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1.
J Clin Psychiatry ; 83(5)2022 09 26.
Article in English | MEDLINE | ID: covidwho-2201522

ABSTRACT

N-acetylcysteine (NAC) augmentation of antipsychotic medication is one of very many antipsychotic augmentation strategies that have been studied in schizophrenia. A recent systematic review and meta-analysis of 6 randomized controlled trials (RCTs) found that NAC (median dose, 2,000 mg/d) improved several clinical outcomes at different time points with medium to large effect sizes; however, many of the significant findings in this meta-analysis are suspect because they appeared to be influenced by 2 short-term (8-week) RCTs with outlying characteristics. Important findings not influenced by the 2 outlying RCTs were significant attenuation by NAC of negative symptom (3 RCTs) and total psychopathology (2 RCTs) ratings at ≥ 24 weeks and improvement in working memory but not processing speed (3 RCTs). Of these findings, reduction in psychopathology ratings, though statistically significant, appeared too small to be clinically meaningful. Finally, a newly published, moderately large RCT of NAC (2,000 mg/d) in schizophrenia patients refractory to clozapine found that 1 year of treatment with NAC did not outperform placebo for any clinical, cognitive, or quality of life outcome. The take-home message is that it is premature to recommend the use of NAC to treat schizophrenia for any target domain in routine clinical practice and that there does not appear to be a role for NAC for any indication in clozapine-refractory schizophrenia. However, it may be worth studying whether NAC, dosed at 2,000 mg/d or higher for 6 months or longer, improves functional outcomes in schizophrenia.


Subject(s)
Antipsychotic Agents , Clozapine , Schizophrenia , Acetylcysteine/pharmacology , Acetylcysteine/therapeutic use , Antipsychotic Agents/therapeutic use , Clozapine/therapeutic use , Humans , Schizophrenia/drug therapy
2.
Rev Epidemiol Sante Publique ; 70(4): 177-182, 2022 Aug.
Article in French | MEDLINE | ID: covidwho-2182743

ABSTRACT

INTRODUCTION: Stigma underlies the violation of certain social, economic, and cultural rights of patients with schizophrenia, including their access to treatment and care. Measurement of stigma remains as complex and multifaceted as the phenomenon itself. Several measurement tools are available to assess the prevalence, intensity and qualities of stigma. The aim of the study was to carry out a cross-cultural adaptation of the Explanatory Model Interview Catalogue (EMIC), in the Moroccan Arabic dialect commonly known as "Darija". PATIENTS AND METHOD: The study was conducted in three psychiatric departments of public hospitals in the Souss-Massa region, located in southern Morocco. For the diagnosis of schizophrenia, the study was based on the decisions of the psychiatrists practicing at the study sites. The cross-cultural adaptation in Moroccan Darija of the stigma scale developed by Michel Weiss in the EMIC was carried out according to the six-step scientific method developed by Dorcas et al. RESULTS: Cronbach's alpha (internal consistency) was 0.845. Convergent validity determined by Pearson's coefficient showed a significant inter-item correlation and the intra-class correlation coefficient (test-retest) was 0.975 (0.993; 0.991). The item added in relation to the COVID-19 situation presented psychometric values similar to the others. CONCLUSION: The Darija version is culturally acceptable and can be used to approach the phenomenon of stigmatization in Morocco.


Subject(s)
COVID-19 , Schizophrenia , COVID-19/epidemiology , Cross-Cultural Comparison , Humans , Language , Morocco/epidemiology , Psychometrics , Reproducibility of Results , Schizophrenia/diagnosis , Schizophrenia/epidemiology , Schizophrenia/therapy , Surveys and Questionnaires
3.
Schizophr Res ; 244: 134, 2022 06.
Article in English | MEDLINE | ID: covidwho-2132287

Subject(s)
Schizophrenia , Humans
4.
J Psychiatr Pract ; 28(6): 497-504, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2116798

ABSTRACT

OBJECTIVE: Long-acting injectable antipsychotics (LAI-As) are a crucial treatment option for individuals with serious mental illness. However, due to the necessity of in-person administration of LAI-As, pandemics pose unique challenges for continuity of care in the population prescribed these medications. This project investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on LAI-A adherence at a Veterans Health Administration medical facility in the United States, as well as changes in LAI-A prescribing and administration practices during this period. METHODS: Electronic health records were evaluated for 101 patients prescribed LAI-As. A subset of 13 patients also participated in an interview and rated subjective concerns about pandemic-related barriers to medication adherence. RESULTS: Pandemic-related barriers to LAI-A adherence and/or changes to LAI-A medications were documented in 33% of the patients. Within-subjects comparison of an adherence metric computed from electronic health record data further suggested a somewhat higher incidence of missed or delayed LAI-A doses during the pandemic compared with before the pandemic. In contrast, only 2 of the 13 patients interviewed anticipated that pandemic-related concerns would interfere with medication adherence. CONCLUSIONS: The results of this study suggest that LAI-A access and adherence can be disrupted by pandemics and other public health emergencies but this finding may not generalize to other sites. As patients may not foresee the potential for disruption, psychiatric service providers may need to assist in proactively problem-solving barriers to access. Improved preparedness and additional safeguards against pandemic-related disruptions to LAI-A access and adherence may help mitigate adverse outcomes in the future. Identifying patients at elevated risk for such disruptions may help support these efforts.


Subject(s)
Antipsychotic Agents , COVID-19 , Schizophrenia , Humans , United States , Antipsychotic Agents/therapeutic use , Pandemics , Schizophrenia/drug therapy , Delayed-Action Preparations/therapeutic use , Injections , Medication Adherence
5.
Psychiatry Res ; 317: 114878, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2113988

ABSTRACT

The COVID-19 pandemic is having an important impact on the practice of mental health services and on schizophrenia patients, and heterogeneous and conflicting findings are being reported on the reduction of long-acting injectable (LAI) antipsychotics use. Aims of the study were to assess the total number of patients treated with LAI, the start of novel LAI and the discontinuation of LAI treatments, analyzing register data of the first year of the pandemic, 2020, compared to a pre-pandemic reference year, 2019. Data from two outpatient centers were retrieved, for a total of 236 participants in 2020: no significant differences were observed comparing 2020 and 2019 when considering the total number of patients on LAI treatment (p = 0.890) and the number of dropouts (p = 0.262); however, a significant reduction in the start of LAI was observed (p = 0.022). In 2020, second generation LAI were more prescribed than first generation LAI (p = 0.040) while no difference was observed in 2019 (p = 0.191). These findings attest the efficacy of measures adopted in mental health services to face the consequences of COVID-19 and shed further light on the impact of the pandemic on the clinical practice of mental health services and on the continuity of care of people with schizophrenia.


Subject(s)
Antipsychotic Agents , COVID-19 , Schizophrenia , Humans , Antipsychotic Agents/therapeutic use , Pandemics , Delayed-Action Preparations/therapeutic use , Schizophrenia/drug therapy , Schizophrenia/chemically induced
6.
Curr Opin Psychiatry ; 34(3): 216-221, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-2114158

ABSTRACT

PURPOSE OF REVIEW: Agitation associated with schizophrenia remains an important clinical concern and if not managed effectively, can escalate into aggressive behavior. This is a review of the recent biomedical literature on agitation in individuals with schizophrenia. RECENT FINDINGS: Themes in the recent literature include consideration of comorbidities such as cigarette smoking and cannabis use. Surveys reveal that pharmacological approaches to manage agitation have changed little, with haloperidol remaining in common use and intramuscular administration of antipsychotics and/or benzodiazepines being frequently administered to more severely agitated/aggressive individuals. Of note, ketamine has been recently adopted for use in severe agitation in medical emergency departments, but the risk of this medication for people with schizophrenia is unclear. At present, inhaled loxapine remains the only rapidly acting noninjectable FDA-approved treatment for agitation associated with schizophrenia. In development is an intranasal formulation for olanzapine (a well characterized atypical antipsychotic already approved to treat agitation) and a sublingual film for dexmedetomidine (an α2-adrenergic agonist used as an anesthetic and now being repurposed). SUMMARY: Comorbidities can contribute to agitation and can make an accurate differential diagnosis challenging. The ongoing development of rapidly acting novel formulations of antiagitation medications, if successful, may facilitate clinical treatment by providing additional options.


Subject(s)
Antipsychotic Agents/therapeutic use , Evidence-Based Medicine , Psychomotor Agitation/drug therapy , Psychomotor Agitation/etiology , Schizophrenia/complications , Aggression , Benzodiazepines/therapeutic use , Humans , Loxapine/therapeutic use , Schizophrenia/drug therapy
7.
Asian J Psychiatr ; 78: 103319, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2104282

ABSTRACT

This study aimed to examine the impact of COVID-19 vaccination on the psychiatric symptoms of hospitalized schizophrenia patients and to evaluate the association between the severity of psychiatric symptoms and the COVID-19 vaccination decision. We assessed the psychiatric symptoms of 330 hospitalized schizophrenia patients who accepted the vaccine and 114 patients who declined the vaccine option with PANSS before and after vaccination. We showed that the unwillingness to receive the vaccine is correlated with a higher level of psychiatric symptoms. COVID-19 vaccination is associated with slight deterioration of the schizophrenia symptoms of elderly hospitalized patients.


Subject(s)
COVID-19 , Schizophrenia , Vaccines , Humans , Aged , Schizophrenia/diagnosis , COVID-19 Vaccines , COVID-19/prevention & control , Cohort Studies , Vaccination
8.
Psychiatr Danub ; 33(1): 18-26, 2021.
Article in English | MEDLINE | ID: covidwho-2100783

ABSTRACT

BACKGROUND: Patients with chronic mental illness are frequently hospitalized and discharged from psychiatry wards. This situation is referred to as the "revolving door phenomenon" (RDP). In addition to factors related to the patient and the disease, limited number of beds leading to shortened hospital stay are among the reasons associated with frequent hospitalization. This study aims to compare patients with RDP and patients with single hospitalization in terms of clinical, sociodemographic, and treatment-oriented characteristics in order to evaluate the risk factors causing frequent hospitalization. SUBJECTS AND METHODS: In this study, patients who were admitted and hospitalized between May 1, 2011 - May 1, 2016 were retrospectively evaluated from patient records. The RDP group consisted of 74 patients and the single-hospitalization group consisted of 59 patients who met inclusion criteria. RESULTS: The RDP group had significantly higher rates of male gender, ECT history, past suicide attempts, multiple drug treatment, clozapine use, legal incidents, and noncompliance to follow up following discharge compared to the single-hospitalization group (p<0.05). CONCLUSION: This study demonstrates that Turkey also has RDP patients with characteristics and hospitalization patterns similar to patients in countries with different cultural, social, and economic conditions. It is important to identify and correct factors that cause frequent hospitalization as it will reduce the burden of the health system as well as provide benefit to the patient.


Subject(s)
Bipolar Disorder , Psychotic Disorders , Schizophrenia , Bipolar Disorder/epidemiology , Hospitalization , Humans , Male , Mood Disorders , Psychotic Disorders/epidemiology , Retrospective Studies , Schizophrenia/epidemiology , Turkey/epidemiology
9.
Ir J Psychol Med ; 38(2): 145-153, 2021 06.
Article in English | MEDLINE | ID: covidwho-2096526

ABSTRACT

Swift medically led scientifically informed responses to the Covid-19 epidemic nationally have been demonstrably superior to other, non-scientific approaches. In forensic psychiatry and across all psychiatric services, urgent and clinically led responses have underlined redundancies and confusions in the governance of mental health services and a vacuum in policy makers. For the future, a greater emphasis on services for patients with schizophrenia and other severe, enduring mental disorders must aim at reducing standardised mortality ratios, managing risk of violence and improving hard outcomes such as symptomatic remission, functional recovery and forensic recovery of autonomy. This will require more use of information technology at service level and at national level where Scandinavian-style population-based data linkage research must now become legally sanctioned and necessary. A national research and development centre for medical excellence in forensic psychiatry is urgently required and is complimentary to and different from quality management.


Subject(s)
COVID-19 , Mental Health Services , Schizophrenia , Forensic Psychiatry , Humans , SARS-CoV-2
10.
Croat Med J ; 63(5): 412-422, 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2092246

ABSTRACT

AIM: To assess whether fear of coronavirus disease 2019 (COVID-19) is associated with depression, anxiety, and psychosis and to evaluate if these variables are correlated with the interaction between spirituality and fear of COVID-19. METHODS: Between September and November 2020, this cross-sectional study enrolled 118 chronic schizophrenia patients. The interview with patients included Fear of COVID-19 Scale, Lebanese Anxiety Scale-10, Montgomery-Asberg Depression Rating Scale, Positive and Negative Syndrome Scale (PANSS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12. The results were analyzed by using linear regressions (Enter method), with anxiety, depression, total PANSS score, positive PANSS, negative PANSS, and general psychopathology PANSS subscales as dependent variables. Spirituality, fear of COVID-19, and the interaction of spirituality with fear of COVID-19 were independents variables. RESULTS: Fear of COVID-19 was positively correlated with increased total PANSS scores (Beta=0.90, P=0.030). Higher spirituality was significantly associated with lower anxiety (Beta=-0.14, P=0.009), lower depression (Beta=-0.21, P=0.001), lower total PANSS score (Beta=-0.90, P=0.004), lower negative PANSS score (Beta=-0.23, P=0.009), and lower general psychopathology PANSS score (Beta=-0.61, P=0.001). In patients with high fear of COVID-19, having low spirituality was significantly associated with higher anxiety, depression, and psychotic symptoms. CONCLUSION: This study suggests a positive correlation between fear of COVID-19 and higher psychosis among inpatients with schizophrenia. The interaction of spirituality with fear of COVID-19 was correlated with reduced anxiety, depression, and psychosis.


Subject(s)
COVID-19 , Psychotic Disorders , Schizophrenia , Humans , Spirituality , Depression/epidemiology , Cross-Sectional Studies , Psychiatric Status Rating Scales , Psychotic Disorders/complications , Psychotic Disorders/diagnosis , Anxiety , Fear
11.
Curr Opin Psychiatry ; 34(3): 203-210, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-2078019

ABSTRACT

PURPOSE OF REVIEW: The coronavirus disease 19 (COVID-19) pandemic is having a critical impact on healthcare systems across the world, as well as on mental health in the general population; however, evidence regarding the impact of the COVID-19 pandemic on people living with schizophrenia and on the onset of psychotic symptoms is currently emerging. RECENT FINDINGS: People living with schizophrenia are at an increased risk of COVID-19 and present worse COVID-19-related outcomes, including mortality. They show low levels of information and of concern regarding the possibility of contagion and infection but presented substantially stable levels of psychotic symptoms and even increased subjective well being during the pandemic. SARS-CoV-2, as well as the prolonged social isolation and the spread of misinformation, appear to be responsible in some cases for the onset of psychotic symptoms. SUMMARY: Clinicians should inform and educate their patients on the risks related to SARS-CoV-2 infection and COVID-19 and on the precautions that they should adopt to avoid contagion. Particular attention should be devoted to maintaining the continuity of care, especially in frail patients. Telemedicine might represent a valid support, but face-to-face visits in some cases remain essential. The hypothesis of a direct role of viral infection on the onset of psychotic disorders is currently debated, as viral involvement of central nervous system appears to be rather infrequent in COVID-19.


Subject(s)
COVID-19 , Continuity of Patient Care , Psychotic Disorders , Schizophrenia , Telemedicine , COVID-19/prevention & control , Humans , Psychotic Disorders/therapy , Schizophrenia/therapy
13.
Ann Med ; 54(1): 2477-2485, 2022 12.
Article in English | MEDLINE | ID: covidwho-2028822

ABSTRACT

PURPOSE: The COVID-19 pandemic led to exacerbation of mental health symptoms and deterioration in psychological well-being in individuals suffering from schizophrenia. The primary objective of this study is to evaluate the impacts of the COVID-19 pandemic on patients suffering from treatment-resistant schizophrenia (TRS) with auditory verbal hallucinations (AVH) having undergone virtual reality therapy (VRT) or cognitive behavioural therapy (CBT) on their symptomatology. The secondary objective is to identify the differences and similarities in relation to the response to the COVID 19 pandemic between these two groups of patients. METHODS: Qualitative analysis of semi-structured interviews was conducted with 42 patients suffering from TRS who had previously followed VRT or CBT. All interviews were recorded, transcribed, and analysed. RESULTS: Four themes emerged in this study: Psychotherapeutic Interventions, Impact of COVID-19 and Public health and safety policies, Substance use and Psychiatric follow-up. Participants from both groups reported that their therapy was beneficial in controlling AVH. Patients having followed CBT reported more depressive symptoms whereas patients having followed VRT reported more anxious symptoms. CONCLUSIONS: This study offers a first qualitative insight in patients suffering from TRS and the impacts of COVID-19 on them and opens the door to the protective factors of CBT and VRT for this specific population.


Subject(s)
COVID-19 , Cognitive Behavioral Therapy , Schizophrenia , Virtual Reality Exposure Therapy , COVID-19/therapy , Hallucinations/complications , Hallucinations/therapy , Humans , Pandemics , Schizophrenia/complications , Schizophrenia/therapy , Schizophrenia, Treatment-Resistant
14.
Zh Nevrol Psikhiatr Im S S Korsakova ; 122(8. Vyp. 2): 26-31, 2022.
Article in Russian | MEDLINE | ID: covidwho-2025843

ABSTRACT

The article presents a case of ischemic stroke after SARS-CoV-2 infection in a patient with dyscirculatory encephalopathy and schizophrenia. Patient 44 years old, was hospitalized due to a confirmed diagnosis of a new coronavirus infection (COVID-19) and diagnosed bilateral pneumonia with a damage to 65% of the lung parenchyma. The patient has a history of dyscirculatory encephalopathy and paranoid schizophrenia, a continuous type of course. A fatal outcome occurs on the 2nd day of inpatient treatment. A brain autopsy revealed pericellular and perivascular edema, looseness of neuroglia with necrobiotic changes in the brain substance. Neuronal damage, small-focal gliosis, basophilic balls, destructive-productive vasculitis, ischemic small-focus necrosis were revealed. In the lungs, areas of atelectasis, disatelectasis, hyaline membranes, and edematous fluid were found. Epithelium of the convoluted tubules showed dystrophic and necrotic changes. The cause of death of the patient was a new coronavirus infection COVID-19, which caused bilateral viral pneumonia, complicated by the development of acute respiratory failure and COVID-associated ischemic cerebral infarction complicated by neuromorphological changes in the brain.


Subject(s)
Brain Diseases , Brain Edema , COVID-19 , Ischemic Stroke , Schizophrenia , Adult , Humans , SARS-CoV-2
15.
Int J Neuropsychopharmacol ; 25(11): 924-932, 2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2008575

ABSTRACT

BACKGROUND: With numerous potentially novel targets and pharmacodynamic biomarkers for schizophrenia entering late-stage testing, the next decade will bring an urgent need for well-conducted clinical trials. A critically important step for the successful execution of clinical research trials is timely and appropriate recruitment of participants. Patients with schizophrenia can be especially challenging to recruit because of the disability inherent in psychotic spectrum disorders. Research on how best to recruit for clinical trials is understudied. Clearly defining a model for recruitment procedures would be valuable for researchers and, by extension, the patient populations that may benefit from the insight gained by future clinical research. METHODS: This article aims to offer suggestions for recruitment based on years of experience at the Columbia Schizophrenia Research Clinic (CSRC), a hub for clinical trials focusing on the etiology and treatment of various psychotic disorders. RESULTS: The present report provides practical, step-by-step recommendations for implementing the highly effective CSRC recruitment model, including the benefits of 2 recruitment initiatives that were instituted in 2018: hiring a dedicated recruiter and targeted chart reviews at affiliated clinics. Other topics discussed include our umbrella protocol and database, advertising, and tips for collaborating with external sites. CONCLUSIONS: Despite ongoing complications from coronavirus disease 2019, these strategies have been successful, increasing the rate of both consents and study enrollments by approximately 40% and enabling the CSRC to conduct multiple studies simultaneously.


Subject(s)
COVID-19 , Psychotic Disorders , Schizophrenia , Humans , Schizophrenia/diagnosis , Schizophrenia/therapy , Patient Selection , Psychotic Disorders/therapy , Longitudinal Studies
16.
Psychiatry Res ; 317: 114841, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2008051

ABSTRACT

OBJECTIVES: This study aims to investigate medication adherence during the COVID-19 pandemic among community-dwelling schizophrenia patients, and to explore the role of social support in improving medication adherence in a rural community sample in China. METHODS: A cross-sectional sample of 800 patients was recruited using a cluster random sampling method in Yingshan County, Sichuan Province. Information on participant demographic characteristics, social support and medication adherence was collected through face-to-face interviews. The data analysis was performed using SAS9.4. Two binary logistic regression models were employed to identify the association between regular medication use and social support. RESULTS: The rate of regular medication adherence among community-dwelling patients with schizophrenia was 41.5%,which was lower than that indicated by recent research(Li et al., 2020) before COVID-19 in western rural China. The mean scores and standard deviation of the patient's objective support, subjective support, and support utilization were 4.94 ± 1.57, 17.03 ± 5.24, and 5.25 ± 2.75, respectively. The social support standard deviation was 27.22 ± 6.32. The crude odds ratio of objective support, subjective support, and support utilization were 0.790 (95%CI:0.713-0.876), 0.999 (95%CI:0.971-1.027), and 1.049 (95%CI:0.995-1.105) respectively. After adjusting for potential factors, the adjusted odds ratio of objective support, subjective support, and support utilization were 0.758 (95%CI:0.673-0.853), 1.030 (95%CI:0.994-1.068), and 1.043 (95%CI:0.985-1.105), respectively. CONCLUSIONS: During the COVID-19 pandemic, community-dwelling schizophrenia patients had a low rate of regular medication adherence. This was particularly true of those who were older adults, less educated and living in rural areas. The results of this study suggest that strengthening social support may effectively improve medication adherence for those patients.


Subject(s)
COVID-19 , Schizophrenia , Humans , Aged , Schizophrenia/drug therapy , Schizophrenia/epidemiology , Cross-Sectional Studies , Independent Living , Pandemics , Medication Adherence
18.
Psychiatry Res ; 317: 114809, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1996499

ABSTRACT

The coronavirus SARS-CoV-2 invades the central nervous system, impacting the mental health of COVID-19 patients. We performed a two-sample Mendelian randomization analysis to assess the potential causal effects of COVID-19 on schizophrenia. Our analysis indicated that genetic liability to hospitalized COVID-19 was associated with an increased risk for schizophrenia (OR: 1.11, 95% CI: 1.02-1.20, P = 0.013). However, genetic liability to SARS-CoV-2 infection was not associated with the risk of schizophrenia (1.06, 0.83-1.37, P = 0.643). Severe COVID-19 was associated with an 11% increased risk for schizophrenia, suggesting that schizophrenia should be assessed as one of the post-COVID-19 sequelae.


Subject(s)
COVID-19 , Schizophrenia , Humans , SARS-CoV-2 , Schizophrenia/epidemiology , Mendelian Randomization Analysis , Hospitalization , Genome-Wide Association Study
19.
Am J Case Rep ; 23: e936306, 2022 Jul 06.
Article in English | MEDLINE | ID: covidwho-1979703

ABSTRACT

BACKGROUND Myocarditis is cardiac muscle inflammation caused by infectious or noninfectious agents. Rarely, clozapine, an atypical antipsychotic drug used to treat resistant schizophrenia, has been reported to cause myocarditis, as we report in this case. CASE REPORT A 29-year-old man, who was known to have schizophrenia and was on olanzapine therapy, presented in our Emergency Department with active psychosis, and was subsequently admitted to the psychiatric ward for refractory schizophrenia. He was started on clozapine, which was cross-titrated with olanzapine. On day 20 of being treated with clozapine, he developed a high-grade fever and chest pain. EKG demonstrated new-onset prolonged QT corrected for heart rate (QTc), premature ventricular contractions, ST-T wave changes with an increased ventricular rate, and ventricular bigeminy with elevated troponin and inflammatory markers. Echocardiography showed a reduced left ventricular ejection fraction. Coronary angiography showed normal coronary arteries, low cardiac output, and cardiac index consistent with cardiogenic shock was also observed. Other pertinent laboratory results included negative respiratory viral panel, including COVID-19 PCR, negative blood cultures, and negative stool screen for ova and parasite. Clozapine was discontinued and the patient received management for heart failure with reduced ejection fraction. He improved clinically with return of EKG to normal sinus rhythm and improved left ventricular ejection fraction on repeat echocardiogram. CONCLUSIONS Acute myocarditis can occur due to a myriad of causes, both infectious and noninfectious; thus, determining the lesser-known causes, such as drug-related etiology, is essential to provide appropriate treatment for patients.


Subject(s)
COVID-19 , Clozapine , Myocarditis , Schizophrenia , Adult , Clozapine/adverse effects , Humans , Male , Myocarditis/chemically induced , Myocarditis/diagnosis , Olanzapine/adverse effects , Schizophrenia/drug therapy , Schizophrenia, Treatment-Resistant , Stroke Volume , Ventricular Function, Left
20.
Arch Psychiatr Nurs ; 40: 132-136, 2022 10.
Article in English | MEDLINE | ID: covidwho-1958530

ABSTRACT

PURPOSE: To assess the effect of a program designed to reduce nursing students' social distancing from individuals diagnosed with schizophrenia. METHOD: This experimental study was designed using a pretest, a posttest, and a control group. All participants were nursing students, of which 25 were included in the intervention group and 23 were placed in the control group. A 13-week program was offered to the intervention group. The measuring instruments consisted of a personal information form and the Social Distance Scale. Data were analyzed using the two-way repeated measures analysis of variance. FINDINGS: A significant difference was found between the two groups. CONCLUSION: The Education Program on Stigmatization in Schizophrenia is an effective intervention that reduces the social distance of nursing students from individuals diagnosed with schizophrenia.


Subject(s)
Education, Nursing, Baccalaureate , Schizophrenia , Students, Nursing , Humans , Physical Distancing , Schizophrenia/diagnosis , Stereotyping
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