PPI) provide another preventive and promotive public health management approach.Copyright © 2023 Bentham Science Publishers.
ABSTRACT
Background: In the context of the COVID-19 pandemic, it is especially important to understand why patients avoid or continuously postpone immunization. The authors aim to understand the impact of the increasingly active spread of anti-vaccine arguments of the vaccination opponents, as well as the general distrust in the pharmaceutical industry, science and healthcare professionals in patients with Hereditary Angioedema (HAE) and recurrent Angioedema (AE) in North Macedonia. Method(s): A total of 92 patients diagnosed with AE and 35 patients diagnosed with HAE underwent structured interview conducted during routine check-ups. Result(s): 52 of the AE patients and 10 of the HAE patients stated that they are indecisive or opposed to vaccination, mostly because of a generalized negative attitude towards vaccines. The patients often stated that their attitude is based on a personal or a family member's negative experience with vaccines (76.9% of AE and 60% of HAE patients opposed to vaccination). When asked about the basis of such opinion, the patients' answers were vague and unspecific. The majority stated that they do not recall the source of information, some speculated about possible role of vaccines in autism diagnosis of a close family member, allergies or other pediatric diseases caused by vaccines, despite the lack of proof of connection. Such examples can be explained with the human tendency to remember negative information, although they have read such information somewhere on the internet or social media with no reliable source or validation. Confirmation bias is the tendency of individuals to seek information that confirm their existing hypothesis, while avoiding explanations that do not fit in with their opinion. Because of this, the previously formed negative attitude towards vaccines, can cause any negative symptoms to be misinterpreted as vaccine side-effects, additionally reaffirming the negative attitude. 61.5% of AE and 70% of HAE patients opposing vaccination stated that they believe that vaccines lead to serious adverse events, do not protect the individuals and society from infective diseases and are not sufficiently tested prior to their use. Conclusion(s): In conclusion, the author considers that continuous education of patients is a key condition for an improved rate of COVID-19 immunization of HAE and AE patients.
ABSTRACT
Background: The aim of our study was to assess the perceived mental health impact of the COVID-19 pandemic on people with schizophrenia spectrum disorder (SSD) in an inpatient forensic psychiatric institution and to identify personal networks most crucial for the patient during the pandemic. Method(s): In this cross-sectional survey study, 44 patients with SSD took part in a COVID-19-specific interview. The data was correlated with the Positive and Negative Syndrome Scale (PANSS) to evaluate the patients' psychopathology. In addition, we investigated subgroups of vaccinated and unvaccinated patients to analyze possible differences in psychopathology. Result(s): Less contact with family members was associated with significantly higher PANSS scores (p < 0.05). Patients who reported to feel less relaxed and more stressed during the pandemic than they had been before the outbreak of the virus showed significantly higher PANSS scores (p < 0.05). Unvaccinated patients demonstrated significantly higher PANSS scores than their vaccinated controls (p < 0.05). Conclusion(s): Social support from family members played an important role for people with SSD in inpatient forensic psychiatric institutions during the pandemic. Moreover, individuals with SSD seemed to be more emotionally vulnerable during the pandemic. A more pronounced symptomatology in patients with SSD might be a potential barrier to immunization against COVID-19.Copyright © 2022 Informa UK Limited, trading as Taylor & Francis Group.
ABSTRACT
Introduction: The COVID-19 pandemic is still having a strong impact on psychological and mental health worldwide. The pandemic generated a change in people's life and fear, loss of structure of daily routine, physical illness, depression, and stress, are only some of the potentially long-term consequences. The coping strategies used to deal with these difficulties may have influenced the perception of well-being, so the present study aimed to evaluate mental health in relation to individual characteristics and to explore the more effective coping strategies used by the Italian population and their impact on psychological well-being. Method(s): The web-based survey was delivered by Qualtrics between 30 November and 10 December 2020. A total of 537 individuals (>18) were recruited and all participants completed measures of sociodemographic data, general psychological well-being (PGWBI), and coping strategies (COPE-NVI). Result(s): Females, students, and unmarried people reported the lowest levels of mental health. Specifically, the coping strategy called "positive attitude" was positively correlated with psychological well-being, while "avoidance" and "social support strategies" negatively influenced it. The coping strategies named "problem-focused" and "transcendentoriented" resulted not statistically significant. Conclusion(s): The use of maladaptive strategies (e.g., avoidance-oriented) set up negative symptoms such as anxiety or depression whereas the beneficial ones can be central to optimally managing the psychological effects of long-lasting current COVID-19. From a preventive point of view, it is hence important to take care both of those who are already suffering from psychological disorders and of the non-clinical population, starting to question how psychopathology will change after the pandemic. New treatment directions should be found. The results suggest that to prevent mental disorders, therapists must consider the use of coping strategies in clinical practice. Implications for clinical preventive interventions are reported.
ABSTRACT
Background-Schizophrenia is a complex, heterogeneous behavioural and cognitive syndrome whose origins appear to lie in genetic and/or environmental disruption of brain development, Cognitive functions are required to perform in the spheres of personal, social, and occupational activities of everyday life. .Restoring cognitive function or bypassing cognitive impairment could significantly contribute to better outcome and recovery in schizophrenia. Aim-. To assess the cognitive functions in patients with schizophrenia and To study the relationship between cognition and disease severity Methods-Cross sectional study done on 50 patients with schizophrenia visiting SDM hospital Dharwad, disease severity measured using PANSS, and cognitive assesment using BACS Result-. The Brief Assessment of Cognition in Schizophrenia (BACS) assessed the aspects of cognition found to be most impaired and most strongly correlated with outcome in patients with schizophrenia Conclusion-Cognitive functions are responsible for better day to day functioning and are related to functioning impairment in everyday living skills;hence by improving cognition, patient's functioning in everyday living skills may improve, giving them a better chance of vocational and independent living success.
ABSTRACT
BACKGROUND: Post-infectious functional gastrointestinal disorders (PI-FGID) involve a broad group of well-recognized conditions such as Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD) that follow an infectious illness involving the GI tract. Post-infectious IBS (PI-IBS) is the most well-known entity occurring in ~10% of patients following acute gastroenteritis due to bacteria or enteropathic viruses, and can last for several months. The SARS-CoV-2 (COVID-19) virus appears to infect the GI system as well as the respiratory tract. While respiratory signs and symptoms are generally the most prominent and life-threatening aspects of COVID-19 infection, nearly half of COVID-19 cases present with digestive symptoms such as diarrhea, anorexia, vomiting, nausea, and abdominal pain. COVID-19 infection has also been associated with autonomic dysregulation, manifesting as fatigue or dizziness. In addition, COVID-19 may infect the brain and lead to MRI changes which may alter emotions and somatic perception. The goal of this study was to determine the impact of COVID-19 on PI-FGID symptoms in children and adolescents. METHODS Recruitment: An electronic medical record (EMR) search was carried out to find all patients 8 years of age or older who were COVID-19 tested at the Ann and Robert H. Lurie Children's Hospital of Chicago between November 2020 and October 2021. Questionnaires: A COVID-19 Phenotype survey was administered to identify COVID-19 symptoms, severity, and duration in the 7 days prior to the COVID-19 test. The following questionnaires were distributed to the parent or guardian of the COVID-19 tested child with instructions to refer to the 3 months following the test (1) COMPASS-31 - assesses presence of symptoms of dysautonomia;(2) PEESS v2.0 - assesses frequency and severity of symptoms of esophageal dysfunction;(3) QPGSIV - assesses presence of functional nausea/vomiting, defecation, and pain disorders;(4) Nausea Profile (NP) - assesses severity of somatic, gastrointestinal and emotional symptoms associated with nausea;(5) Dyspepsia Symptom Survey (DSS) - novel survey to assess frequency and severity of symptoms related to gastric or duodenal dysfunction;(6) Nausea Severity Profile - assess severity of nausea (7) PedsQL General Well-Being Survey - assesses overall quality of life. An email was sent in July 2021 to patients tested November 2020-March 2021, and an email was sent in December 2021 to patients tested April-October 2021. Consent was obtained by patients agreeing to complete the surveys, and data were collected to a RedCAP database. Data analysis: A comparison of survey results was carried out for the following subgroups: COVID-19 positive, COVID-19 negative without symptoms at time of viral testing, and COVID-19 negative with symptoms at time of viral testing. Due to the small size of the COVID-19 positive group relative to the COVID-19 negative groups, a Mann-Whitney U was utilized to compare the COVID-19 positive group with the COVID-19 negative asymptomatic group and COVID-19 negative symptomatic group separately, along with the COVID-19 negative asymptomatic group versus the COVID-19 negative symptomatic group. Categorical data were compared via Fischer's Exact Test. RESULT(S): A total of 771 patients/parent(s)/guardian(s) completed the required questionnaires. The demographics for each of the comparative subpopulations were well-matched. The COVID-19 negative patients with symptoms present prior to the COVID test had significantly increased composite scores on all surveys compared to the COVID-19 negative asymptomatic group (p-values=0.014-0.0001). The COVID-19 positive group had no significant differences in composite scores compared to the COVID-19 negative symptomatic group with the exception of the NP somatic score (p-value=0.02). The COVID-19 positive group had significantly increased composite scores compared to the COVID-19 negative asymptomatic group on the DSS frequency composite and NP somatic, gastrointestinal, and emotional scores (p-value=0.03-0.0001). The COVID-19 negative symptomatic group had a significant increase in FGID prevalence detected by the QPGSIV (p-value <0.05) compared to the COVID-19 negative asymptomatic group, while the COVID-19 positive group showed no difference. CONCLUSION(S): We found an increased frequency of functional dyspepsia and nausea symptoms compared to a control population, although no differences were seen compared to a population with presumptive non-COVID-19 infection. Further, we found a significant increase in somatic and emotional symptoms in COVID-19 positive patients compared to a control population underscoring the need for a comprehensive biopsychosocial approach. Thus, Long-COVID GI disease likely exists in children. However, its manifestations do not appear worse than those following any other viral infection.
ABSTRACT
SCOPO DEL LAVORO: The Coronavirus Disease 2019 (COVID-19) is a syndrome caused by a new Coronavirus strain, diagnosed for the first time in China and subsequently spread throughout the world. For this reason, on January 2020 the World Health Organization (WHO) declared a state of pandemic. In Italy, the first case of COVID-19 was reported on February 2020. Since then, the Italian Government imposed some restrictions, such as social distancing, in some cases confinement, that have contributed to generate a great psychological distress and forced people to seek new strategies to cope to the emergency. The American Psychological Association (APA) defines the perception of risk as an “individual's subjective assessment of the level of risk associated with a particular hazard”. The risk perception has a strong impact on changing people's choices in the face of events and it can be divided into a rational part and a heuristic part guided by emotions. The aim of this study was to evaluate the perception of risk in three groups of psychiatric patients (depressed, bipolar and schizophrenic) in order to address which categories of patients were most vulnerable during an emergency situation and to evaluate future choices on public health and emergency planning. MATERIALI E METODI: A cross-sectional observational study was conducted on an outpatient setting between January 2021 and February 2021, which was during of Phase 2 of the Italian COVID-19 lockdown. Patients were previously tested to check the clinical stability through Drug Attitude Inventory (DAI), Quality of Life Index (QLF), Insight Scale (IS) and Short Form-12 Health Survey (SF-12), Positive and Negative Syndrome Scale (PANSS) for schizophrenic patients, Hamilton Rating Scale for Depression (MADRS) for depressed patients and MADRS plus Young Mania Rating Scale (YMRS) for bipolar patients. In addition, we used a questionnaire proposed by Lanciano et al., (2020) composed by 10 items to assess the perception of risk, risk-related variables and emotional states during COVID-19 emergency. RISULTATI: There were no statistical differences among the three groups of patients, thus the suggesting an homogeneity of the sample. Results showed that patients were more concerned about economic, psychologic and interpersonal consequences of COVID-19 pandemic, than about their own health. Positive and anxiety related emotions were the most frequent. In the multiple regression analysis, the likelihood of COVID resolution was positively correlated with the diagnosis of schizophrenia, the increased perceived effectiveness, and the presence of positive emotions. The perception of knowledge of the COVID phenomenon positively influenced both the institutional-economy risk and the psychological risk. Finally, positive emotions and uncertainty positively influenced the interpersonal risk. CONCLUSIONI: Our study highlight the need to give more attention to support psychiatric patients during emergency situations to reduce the perceived isolation. to prevent them from engaging in risky behavior.
ABSTRACT
The proceedings contain 29 papers. The topics discussed include: is the quality of the patient-therapist relationship a causal factor for therapy outcome?;prevalence of anxiety symptoms among the general population of Latvia in 2019-2020;outcomes of psychiatric rehabilitation - a retrospective study of young adults with severe mental disorders after psychiatric rehabilitation;the Finnish individual placement and support (IPS) evaluation study protocol (2020-2023);prevalence of anxiety and depression symptoms in adolescents with type 1 diabetes (T1D) and their parents;emotional neglect in childhood is common and associates with adult mental ill health;characterization of conspiracy believers and their mental health during the COVID-19 emergency state in Latvia;exploring the comorbidity of personality disorder and musculoskeletal diseases among adults: a scoping review;the quality of mental health care-clinic Veldre pilot study results;and health-related quality of life prediction using the self-evaluation of negative symptoms scale (SNS) in patients with schizophrenia.
ABSTRACT
Schizophrenia is a debilitating, genetic brain condition caused by anomalies that appear early in infancy and interrupt normal brain development. It has a lifetime risk of 1% and affects people of all ages, with around 10% dying by suicide. COVID-19 may raise the risk of mortality and morbidity in people with schizophrenia. Although antipsychotic medications of the first, second, and third generations are the most commonly prescribed treatments for schizophrenia, they are linked to major side effects such as tardive dyskinesia, oxidative stress, and EPS. Ayurvedic herbal medications and some dietary supplements score well in this category since they can be taken for a long time without causing major adverse effects and have antioxidant properties. Low potency first generation antipsychotics, sedating antihistamines, and benzodiazepines, as well as inhalable antipsychotics, oral and short acting injectable olanzapine, and ziprasidone, as well as low potency first generation antipsychotics, sedating antihistamines, and benzodiazepines, should be avoided or closely monitored for patients with COVID-19. Mentally ill patients with COVID-19 should be segregated if at all possible, and employees should be adequately protected.
ABSTRACT
Introduction: SARS-CoV-2 infection causes a pulmonary disease (COVID-19) which spread worldwide in 2020, leading the World Health Organization (WHO) to declare a pandemic [1] and the Italian government firstly to declare a state of emergency, then to impose restrictive measures lasting about two months. COVID-19 pandemic generated fear, anxiety, depression and post-traumatic symptoms in the general population [2,3] as well as among subjects affected by mental disorders [4]. Little is known about which different psychopathological changes the pandemic caused among individuals affected by different psychiatric disorders. Aims: To investigate potential psychopathological changes over time during the first wave of COVID-19 pandemic comparing different psychiatric disorders. Methods: Data about demographic/clinical variables and psychopathological status were retrospectively collected. Specific psychometric scales were administered at three time points: T0 as outbreak of pandemic, T1 as lockdown period, T2 as reopening. Primary outcomes: Brief Psychiatry Rating Scale (BPRS), Clinical Global Impression (CGI), Hamilton Anxiety Rating Scale (HAM-A). Secondary outcomes: Disability Scale (DISS), Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAM-D), Montgomery and Åsberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Descriptive analyses and linear regression models were performed. Summary of results: A total of 166 outpatients were included. Overall, psychometric scores showed a significant worsening at T1 with a mild improvement at T2 (p<0.05). Only psychotic and OC symptoms did not significantly improve at T2. Primary outcomes: time had a significant effect on the change of BPRS (F=26.56;p<0.001), CGI-severity (F=8.29;p<0.001), CGI-improvement (F=41.88;p<0.001) and HAM-A (F=33.63;p<0.001) scores. BPRS and CGI-S scores were higher among subjects affected by personality disorders (PDs) than in the depressed (MDD) and anxiety/obsessive-compulsive (OC) groups (p<0.05). PD patients also showed higher HAM-A scores than schizophrenia (SKZ) ones (p=0.02). Secondary outcomes: Time had a significant effect on the change of DISS-stress (F=40.80;p<0.001), DISS-support (F=9.26;p<0.001), HAM-D (F=9.50;p<0.001) and MADRS (F=9.40;p<0.001) scores. The time effect was not significant for DISS-disability (F=1.23;p=0.29), PANSS (F=1.37;p=0.26), YMRS (F=2.84;p=0.06) and Y-BOCS (F=0.55;p=0.59) scores. DISS-disability scores were higher in the PD group with respect to bipolar disorder (BD) (p=0.009), MDD (p<0.001) and anxiety/OCD (p=0.03) groups;SKZ and BD patients had lower DISS-stress scores than PD ones (both p values = 0.02). Conclusions: Patients affected by PDs showed to be particularly affected by the negative effects of outbreaks on mental health and perhaps they require specific clinical attention in case of traumatic events such as pandemics. Moreover, although SKZ patients reported lower anxiety levels than PD ones, the worsening of psychotic and OC symptoms should be strictly monitored by clinicians, as these aspects did not improve with the end of lockdown measures. Further studies on larger samples would allow an in-depth comparison of the psychopathological impact of pandemics between the different psychiatric diagnoses. The study has been registered on ClinicalTrials.gov with the following ID number: NCT04694482 No conflict of interest