Subject(s)
COVID-19 , Day Care, Medical , Hospitals, Psychiatric , Mental Disorders/rehabilitation , Adult , Delivery of Health Care , Exercise/psychology , Female , Humans , Japan , Male , Medication Adherence , Mental Disorders/psychology , Middle Aged , Motivation , Psychotic Disorders/psychology , Psychotic Disorders/rehabilitation , Schizophrenia/rehabilitation , Sleep , Stress, Psychological/psychology , Symptom Flare UpABSTRACT
During the COVID-19 pandemic, the Oasi Research Institute of Troina (Italy) became an important hotbed for infection; in fact, 109 patients with different levels of Intellectual Disability (ID) tested positive for COVID-19. The procedures and interventions put in place at the Oasi Research Institute due to the COVID-19 pandemic are exhaustively reported in this paper. The description of the clinical procedures as well as remote/in person psychological support services provided to people with ID and their families are here divided into three different sections: Phase I (or Acute phase), Phase II (or Activity planning), and Phase III (or Activity consolidation). In each section, the main psycho-pathological characteristics of patients, the reactions of family members and the multidisciplinary interventions put in place are also described.
Subject(s)
COVID-19/epidemiology , Developmental Disabilities/rehabilitation , Intellectual Disability/rehabilitation , Psychosocial Support Systems , Telemedicine , Academies and Institutes , Adolescent , Adult , Aged , Aged, 80 and over , Autism Spectrum Disorder/epidemiology , Autism Spectrum Disorder/psychology , Autism Spectrum Disorder/rehabilitation , COVID-19/mortality , COVID-19/physiopathology , COVID-19/psychology , Child , Child, Preschool , Comorbidity , Developmental Disabilities/epidemiology , Developmental Disabilities/psychology , Disease Hotspot , Disease Outbreaks , Epilepsy/epidemiology , Female , Hospitals, Special , Humans , Hypothyroidism/epidemiology , Infant , Intellectual Disability/epidemiology , Intellectual Disability/psychology , Italy , Male , Middle Aged , Mood Disorders/epidemiology , Mood Disorders/psychology , Mood Disorders/rehabilitation , Obesity/epidemiology , Overweight/epidemiology , Personality Disorders/epidemiology , Personality Disorders/psychology , Personality Disorders/rehabilitation , Psychotic Disorders/epidemiology , Psychotic Disorders/psychology , Psychotic Disorders/rehabilitation , Respiratory Distress Syndrome/physiopathology , SARS-CoV-2 , Severity of Illness Index , Young AdultABSTRACT
OBJECTIVE: To report the clinical characteristics and transmission rate of coronavirus disease 2019 (COVID-19) in a community inpatient long-term care psychiatric rehabilitation facility designed for persons with serious mental illness to provide insight into transmission and symptom patterns and emerging testing protocols, as well as medical complications and prognosis. METHODS: This study examined a cohort of 54 residents of a long-term care psychiatric rehabilitation program from March to April 2020. Baseline demographics, clinical diagnoses, and vital signs were examined to look for statistical differences between positive versus negative severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) groups. During the early phase of the pandemic, the facility closely followed the local shelter-in-place order (starting March 19, 2020) and symptom-based testing. RESULTS: Of the residents, the primary psychiatric diagnoses were schizoaffective disorder: 28 (51.9%), schizophrenia: 21 (38.9%), bipolar I disorder: 3 (5.5%), and unspecified psychotic disorder: 2 (3.7%). Forty (74%) of 54 residents tested positive for SARS-COV-2, with a doubling time of 3.9 days. There were no statistical differences between the positive SARS-COV-2 versus negative groups for age or race/ethnicity. Psychiatric and medical conditions were not significantly associated with contracting SARS-COV-2, with the exception of obesity (n = 17 [43%] positive vs n = 12 [86%] negative, P = .01). Medical monitoring of vital signs and symptoms did not lead to earlier detection. All of the residents completely recovered, with the last resident no longer showing any symptoms 24 days from the index case. CONCLUSION: Research is needed to determine optimal strategies for long-term care mental health settings that incorporate frequent testing and personal protective equipment use to prevent rapid transmission of SARS-COV-2.