Psychotraumatology of the war in Ukraine: The question of the psychological care of victims who are refugees or who remain in Ukraine

The war in Ukraine is a major poly-traumatic event, which leads to massive population displacements. The question of the evaluation and psychological care of psychotraumatised people is an urgent matter. As many countries hosting refugees are well endowed with a good number of psychologists, some of these interested professionals should mobilise themselves and make themselves known to carry out these clinical acts. Priority should be given to trained and experienced psychologists to support victims. The language barrier will have to be overcome. Initially, it would be desirable to make contact or get closer to local and national refugee centres to facilitate these operations. Face-to-face or remote consultations, as developed during the Covid-19 pandemic, are possible. Reinforcements of the number of available and dedicated psychologists, including remotely, from the countries hosting the most refugees, are also desirable. The issue of detection, assessment and care of psychologically traumatised people who remained on the Ukrainian territory is probably even more massive. Whether non-combatants or combatants, part of the international psychological community should mobilise, in addition to local colleagues, to provide them with this psychological help. These humanitarian actions would be feasible depending on the evolution of the conflict. Whether it is psychological support for refugees or people still on the Ukrainian soil, models for organising and coordinating these actions must be carefully considered and implemented in an evolving way to optimise their effectiveness. © 2022

Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians.

COVID-19 has challenged the health workforce worldwide. In this cross-sectional study with a retrospective assessment, we explored the impact of the pandemic on mental health and sleep among a sample of Italian nurses and medical doctors. A total of 287 healthcare workers (212 nurses and 75 physicians) completed a web survey on socio-demographic, psychological, and sleep-related aspects referring to the period before the pandemic and to the present period of February to June 2022. Comparisons between nurses and physicians revealed that the former had greater distress in response to the pandemic. Consistently, the multivariate analysis of covariance showed that even if both groups were negatively impacted by the pandemic, nurses presented a greater worsening over time regarding several psychological and sleep symptoms. Furthermore, we observed that working on the frontline represented an additional risk factor for nurses. In line with previous evidence, we also found that personal experiences with COVID-19 are significant predictors of the current health status. Our results underscore the urgent need for preventive programs among healthcare operators to increase their coping skills and prevent the long-term consequences of chronic stress, especially for high-risk professionals. Specific attention should also be devoted to programs to improve sleep quality and reduce sleep-related traumatic symptoms.

Psychotraumatology of the war in Ukraine: The question of the psychological care of victims who are refugees or who remain in Ukraine

The war in Ukraine is a major poly-traumatic event, which leads to massive population displacements. The question of the evaluation and psychological care of psychotraumatised people is an urgent matter. As many countries hosting refugees are well endowed with a good number of psychologists, some of these interested professionals should mobilise themselves and make themselves known to carry out these clinical acts. Priority should be given to trained and experienced psychologists to support victims. The language barrier will have to be overcome. Initially, it would be desirable to make contact or get closer to local and national refugee centres to facilitate these operations. Face-to-face or remote consultations, as developed during the Covid-19 pandemic, are possible. Reinforcements of the number of available and dedicated psychologists, including remotely, from the countries hosting the most refugees, are also desirable. The issue of detection, assessment and care of psychologically traumatised people who remained on the Ukrainian territory is probably even more massive. Whether non-combatants or combatants, part of the international psychological community should mobilise, in addition to local colleagues, to provide them with this psychological help. These humanitarian actions would be feasible depending on the evolution of the conflict. Whether it is psychological support for refugees or people still on the Ukrainian soil, models for organising and coordinating these actions must be carefully considered and implemented in an evolving way to optimise their effectiveness. Résumé La guerre en Ukraine est un événement polytraumatique majeur qui donne lieu à des déplacements massifs de population. La question de l’évaluation et de la prise en charge psychologique des personnes psychotraumatisées se pose de façon urgente. De multiples pays d’accueil de réfugiés étant bien dotés en nombre de psychologues, une partie de ces professionnels intéressés devrait se mobiliser et se faire connaître pour réaliser ces actes cliniques. La priorité devrait être donnée aux psychologues formés et expérimentés pour prendre en charge les victimes. La barrière de la langue devra être surmontée. Dans un premier temps, une prise de contact ou un rapprochement auprès des dispositifs locaux et nationaux d’accueil des réfugiés serait souhaitable pour faciliter ces opérations. Des consultations en présentiel ou en distantiel, comme cela a été développé pendant la pandémie de Covid-19, sont envisageables. Des renforts en psychologues, y compris à distance, des pays accueillant le plus de réfugiés sont également souhaitables. La question de la détection, de l’évaluation et de la prise en charge des personnes psychologiquement traumatisées restées sur le territoire ukrainien est probablement encore plus massive. Que ce soit des non-combattants ou des combattants, une partie de la communauté psy internationale devrait se mobiliser, en complément des collègues locaux, pour leur apporter cette aide psychologique. Ces actions humanitaires seraient réalisables en fonction de l’évolution du conflit. Qu’il s’agisse de soutien psychologique aux réfugiés ou aux personnes sur le sol ukrainien des modèles d’organisation et de coordination de ces actions doivent être pensés et mis en place de façon évolutive pour en optimiser l’efficacité.

Event-related potentials studies of PTSD after infection of SARS-COV-2 and neuroCOVID-19

Background: Coronavirus disease 19 (COVID-19) hospitalisation is a potentially traumatic experience, especially in severe cases. Furthermore, the unprecedented context of the SARS-CoV-2 pandemic, with the daily media bombardment about COVID-19 mortality, may have amplified its life-threatening perception also in patients with moderate infection. The purpose of our study was twofold: 1) to evaluate QEEG/ERPs shows of PTSD associated with severe infection SARS-CoV-2, and neuroCOVID-19, 2) to construct a neurofeedback protocol based on these indices to support the psychotherapy of the case study described herein. Case study: Patient N.C. 49, a frontline healthcare worker in the emergency services (an ambulance driver), became ill with Covid-19 on November 14, 2020. Initially, he lost his sense of smell (anosmia), of taste (ageusia), and had latent blinks (heterophila), headaches, and dizziness. After 10 days of illness, the patient had additionally a dry cough and a shortness of breath and he was hospitalized, sedated and mechanically ventilated for 24 days. After a few months he was diagnosed with PTSD (according to the DSM- 5 criteria) and referred to the Reintegration and Training Center of the Polish Neuropsychological Society for further diagnosis and treatment. It was found that the P3 GO and P3 NOGO waves were indeed less in his case (p < 0.01) when compared to the ERPs results of a health group of individuals of a similar age (n = 100), derived from the normative data bases of the Human Brain Index (HBI) in Switzerland. The ERPs wave pattern in our patient reflects the pattern appearing in patients with PTSD. The patient took part in 20 sessions of individually tailored anodal transcranial direct current stimulation (tDCS), with the excitatory stimulation of the left prefrontal cortex and inhibitory stimulation of the right prefrontal cortex which can reduce anxiety, as was proposed in the subject literature. Also, the neuromarker of PTSD obtained with the use of QEEG/ERPs was helpful in choosing the appropriate tDCS protocol. Neurostimulation with the use of tDCS was administered systematically, every day, 15-20 and 30-40 minutes for each session, for 20 days. He also received individual sessions of psychotherapy every day, 30-40 minutes for each session, for 20 day. After the treatment the patient improved and returned to his previous job as a frontline healthcare worker in the emergency services (an ambulance driver) in the fight against COVID-19. Conclusions: Detection of the PTSD neuromarker enabled the development of a proper tDCS protocol and the conduct of effective brain neurostimulation of a patient with PTSD. The proposed protocol of treatment, in combination with goal-oriented individual psychotherapy, offered to the patient, was effective in the reduction of PTSD. ERPs can be useful in the diagnosis of PTSD as well as in selecting an appropriate therapy protocol for these patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Factors Associated with Psychological Distress in French Medical Students during the COVID-19 Health Crisis: A Cross-Sectional Study.

BACKGROUND: The purpose of this study was to assess the prevalence of psychological distress in medical students during the COVID-19 health crisis and to identify factors associated with psychological distress. METHODS: A cross-sectional observational study was presented to 1814 medical students (from first to sixth year) in a French university hospital center. Sociodemographic, occupational and medical information (psychological distress measured on the French GHQ12 scale) were collected via an online anonymous self-administered questionnaire. Variables associated with psychological distress were investigated using univariate analysis and multivariate analysis (modified Poisson regression). RESULTS: In total, 832 medical students responded (46%) and 699 completed the questionnaire in full (39%); 625 (75%) showed signs of psychological distress and 109 (15%) reported suicidal ideation. Female gender, psychological trauma during the COVID-19 health crisis, change in alcohol consumption, and difficulties with online learning emerged as risk factors for psychological distress, whereas a paid activity, a feeling of mutual aid and cooperation within the studies framework, and recognition of work appeared to be protective factors. CONCLUSIONS: Mental health care or suicide prevention should be provided to students at risk in the aftermath of the pandemic. Knowing the educational and medical factors associated with psychological distress enables areas for prevention to be identified.

The Consequences of COVID-19 Toward Human Growth: The Role of Traumatic Event and Coping Strategies Among Indonesian Sample.

COVID-19 has brought a massive psychological impact on individuals' life. The current study sets a significant purpose to test the model whether post-traumatic stress and coping strategies affect stress-related growth regarding the COVID-19 event. One hundred and ninety-nine participants have participated in an online survey in the period of lockdown. The proposed hypotheses model is further tested using PLS-SEM. The first model explains a significant moderate, 46% amount of variance for stress-related growth. With gender as moderator, the second model explains a significant 29% amount of variance for stress-related growth, which is also moderate. This study shows that active coping strategies and positive affirmation significantly influence individual stress-related growth. The trauma event (COVID-19) does not significantly affect growth. Women experience trauma compared to men, besides active coping with the COVID-19 situation is higher in men than women. Using the Bio-centric perspective, having a positive connection through acceptance and awareness of the situation, self-care, and affective interaction with others would develop growth regarding traumatic situations. Further, interventions about coping skills and positive affirmations are essential to give, especially to vulnerable groups such as women.

COVID-19 Pandemic and Helsinki University Hospital Personnel Psychological Well-Being: Six-Month Follow-Up Results.

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2-71.9%) and negative changes in sleep (75.6%, 95% CI 72.2-79.2%) than the study survey wave (1.6%, CI 0.5-5.5%; and 0.3%, CI 0.1-1.2%). Regional COVID-19 incidence rates correlated with the personnel's psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00-8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37-2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.

REACH for mental health in the COVID19 pandemic: an urgent call for public health action.

Our submission is responsive to the urgent need for public mental health action prompted by the escalating COVID-19 pandemic. In it, we review the evidence calling for urgent public mental health action, propose a mental health equivalent fo the World Health Organization's 'Do the Five' concept, and describe the 'REACH for Mental Health' public health measure we have launched at the Harvard T.H. Chan School of Public Health.

Nuestra presentación responde a la necesidad urgente de acciones en la salud mental pública debido a la creciente pandemia de COVID-19. En esta presentación revisamos la evidencia que exige acciones urgentes de la salud mental pública, proponemos un equivalente de salud mental del concepto 'Haz los cinco' de la Organización Mundial de la Salud, y describimos la intervención de salud pública 'REACH (por sus siglas en ingles) para Salud Mental' que hemos lanzado en la Escuela T.H. Chan de Salud Pública de Harvard.