Fitting in an Unfit Society With Autism Spectrum Disorder: Case Report.

Evaluating behavioral mimicking is important in healthcare providers' everyday functioning with an increased presentation of Tourette syndrome-like cases during the COVID-19 pandemic, seen due to the popular video creators on social media (e.g., TikTok) exhibiting these behaviors. Individuals with autism spectrum disorder (ASD) face difficulties with connection and assimilation, and they adapt by camouflaging their behaviors to fit with those of the neurotypical majority. Our team evaluated the behaviors of one individual with ASD to establish whether camouflaging was playing a role in her psychiatric stabilization in our inpatient psychiatric unit. We present a case of a 30-year-old female with ASD, admitted to our long-term inpatient psychiatric facility for significant mood dysregulation that persisted despite numerous treatment approaches (mediations, groups, etc.). While her initial behaviors included head banging and self-induced falls, her behaviors seemed to change based on those of her peers, in an apparent attempt to camouflage into the social environment within the unit. She also appeared to learn new self-harm behaviors, such as skin picking, from peers around her. The team was able to establish a temporal link between some instances of peers exhibiting specific behaviors and our patient engaging in similar behavior. Although inpatient units effectively manage long-term stabilization in other psychiatric disorders, these environments are not designed for individuals with ASD. Treatment teams should recognize the malleability of behaviors in patients with ASD and must identify and manage behavioral mimicking early during inpatient psychiatric treatment; otherwise, it may lead to significant harm.

Evidence of mental health-related morbidities and its association with socio-economic status among previously hospitalized patients with symptoms of COVID-19 in Bangladesh.

Introduction: The long-term impact of COVID-19 on mental health, particularly in relation to socio-economic vulnerabilities, has received little attention. This study reports the prevalence of mental health-related symptoms among previously hospitalized patients after recovery from COVID-19, and its association with socio-economic status (SES). Methods: Data collection of this cross-sectional study was conducted during February-April 2021, among previously hospitalized patients with COVID-19 like symptoms, on average six months after their discharge from the hospital. Using DASS-21, a validated scale to document symptoms of depression, anxiety, and stress, information on mental health-related symptoms were recorded from 481 respondents along with sociodemographic and economic information through telephone interviews. Chi-square tests were performed to identify significant group differences. Multinomial logistic regression analyzed the association between the changes in socioeconomic characteristics and mental health-related symptoms. Relative index of inequality (RII), slope index of inequality (SII), and concentration index (CIX) were applied to capture relevant inequalities in relation to mental health-related symptoms. Results: Eleven percent of the respondents reported changes in employment status, nearly half changes in income and expenditure. Forty-five percent reported symptoms of depression, anxiety and/or stress, and 12% reported coexistence of all three symptoms. Women [Adjusted Odds Ratio, AOR: 2.95; 95% Confidence Interval, CI: 1.39-5.68], and those who reported changes in occupation [AOR: 3.04; 95% CI: 1.01-9.08] and expenditure [AOR: 2.46; 95% CI: 1.12-5.37] were more likely to report all three mental health-related symptoms compared to men and those without changes in occupation and expenditure. The older age group was less likely [AOR: 0.96; 95%CI: 0.93-0.99] to report coexistence of all three symptoms compared to their younger counterparts. Negative values of concentration index (CIX) indicate that any one mental health-related symptom was significantly concentrated among those with lower expenditure and poor SES. Conclusion: This study will help in addressing mental health-related challenges after recovery from COVID-19 among the identified vulnerable groups through relevant community-based and clinical response, including counseling services, in Bangladesh and similar LMIC contexts.

Trends in online searching toward suicide pre-, during, and post the first wave of COVID-19 outbreak in China.

COVID-19 may increase the risk of suicide, but the conclusion is still unclear. This study was designed to assess the impact of COVID-19 on suicide pre-, during, and post the first wave of COVID-19 in China. It was reported that online public searching was associated with their offline thoughts and behaviors. Therefore, this study was designed to explore the online search for suicide pre-, during, and post-COVID-19 in China. The keywords on suicide, COVID-19, unemployment, and depression were collected in 2019 and 2020 using the Baidu Search Index (BSI). A time-series analysis examined the dynamic correlations between BSI-COVID-19 and BSI-suicide. A generalized estimating equation model was used to calculate the coefficients of variables associated with the BSI-suicide. The BSI-suicide showed a significant increase (15.6%, p = 0.006) from the 5th to 9th week, which was also the point of the first wave of the COVID-19 outbreak. A time-series analysis between BSI-suicide and BSI-COVID-19 showed that the strongest correlation occurred at lag 1+ and lag 2+ week. In the pre-COVID-19 model, only BSI-depression was highly associated with BSI-suicide (ß = 1.38, p = 0.008). During the COVID-19 model, BSI-depression (ß = 1.77, p = 0.040) and BSI-COVID-19 (ß = 0.03, p < 0.001) were significantly associated with BSI-suicide. In the post-COVID-19 model, BSI depression (ß = 1.55, p = 0.010) was still highly associated with BSI-suicide. Meanwhile, BSI-unemployment (ß = 1.67, p = 0.007) appeared to be linked to BSI-suicide for the first time. There was a surge in suicide-related online searching during the early stage of the first wave of the COVID-19 outbreak. Online suicide search volume peaked 1-2 weeks after the COVID-19 peak. The BSI of factors associated with suicide varied at different stages of the COVID-19 pandemic. The findings in this study are preliminary and further research is needed to arrive at evidence of causality.

Proposal from the World Association of Social Psychiatry (WASP)

Covid-19 pandemic has been an unprecedented crisis seen by the humanity in the last two years with a magnitude no less than the two world wars. Globally, more than 260 million cases have been reported and more than 5 million deaths have been attributed to Covid-19 till the end of November 2021. Despite introduction of the vaccine nearly a year ago, though there has been a big hope of controlling the pandemic, there have been repeated rises in infections due to the mutations in virus, like the coming of Delta, Delta plus and Omicron variants, which are increasingly infectious. There have already been two waves of the pandemic with the second wave being very lethal in India. The pandemic had both direct as well as indirect effects on mental health of the population across allover the world. Many countries had to resort to lockdowns to control the spread of infection, which had serious economic consequences, adding to the mental and social distress. Other infection control measures like quarantine and social isolation, and inability of the persons with existing mental illnesses to access treatment further added to the problem. Introduction of vaccine brought some hope, but it has been a great challenge to cover such a huge population with vaccine alongwith dealing with vaccine hesitancy. This symposium being proposed by the World Association of Social Psychiatry. The symposium will assess the current situation with focus on psychosocial aspects, social psychiatry approach used to deal with the mental health issues, challenges ahead and the lessons learnt to deal with any future challenges of similar nature.

Effects of the Coronavirus Pandemic on Mental Health Self-help Group Members: Call for Targeted Patient-centered Interventions

Background: A large number of research publications are related to the bidirectional effects of the COVID pandemic on people living with mental disorders, but only few of them report directly the opinions and experience of users of psychiatric services. Devora Kestel, Director, Mental Health and Substance Use, WHO, at the recent WPA 21th World Congress emphasized the following consequences of the Pandemic on people living with mental problems: (i) isolation, (ii) difficult grieving process when losing a close relative, (iii) less access to social support systems, (iv) stigma, (v) pre-existing mental disorders' exacerbation by COVID-19. Aim: To understand the main fields of distress and of resilience of patients to target interventions as part of our state-of-the-art community psychiatry service treating more than 500 patients with major mental disorders. Methods: We passed an online questionnaire to members of online self-help groups in July, 2021, to describe the effects of the Pandemic on their lives by three labels, following the qualitative research method of Rose et al. We created groups from the similar answers. Results: 78 people gave 223 labels. The most frequent negative labels were isolation (51 labels), fear (31 labels), mental symptoms (22 labels), feeling of insecurity (15 labels), frustration/anger (11 labels), paranoid ideas (10 labels) and economic burden (5 labels). The most frequent positive labels were related to resilience (35 labels), a silent period of life (11 labels), good health (6 labels) and getting closer to family (3 labels). Discussion: Results facilitate discussions to find and reinforce new ways of resilience of patients and families and to target their personal 'COVID-related' impairment by evidence-based interventions to prepare for the 4th wave of the Pandemic. Mental health problems are in close connection with distress, while learning from the crisis is an important factor of personal development and recovery. Limitations: We were not able to reach those patients who are lacking or refuse online communication during the Pandemic. Implications for Health Care Provision and Use: Providers should evaluate the personal situation and reactions of patients and families and target their individual needs by evidence-based intervention. The development of resilience in crisis is a step towards recovery. Implications for Health Policies: Supporting online facilities and regular evaluation-based targeted community psychiatric intervention is needed. Disabled people also have various resources related to their development of resilience in crisis. They should be involved in policy making.

Social Determinants of Mental Health As Mediators and Moderators of the Mental Health Impacts of the COVID-19 Pandemic.

Contracting COVID-19, being exposed to it, or being affected by societal containment measures can have consequences that are themselves social determinants of health. Preexisting social determinants of health also drive the disproportionately high prevalence of COVID-19 infection and deaths among minority, marginalized, and other vulnerable populations. Thus, the social determinants of mental health act as both mediators and moderators of the pandemic's impacts, and like all social determinants, the effects of the pandemic are underpinned by public policies and social norms. The major economic impacts of containment measures have had cascading effects that will affect mental health for years to come.

When basic supplies are missing, what to do? Specific demands of the local street population in times of coronavirus - a concern of social psychiatry.

BACKGROUND: Homeless experts and some federal housing officials are sounding the alarm that the patchwork of government efforts to address the coronavirus outbreak risks leaving out one group of acutely vulnerable people: the homeless. In terms of isolation, it is too unclear what that looks like if you normally sleep on the streets. In this tough moment, when people should be turned away, not only it feels inhumane, but it is also a big public health risk, because where are they going to go? METHOD: The studies were identified using large-sized newspapers with international circulation RESULTS: With more cities suspecting community transmission of the novel coronavirus, people who sleep in shelters or hunker down outside already have a lower life expectancy and often have underlying health conditions that put them at greater risk if they develop COVID-19 (Global News, 2020). These people face lack of sleep, malnutrition, and "extreme stress levels just to meet their daily needs", all of which weakens the immune system. Along with mental illness or substance abuse disorders, they are "incredibly vulnerable to this virus". CONCLUSIONS: Health organizations are well aware of the risks involved in mental health. A large population of homeless people experience their pain and psychological distress intermittently. For low-income patients, the various borderline situations related to health/illness involve growing expectations regarding the basic needs. This is a serious concern when linked to the pandemic.