Acceptabilité et faisabilité d'un module TCD-A multi-familles « tolérance à la détresse » proposé à des adolescents ayant un trouble de la personnalité borderline ou des troubles de la régulation émotionnelle

Le trouble de la personnalité borderline est un trouble psychiatrique fréquent qui apparaît à l'adolescence. La thérapie comportementale dialectique adaptée aux adolescents (TCD-A) a montré son efficacité dans la prise en charge psychothérapeutique des adolescents souffrant de conduites suicidaires ou d'auto-agressivité associées au trouble de la personnalité borderline. Au travers de notre étude nous avons souhaité explorer la faisabilité et l'acceptabilité, pour des adolescents présentant un TPL diagnostiqué ou des troubles de la régulation des émotions, d'un module TCD intitulé « tolérance à la détresse » proposé sur le mode d'un groupe multi-familles. Pour ce faire nous avons mis en place un groupe multi-familles de six adolescents et de leurs parents. L'acceptabilité et la faisabilité du protocole étaient excellentes. Les témoignages des adolescents et de leurs parents nous apportent des informations précieuses sur l'intérêt d'un tel groupe et sur les améliorations à introduire. La mise en place d'un tel groupe est une première en France et nous souhaitions montrer par notre étude pilote, sa faisabilité, son acceptabilité et ses effets afin de promouvoir son développement et son implémentation dans le contexte pédopsychiatrique français. Borderline personality disorder is a common psychiatric disorder emerging in adolescence. Dialectical Behavioral Therapy adapted to adolescents (DBT-A) has proven to be effective as a psychotherapeutic treatment for adolescents suffering from borderline-related behaviors, such as suicidal or self-aggressive behaviors. In our study, we were interested in exploring the feasibility and acceptability of a DBT-A module entitled "distress tolerance", which reduces borderline-related behaviors in borderline adolescents or undiagnosed adolescents who experience difficulties in regulating their emotions. To do this, we set up a pilot study with one multi-family treatment group of six adolescents and their parents. The treatment was fully accepted by all adolescents and parents with an excellent acceptability. Comments from adolescents and parents gave us valuable information about the great interest of a multi-family treatment group and potential improvements for its implementation. This is the first study exploring a DBT-A multi-family treatment group in France. It highlights its feasibility, acceptability and potential positive effects. Further studies are needed to promote the implementation and development of such interventions in the context of child and adolescent psychiatry in France. [ FROM AUTHOR] Copyright of Neuropsychiatrie de l'enfance & de l'Adolescence is the property of Elsevier B.V. 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.)

A systematic review and meta-analysis of long COVID symptoms.

BACKGROUND: Ongoing symptoms or the development of new symptoms following a SARS-CoV-2 diagnosis has caused a complex clinical problem known as "long COVID" (LC). This has introduced further pressure on global healthcare systems as there appears to be a need for ongoing clinical management of these patients. LC personifies heterogeneous symptoms at varying frequencies. The most complex symptoms appear to be driven by the neurology and neuropsychiatry spheres. METHODS: A systematic protocol was developed, peer reviewed, and published in PROSPERO. The systematic review included publications from the 1st of December 2019-30th June 2021 published in English. Multiple electronic databases were used. The dataset has been analyzed using a random-effects model and a subgroup analysis based on geographical location. Prevalence and 95% confidence intervals (CIs) were established based on the data identified. RESULTS: Of the 302 studies, 49 met the inclusion criteria, although 36 studies were included in the meta-analysis. The 36 studies had a collective sample size of 11,598 LC patients. 18 of the 36 studies were designed as cohorts and the remainder were cross-sectional. Symptoms of mental health, gastrointestinal, cardiopulmonary, neurological, and pain were reported. CONCLUSIONS: The quality that differentiates this meta-analysis is that they are cohort and cross-sectional studies with follow-up. It is evident that there is limited knowledge available of LC and current clinical management strategies may be suboptimal as a result. Clinical practice improvements will require more comprehensive clinical research, enabling effective evidence-based approaches to better support patients.

Impact of the COVID-19 pandemic on the hospitalization trends in a third level Child Neuropsychiatry Unit

Introduction: The COVID-19 outbreak and related confinement measures have disturbed the psychological well-being of young children and adolescents, especially in at-risk groups. Aim of the study was to evaluate the trend and severity of children' and adolescents' neuropsychiatric diseases in the context of a prolonged state of confinement measures. Materials and Methods: Data were retrospectively collected from all subjects aged between 4 and 16 years +/- 6 months, admitted to the Child Neuropsychiatry ward of the Gaslini Children Hospital between 01/01/20 and 30/05/21. Demographic and clinical characteristics were noted for each subject. Subjects were then divided in admitted before or after COVID outbreak, considered as the 9th Match 2020. Data of psychiatric patients about subjects' functioning (Children Global Assessment Scale, C-GAS) and disease severity (Global Impression- Severity, CGI-S) were collected. Results: Of 561 inpatients, 105 were admitted before the COVID-19 outbreak and 456 after, with an absolute increment of 30% for psychiatric diseases compared to neurological ones (33/105, 31.43% before vs. 187/456, 41.0% after;p = .013). For psychiatric diseases, there was an increase in the hospitalization duration (3.91 +/- 4.07 vs. 13.02 +/- 4.25;p = .04), an increase of subjects with previous neuropsychiatric disorders (27.7%, 9/33 vs. 47.7%, 89/187;p = .034), a decrease of CGAS scores (56,24 +/- 13,87 vs. 51,63 +/- 17,797;p = .050) and an increase disease severity worsening (CGI-S 3.76 +/- 1.12 vs. 4. 48 +/- 1.36;p = .006). In the female gender and in the ethnic minorities' subgroup, number of hospitalizations have statistically increased, with CGI-S and CGAS scores more impaired after the COVID-19 outbreak. On multivariate analysis, being female, having a previous psychiatric diagnosis, and belonging to an ethnic minority appeared to influence patients' overall impairment index (p < .005). Conclusions: The COVID-19 outbreak and the measures adopted to contain the virus spread had an impact on the severity of the course of psychiatric admissions, with greater influence on subjects who were already psychologically vulnerable, female, and who belonged to ethnic minorities. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Italian) Introduzione: Lo scoppio della pandemia da COVID-19 e le relative misure di confinamento hanno minato il benessere psicologico della popolazione in eta evolutiva, soprattutto nelle categorie a rischio. Scopo dello studio e stato quello di valutare andamento e gravita dei soggetti accolti per patologia neuropsichiatrica nel contesto di uno stato prolungato di prosecuzione di misure di contenimento del contagio. Materiali e metodi: Sono state retrospettivamente raccolti i dati di tutti i soggetti di eta compresa fra 4 e 16 anni +/- 6 mesi ricoverati presso la UO di Neuropsichiatria Infantile dell'Ospedale Gaslini tra lo 01/01/20 e il 30/05/21. Per ciascun caso sono state annotate le caratteristiche demografiche e cliniche. I soggetti sono stati divisi tra ricoverati prima e dopo l'inizio della pandemia, considerato come data il 9 marzo 2020. Per i casi psichiatrici sono state applicate scale di funzionamento Children Global Assessment Scale (C-GAS) e di gravita Global Imression-Severity (CGI-S). Risultati: Di 561 accessi, 105 sono avvenuti preCOVID e 456 postCOVID, con un incremento assoluto del 30% degli accessi per patologia psichiatrica rispetto a quella neurologica (33/105, 31,4% preCOVID vs 187/456, 41,0% postCOVID;p = ,013). Per la patologia psichiatrica, si e assistito ad un aumento dei giorni di ospedalizzazione (3,91 +/- 4,07 vs 13,02 +/- 4,25;p = ,04), un aumento dei soggetti con precedente diagnosi neuropsichiatrica (27,7%, 9/33 vs 47,7%, 89/187;p = ,034), una diminuzione dei punteggi CGAS (56,24 +/- 13,87 vs 51,63 +/- 17,797;p = ,050) ed un aumento della gravita di patologia (CGI-S 3,76 +/- 1,12 vs 4,48 +/- 1,36;p = ,006). Nel sottogruppo di soggetti di genere femminile e delle minoranze etniche, i ricoveri per patologia psichiatrica sono risultati significativamente aumentati con punteggi CGI-S e CGAS maggiormente compromessi dopo lo scoppio del COVID-19. All'analisi multivariata, il sesso femminile, una pregressa diagnosi psichiatrica e l'appartenenza a minoranze etniche appaiono avere un effetto sull'indice di compromissione globale dei pazienti (p < ,005). Conclusioni: La pandemia da COVID-19 e le misure adottate per contenere il contagio hanno impattato la gravita del decorso dei ricoveri neuropsichiatrici, con maggiore effetto su soggetti gia fragili, di genere femminile ed appartenenti a minoranze etniche. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

British Neuropsychiatry Annual Meeting 2021

The proceedings contain 40 papers. The topics discussed include: sex, bugs microwave attacks: how bad science, mating insects psychogenic illness created an international incident with Cuba;Covid-19 and neuropsychiatry;clinical update on delirium;fibromyalgia and myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS): an interoceptive predictive coding model of pain and fatigue expression;when the spark goes out: the neurology of apathy and motivation;is subjective cognitive decline (SCD) a better marker of susceptibility to functional cognitive disorder (FCD) than to neurodegeneration?: the caerphilly prospective study;temporal and spectral dynamics of reward and risk processing in the amygdala revealed with stereo-EEG recordings in epilepsy;a systematic review of extra-motor symptom evaluation in clinical trials for amyotrophic lateral sclerosis;and stimulation of the ventrolateral prefrontal cortex speeds up evidence accumulation in conflictual-uncertain environments.

Online medical, psychological and nutritional assistance for patients with eating disorders and their parents during the lockdown caused by COVID-19 from March 9th to May 4th, 2020

The COVID-19 pandemic severely hit Italy in early 2020, forcing the government to arrange a general lockdown across the country. The condition of forced quarantine, already experienced in China, has led to a worsening of symptoms in subjects already suffering from psychopathology, including Eating Disorders. To avoid this, after the closure of the Service, the Day Hospital of the Regional Center on Eating Disorders of the UO of Child Neuropsychiatry of the Azienda Policlinico S. Orsola-Malpighi of Bologna has activated an online treatment program aimed at five adolescent patients and their parents. The meetings were conducted by the Psychotherapist, the Child Neuropsychiatrist, the Dietitian and the Family Psychotherapist. During the lockdown, tests were administered to the patients, compared with test administered in the entry, to see if the symptoms related to the eating disorder and general psychopathology had changed. In addition, other tests were administered to both patients and parents with the aim of investigating the dynamics established during quarantine, which measured psychological well-being and general functioning. The observation made it possible to identify five psychological phases that the patients faced, related to eating symptoms, family dynamics and adaptation to the pandemic. The tests did not show significant changes in the psychopathology of the patients, while comparing the results of the tests also administered to the parents, an influence between mother and daughter can be seen, with often overlapping trends in relation to symptoms. The online treatment was effective and satisfactory for both patients and parents, and within the families greater moments of communication, listening and mutual involvement in the life of family members developed while maintaining personal spaces. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Italian) La pandemia COVID-19 ha gravemente colpito l'Italia nei primi mesi del 2020, costringendo il governo a predisporre un lockdown generale in tutto il paese. La condizione di quarantena forzata, gia sperimentata in Cina, ha portato un peggioramento dei sintomi in soggetti gia affetti da psicopatologia, compresi i Disturbi del Comportamento Alimentare. Per evitare questo, dopo la chiusura del Servizio, il Day Hospital del Centro Regionale sui Disturbi Alimentari dell'UO di Neuropsichiatria Infantile dell'Azienda Policlinico S. Orsola-Malpighi di Bologna ha attivato un programma di trattamento online rivolto a cinque pazienti adolescenti e ai loro genitori. Gli incontri sono stati condotti dalla Psicotera-peuta, dalla Neuropsichiatra Infantile, dalla Dietista e dalla Psicoterapeuta della famiglia. Durante il lockdown sono stati somministrati dei test alle pazienti, confrontati con quelli in entrata, per osservare se i sintomi relativi al disturbo alimentare e alla psicopatologia generale si fossero modificati. Inoltre sono stati somministrati altri test sia alle pazienti sia ai genitori con l'obiettivo di indagare le dinamiche instaurate durante la quarantena, che misuravano il benessere psicologico e il funzionamento generale. L'osservazione ha permesso di individuare cinque fasi psicologiche che hanno affrontato le pazienti, legate alla sintomatologia alimentare, alle dinamiche familiari e all'adattamento alla pandemia. I test non hanno riportato cambiamenti significativi nella psicopatologia delle pazienti, mentre confrontando i risultati dei test somministrati anche ai genitori si evince un'influenza fra madre e figlia, con andamenti spesso sovrapponibili relativamente ai quadri sintomatici. Il trattamento online e stato efficacie e soddisfacente sia per le pazienti sia per i genitori e all'interno delle famiglie si sonosviluppati maggiori momenti di comunicazione, ascolto, coinvolgimento reciproco nella vita dei familiari pur mantenendo gli spazi personali. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Telepsychology: The experience of Clinical Psychology Unit-ASST della Brianza in the COVID-19 era

The onset of COVID-19 pandemic has implied the need for a deep rearrangement of several healthcare settings, to provide patients with safe treatment solutions. Accordingly, healthcare professionals have witnessed an exponential increase in the use of telehealth since the beginning of pandemic. We hereby provide a systematic review of the latest national and international published literature and guidelines about telepsychology. Finally, by describing the experience of the Clinical Psychology Unit of ASST Brianza (NHS, Lombardy-Italy) in remodeling everyday clinical activity, we will provide a concrete example of how telepsychology interventions have proved to be effective both in ensuring continuity to already-in-charge patients and in empowering emergency services to support general population. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Italian) L'esordio della pandemia da COVID-19 ha implicato il bisogno di una profonda riorganizzazione del sistema sanitario, al fine di poter offrire ai pazienti soluzioni di trattamento sicure. Per tali motivi, dall'inizio della pandemia tra i professionisti sanitari si e assistito ad un incremento esponenziale nell'utilizzo della telemedicina. In questo lavoro esporremo una revisione sistematica delle piu aggiornate linee guida nazionali ed internazionali pubblicate in letteratura in merito alla telepsicologia. In conclusione, descrivendo l'esperienza di riorganizzazione dell'attivita clinica ordinaria dell'Unita Operativa di Psicologia Clinica di ASST Brianza (SSN, Regione Lombardia) intendiamo fornire un esempio concreto di come gli interventi di telepsicologia si siano dimostrati efficaci sia nell'offrire continuita di intervento ai pazienti gia in carico, sia nell'implementazione di servizi emergenziali a supporto della popolazione generale. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Covid-19 and Neuropsychiatry

As the clinical features and potential complications of COVID- 19 emerged last year it became clear that neurological, neuropsychiatric and psychiatric disorders were potentially significant. There were also reasons to expect this from past viral outbreaks, including other severe coronaviruses. The Coro- Nerve study, led by Ben Michael and colleagues, was rapidly set up to as a UK-wide surveillance system for clinicians to initially briefly notify cases and later provide full clinical details. A psychiatry reporting system, led by the RCPsych neuropsychiatry faculty, was added and the first 153 notifications were published last June . The full clinical details of the first 267 cases completed were published as a preprint in January. The has been a rapid growth in the number and quality of publications regarding the neuropsychiatry of COVID-19 and this has been collated on the JNNP Neurology & Neuropsychiatry of COVID-19 blog which we set up to respond to the need for rapid capture and synthesis of a fast moving field with weekly updates and publications from a growing international team, including a recently published preprint systematic review and meta-analysis of the neurology and neuropsychiatry of COVID-19. We will jointly review the CoroNerve data and its context in the emerging wider evidence base regarding the neuropsychiatry of COVID-19, highlighting exciting new research areas such as long COVID and projects such as the recently started COVID-CNS study funded by UKRI. We would like to thank those who have already submitted cases to CoroNerve and encourage others to do the same, including those associated with COVID-19 vaccination, and to flag up that notifying a case and providing data results in pubmed searchable collaborator status on resulting publications.

Is There a Rendezvous for SARS-CoV-2 and Agmatine?

The catastrophe of the ongoing COVID-19 pandemic is caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). The respiratory system appears to be ground zero in the majority of the patients. However, many other organs can get infected by cytokines, chemokines and other mediators released in response to the presence of the virus. The neurotropism by the SARS-CoV-2 is established beyond doubt. In addition to non-specific symptoms, the symptoms specific to central and/or peripheral nervous system diseases as well as neuromuscular diseases have been observed in numerous clinical cases. These observations and the experiences with other coronavirus infections earlier and flu pandemics raise concerns not only about the neurological effects in active disease but also about the long-term effects generated by the infection, immune and inflammatory functions. The knowledge of biological actions of agmatine in the backdrop of physiological events instigated by invading SARS-CoV-2 and host's response, especially in neural events, focuses on the possible overlaps of biomolecular pathways at a number of instances. This is not surprising since the factors stimulated during SARS-CoV-2 infection are the disease-generating neuroinflammatory components altered by agmatine. Hence, we hypothesize the possible beneficial role of agmatine in SARS-CoV-2 infection. Based on a narrative review of the literature, agmatine can be proposed as a plausible beneficial candidate for supporting treatment of SARS-CoV-2 infection and for addressing post-infection neurological complications.Copyright © 2022 Bentham Science Publishers.

What is brain fog?

BACKGROUND: The term 'brain fog' is increasingly used colloquially to describe difficulties in the cognitive realm. But what is brain fog? What sort of experiences do people talk about when they talk about brain fog? And, in turn, what might this tell us about potential underlying pathophysiological mechanisms? This study examined first-person descriptions in order to better understand the phenomenology of brain fog. METHODS: Posts containing 'brain fog' were scraped from the social media platform Reddit, using python, over a week in October 2021. We examined descriptions of brain fog, themes of containing subreddits (topic-specific discussion forums), and causal attributions. RESULTS: 1663 posts containing 'brain fog' were identified, 717 meeting inclusion criteria. 141 first person phenomenological descriptions depicted forgetfulness (51), difficulty concentrating (43), dissociative phenomena (34), cognitive 'slowness' and excessive effort (26), communication difficulties (22), 'fuzziness' or pressure (10) and fatigue (9). 50% (363/717) posts were in subreddits concerned with illness and disease: including COVID-19 (87), psychiatric, neurodevelopmental, autoimmune and functional disorders. 134 posts were in subreddits about drug use or discontinuation, and 44 in subreddits about abstention from masturbation. 570 posts included the poster's causal attribution, the most frequent attribution being long COVID in 60/570 (10%). CONCLUSIONS: 'Brain fog' is used on Reddit to describe heterogeneous experiences, including of dissociation, fatigue, forgetfulness and excessive cognitive effort, and in association with a range of illnesses, drugs and behaviours. Encouraging detailed description of these experiences will help us better understand pathophysiological mechanisms underlying cognitive symptoms in health and disease.

Confirmation of increased and more severe adolescent mental health-related in-patient admissions in the COVID-19 pandemic aftermath: A 2-year follow-up study.

COVID-19 pandemic may have affected youth's mental wellbeing. Youth admissions for mental health emergencies over the 2-year period following the COVID-19 outbreak (March 2020-February 2022) were compared to those occurring in the same period of 2018-2020, with reference to individual and clinical data. The study identified 30 admissions in the pre-pandemic period and 65 (+116.7%) in the post-pandemic period, with the latter being younger, less likely to have a personal psychiatric history, and more likely to receive psychopharmacological treatment. A higher likelihood of earlier, ex novo psychiatric manifestations, requiring medication to reach clinical stability, in the post-COVID era, is suggested.

Nervous system manifestations related to COVID-19 and their possible mechanisms.

In December 2019, the novel coronavirus disease (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection broke. With the gradual deepening understanding of SARS-CoV-2 and COVID-19, researchers and clinicians noticed that this disease is closely related to the nervous system and has complex effects on the central nervous system (CNS) and peripheral nervous system (PNS). In this review, we summarize the effects and mechanisms of SARS-CoV-2 on the nervous system, including the pathways of invasion, direct and indirect effects, and associated neuropsychiatric diseases, to deepen our knowledge and understanding of the relationship between COVID-19 and the nervous system.

COVID-19: Brain Effects.

Severe acute respiratory syndrome coronavirus 2, the novel coronavirus responsible for the coronavirus disease (COVID-19), affects the brain. Neurologic and neuropsychiatric symptoms may manifest in the acute and post-acute phases of illness. The vulnerability of the brain with aging further increases the burden of disease in the elderly, who are at the highest risk of complications and death from COVID-19. The mechanisms underlying the effects of COVID-19 on the brain are not fully known. Emerging evidence vis-à-vis pathogenesis and etiologies of COVID-19 brain effects is promising and may pave the way for future research and development of interventions.

Neuropsychiatric symptoms in post-COVID-19 long haulers.

BACKGROUND: Long haulers have been recently reported after contracting coronavirus disease (COVID-19). In the present study, we aimed to screen for the neuropsychiatric signs detected <1 to >6 months after infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to determine whether vaccination has an effect on them. METHODS: An online survey was conducted among participants who had been diagnosed with laboratory-confirmed SARS-CoV-2 infection. The clinical signs and durations of neuropsychiatric complaints and their correlations to sex, age, severity of COVID-19 signs, and vaccination status were screened. RESULTS: A total of 2218 individuals, including 1358 females and 860 males, with an age range of 12-70 years, submitted their responses. The respondents experienced cognitive dysfunction, mood alteration, depression, tinnitus, sleep disorders, and loss of taste and smell, with prevalence rates ranging from 18.9% (tinnitus) to 63.9% (loss of taste and smell). Of the respondents, 2.2-7.7% confirmed the persistence of symptoms for >6 months. Tinnitus was the least common complaint, and only 2.2% of the study participants had tinnitus for >6 months. Meanwhile, mood alteration persisted for >6 months in 7.6% of the study participants. More respondents who received two doses of BNT162b2 vaccine showed persistent symptoms than those in the other groups. Disease severity and female sex were identified as potential determinants of the development and persistency of such symptoms. CONCLUSION: Post-COVID neuropsychiatric symptoms were present in considerable percentages of the study participants with SARS-CoV-2 infection, persisting for >6 months in up to 7.6% of the participants.

HIV, HSV, SARS-CoV-2 and Ebola Share Long-Term Neuropsychiatric Sequelae.

Long COVID, in which disease-related symptoms persist for months after recovery, has led to a revival of the discussion of whether neuropsychiatric long-term symptoms after viral infections indeed result from virulent activity or are purely psychological phenomena. In this review, we demonstrate that, despite showing differences in structure and targeting, many viruses have highly similar neuropsychiatric effects on the host. Herein, we compare severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus 1 (HIV-1), Ebola virus disease (EVD), and herpes simplex virus 1 (HSV-1). We provide evidence that the mutual symptoms of acute and long-term anxiety, depression and post-traumatic stress among these viral infections are likely to result from primary viral activity, thus suggesting that these viruses share neuroinvasive strategies in common. Moreover, it appears that secondary induced environmental stress can lead to the emergence of psychopathologies and increased susceptibility to viral (re)infection in infected individuals. We hypothesize that a positive feedback loop of virus-environment-reinforced systemic responses exists. It is surmised that this cycle of primary virulent activity and secondary stress-induced reactivation, may be detrimental to infected individuals by maintaining and reinforcing the host's immunocompromised state of chronic inflammation, immunological strain, and maladaptive central-nervous-system activity. We propose that this state can lead to perturbed cognitive processing and promote aversive learning, which may manifest as acute, long-term neuropsychiatric illness.

First Episode Psychosis due to COVID-19: Case Report in Saudi Arabia

A 53-year-old Saudi male businessman had a history of dyslipidemia and ischemic stroke a few years ago. He was diagnosed with COVID-19 complicated with pneumonia;he was admitted in April 2021 and discharged after 12 days. He maintained his usual state of mental health and was functionally well until 1 month later. He presented to the emergency department (ED) with a chief complaint of feeling anxious most of the time on a daily basis for the last three days, as well as associated sleep disturbance and fatigue. The physical exam and laboratory investigation were unremarkable. Copyright © 2022, Bahrain Medical Bulletin. All rights reserved.

First episode psychosis related to COVID-19 infection

Introduction: During the course of COVID-19 pandemic, The respiratory system is the most commonly affected while many neuropsychiatric manifestations of the disease have been observed. Objective(s): Emphasize the importance of eliminating the diagnosis of covid 19 infection in a pandemic context face to first episode psychosis. Method(s): Presentation of case report Results: A 29-year-old woman unemployed married with no personal medical history and with psychiatric family history. She wasn't exposed to subject with covid 19 in her family circle. She was admitted in psychiatric care for acute behavioural disorders during five days. On physical examination: she was afebrile, eupneic and tachycardiac. Oxygen saturation was 96% and blood pressure was 100/50 mmHg. Specialized neurological examination was normal and cerebral CT scan was without abnormalities. At the psychiatric interview she was extremely agitated. She was distressed her speech was incoherent. She had auditory and visual hallucinations and a multi-thematic delirium. One day after her admission she died suddenly, the autopsy found positive RT PCR covid test and bilateral basal pneumonia. Conclusion(s): In individuals presenting with new-onset psychosis in areas endemic to COVID-19, consideration should be made for neuropsychiatric manifestations of Covid 19 from where the importance to push the explorations and to test the patients.

Functional cognitive disorders: clinical presentations and treatment approaches.

Functional cognitive disorders (FCDs) are a common cause of subjective and mild cognitive impairment. Isolated FCDs commonly present to the cognitive clinic, but examination of the nature of the symptoms suggests that they can also be understood as a transdiagnostic feature of many other conditions. This article examines methods of formulating the cognitive difficulties in order to identify treatment targets in people with FCDs.