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1.
Nutrients ; 14(1)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1580544

ABSTRACT

There are many ways to regulate emotions. People use both adaptive (e.g., regulation by music) and maladaptive (e.g., regulation by food) strategies to do this. We hypothesized that participants with a high level of food-based regulatory strategies and a low level of music-based regulatory strategies (a group with the least adaptive form of emotion regulation) would have significantly greater levels of unhealthy eating behaviours, depression, anxiety and stress, as well as a significantly lower level of healthy eating behaviours than those with a low level of food-based regulatory strategies and a high level of music-based regulatory strategies (a group with the greatest adaptive form of emotion regulation). Participants (N = 410; Mage = 31.77, SD = 13.53) completed: the Brief Music in Mood Regulation Scale, the Emotional Overeating Questionnaire, the Healthy and Unhealthy Eating Behavior Scale, the Depression, Anxiety and Stress Scale and a socio-demographic survey. The four clusters were identified: (a) Cluster 1 (N = 148): low food-based regulatory strategies and high music-based regulatory strategies; (b) Cluster 2 (N = 42): high food-based regulatory strategies and high music-based regulatory strategies; (c) Cluster 3 (N = 70): high food-based regulatory strategies and low music-based regulatory strategies; (d) Cluster 4 (N = 150): low food-based regulatory strategies and low music-based regulatory strategies. Overall, our outcomes partially support our hypothesis, as higher levels of unhealthy eating behaviours, depression, anxiety and stress were observed in participants with high food-based and low music-based regulatory strategies as compared with adults with low food-based and high music-based regulatory strategies. To sum up, the results obtained indicate that during the COVID-19 pandemic the group of people regulating their emotional state and unhealthy eating predominantly with food is potentially characterized by worse functioning than the group of people regulating with music. Therefore, it can be concluded that people who regulate their functioning using food should be included in preventive measures by specialists. During the visit, psychologists and primary care physicians can ask patients about their daily strategies and based on this information specialists can estimate the potential risk of developing high levels of stress and anxiety, depressive disorders and unhealthy eating habits and provide specific (match) intervention.


Subject(s)
Anxiety Disorders/therapy , COVID-19/psychology , Depressive Disorder/therapy , Diet, Healthy/statistics & numerical data , Feeding and Eating Disorders/therapy , Music/psychology , Stress, Psychological/therapy , Adolescent , Adult , Aged , Anxiety Disorders/complications , Anxiety Disorders/psychology , Cluster Analysis , Depressive Disorder/complications , Depressive Disorder/psychology , Emotional Regulation , Feeding and Eating Disorders/complications , Feeding and Eating Disorders/psychology , Female , Humans , Male , Middle Aged , Patient Acuity , SARS-CoV-2 , Stress, Psychological/complications , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
2.
Holist Nurs Pract ; 36(1): 46-51, 2022.
Article in English | MEDLINE | ID: covidwho-1517925

ABSTRACT

The study aims to test the effect of mindfulness breathing meditation on psychological well-being among nurses working for COVID-19 patients. A total of 50 nurses (25 each in the intervention and control groups) were included in the study. We found significant differences between the preintervention and postintervention mean scores of both groups, based on the Warwick-Edinburgh Mental Well-being Scale Indonesian version.


Subject(s)
COVID-19 , Meditation , Mindfulness , Nurses , Humans , SARS-CoV-2 , Stress, Psychological/therapy
3.
J Neuroinflammation ; 18(1): 231, 2021 Oct 13.
Article in English | MEDLINE | ID: covidwho-1468067

ABSTRACT

It is well accepted that environmental stressors experienced over a one's life, from microbial infections to chemical toxicants to even psychological stressors, ultimately shape central nervous system (CNS) functioning but can also contribute to its eventual breakdown. The severity, timing and type of such environmental "hits", woven together with genetic factors, likely determine what CNS outcomes become apparent. This focused review assesses the current COVID-19 pandemic through the lens of a multi-hit framework and disuses how the SARS-COV-2 virus (causative agent) might impact the brain and potentially interact with other environmental insults. What the long-term consequences of SAR2 COV-2 upon neuronal processes is yet unclear, but emerging evidence is suggesting the possibility of microglial or other inflammatory factors as potentially contributing to neurodegenerative illnesses. Finally, it is critical to consider the impact of the virus in the context of the substantial psychosocial stress that has been associated with the global pandemic. Indeed, the loneliness, fear to the future and loss of social support alone has exerted a massive impact upon individuals, especially the vulnerable very young and the elderly. The substantial upswing in depression, anxiety and eating disorders is evidence of this and in the years to come, this might be matched by a similar spike in dementia, as well as motor and cognitive neurodegenerative diseases.


Subject(s)
COVID-19/immunology , Inflammation Mediators/immunology , Mental Disorders/immunology , Neurodegenerative Diseases/immunology , Neuroimmunomodulation/immunology , Animals , Brain/immunology , COVID-19/epidemiology , Humans , Immunotherapy/trends , Mental Disorders/epidemiology , Mental Disorders/therapy , Neurodegenerative Diseases/epidemiology , Neurodegenerative Diseases/therapy , Stress, Psychological/epidemiology , Stress, Psychological/immunology , Stress, Psychological/therapy
4.
Int J Environ Res Public Health ; 18(15)2021 08 02.
Article in English | MEDLINE | ID: covidwho-1335089

ABSTRACT

The aim of this study is to investigate the effectiveness of a novel self-administered at-home daily virtual reality (VR)-based intervention (COVID Feel Good) for reducing the psychological burden experienced during the COVID-19 lockdown in Italy. A total of 40 individuals who had experienced at least two months of strict social distancing measures followed COVID Feel Good between June and July 2020 for one week. Primary outcome measures were depression, anxiety, and stress symptoms, perceived stress levels, and hopelessness. Secondary outcomes were the experienced social connectedness and the level of fear experienced during the COVID-19 pandemic. Linear mixed-effects models were fitted to evaluate the effectiveness of the intervention. Additionally, we also performed a clinical change analysis on primary outcome measures. As concerning primary outcome measures, participants exhibited improvements from baseline to post-intervention for depression levels, stress levels, general distress, and perceived stress (all p < 0.05) but not for the perceived hopelessness (p = 0.110). Results for the secondary outcomes indicated an increase in social connectedness from T0 to T1 (p = 0.033) but not a significant reduction in the perceived fear of coronavirus (p = 0.412). Among these study variables, these significant improvements were maintained from post-intervention to the 2-week follow-up (p > 0.05). Results indicated that the intervention was associated with good clinical outcomes, low-to-no risks for the treatment, and no adverse effects or risks. Globally, evidence suggests a beneficial effect of the proposed protocol and its current availability in 12 different languages makes COVID Feel Good a free choice for helping individuals worldwide to cope with the psychological distress associated with the COVID-19 crisis, although large scale trials are needed to evaluate its efficacy.


Subject(s)
COVID-19 , Psychological Distress , Virtual Reality , Communicable Disease Control , Depression/therapy , Follow-Up Studies , Humans , Pandemics , SARS-CoV-2 , Stress, Psychological/therapy
6.
PLoS Med ; 18(6): e1003625, 2021 06.
Article in English | MEDLINE | ID: covidwho-1315879

ABSTRACT

John Naslund and Eirini Karyotaki discuss Mark Jordans and colleagues' accompanying research study on therapy for people with psychological distress in Nepal.


Subject(s)
Depression , Psychological Distress , Depression/diagnosis , Depression/epidemiology , Depression/therapy , Emergencies , Humans , Nepal , Stress, Psychological/therapy
7.
PLoS Med ; 18(6): e1003621, 2021 06.
Article in English | MEDLINE | ID: covidwho-1315878

ABSTRACT

BACKGROUND: Globally, 235 million people are impacted by humanitarian emergencies worldwide, presenting increased risk of experiencing a mental disorder. Our objective was to test the effectiveness of a brief group psychological treatment delivered by trained facilitators without prior professional mental health training in a disaster-prone setting. METHODS AND FINDINGS: We conducted a cluster randomized controlled trial (cRCT) from November 25, 2018 through September 30, 2019. Participants in both arms were assessed at baseline, midline (7 weeks post-baseline, which was approximately 1 week after treatment in the experimental arm), and endline (20 weeks post-baseline, which was approximately 3 months posttreatment). The intervention was Group Problem Management Plus (PM+), a psychological treatment of 5 weekly sessions, which was compared with enhanced usual care (EUC) consisting of a family psychoeducation meeting with a referral option to primary care providers trained in mental healthcare. The setting was 72 wards (geographic unit of clustering) in eastern Nepal, with 1 PM+ group per ward in the treatment arm. Wards were eligible if they were in disaster-prone regions and residents spoke Nepali. Wards were assigned to study arms based on covariate constrained randomization. Eligible participants were adult women and men 18 years of age and older who met screening criteria for psychological distress and functional impairment. Outcomes were measured at the participant level, with assessors blinded to group assignment. The primary outcome was psychological distress assessed with the General Health Questionnaire (GHQ-12). Secondary outcomes included depression symptoms, posttraumatic stress disorder (PTSD) symptoms, "heart-mind" problems, social support, somatic symptoms, and functional impairment. The hypothesized mediator was skill use aligned with the treatment's mechanisms of action. A total of 324 participants were enrolled in the control arm (36 wards) and 319 in the Group PM+ arm (36 wards). The overall sample (N = 611) had a median age of 45 years (range 18-91 years), 82% of participants were female, 50% had recently experienced a natural disaster, and 31% had a chronic physical illness. Endline assessments were completed by 302 participants in the control arm (36 wards) and 303 participants in the Group PM+ arm (36 wards). At the midline assessment (immediately after Group PM+ in the experimental arm), mean GHQ-12 total score was 2.7 units lower in Group PM+ compared to control (95% CI: 1.7, 3.7, p < 0.001), with standardized mean difference (SMD) of -0.4 (95% CI: -0.5, -0.2). At 3 months posttreatment (primary endpoint), mean GHQ-12 total score was 1.4 units lower in Group PM+ compared to control (95% CI: 0.3, 2.5, p = 0.014), with SMD of -0.2 (95% CI: -0.4, 0.0). Among the secondary outcomes, Group PM+ was associated with endline with a larger proportion attaining more than 50% reduction in depression symptoms (29.9% of Group PM+ arm versus 17.3% of control arm, risk ratio = 1.7, 95% CI: 1.2, 2.4, p = 0.002). Fewer participants in the Group PM+ arm continued to have "heart-mind" problems at endline (58.8%) compared to the control arm (69.4%), risk ratio = 0.8 (95% CI, 0.7, 1.0, p = 0.042). Group PM+ was not associated with lower PTSD symptoms or functional impairment. Use of psychosocial skills at midline was estimated to explain 31% of the PM+ effect on endline GHQ-12 scores. Adverse events in the control arm included 1 suicide death and 1 reportable incidence of domestic violence; in the Group PM+ arm, there was 1 death due to physical illness. Study limitations include lack of power to evaluate gender-specific effects, lack of long-term outcomes (e.g., 12 months posttreatment), and lack of cost-effectiveness information. CONCLUSIONS: In this study, we found that a 5-session group psychological treatment delivered by nonspecialists modestly reduced psychological distress and depression symptoms in a setting prone to humanitarian emergencies. Benefits were partly explained by the degree of psychosocial skill use in daily life. To improve the treatment benefit, future implementation should focus on approaches to enhance skill use by PM+ participants. TRIAL REGISTRATION: ClinicalTrials.gov NCT03747055.


Subject(s)
Depression/therapy , Mental Health , Natural Disasters , Problem Solving , Psychotherapy, Brief , Psychotherapy, Group , Relief Work , Stress Disorders, Post-Traumatic/therapy , Stress, Psychological/therapy , Adaptation, Psychological , Adolescent , Adult , Aged , Aged, 80 and over , Depression/diagnosis , Depression/etiology , Depression/psychology , Female , Functional Status , Humans , Male , Middle Aged , Nepal , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Stress, Psychological/diagnosis , Stress, Psychological/etiology , Stress, Psychological/psychology , Time Factors , Treatment Outcome , Young Adult
8.
J Affect Disord ; 293: 373-378, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1284165

ABSTRACT

BACKGROUND: To mitigate the psychological burdens of COVID-19 for frontline clinicians (FCs), we adapted an existing evidence-based resiliency program, Stress Management and Resilience Training Relaxation Response Program (SMART-3RP), for FCs. This analysis explores moderators of stress coping to determine which subgroups of FCs benefited most from SMART-3RP. METHODS: 102 FCs from Mass General Brigham hospitals engaged in the adapted SMART-3RP. Assessments were completed at group entry (Week 0) and completion (Week 4). The primary outcome was stress coping, and we examined 15 possible baseline moderators. We fit linear mixed effects regression models and assessed potential baseline moderators using a likelihood ratio test. We report model-based estimates and confidence intervals for each moderator-by-time interaction (i.e., differential effect), where positive/negative values indicate more/less improvement in average perceived stress coping. RESULTS: Stress coping improved from Week 0 to Week 4 (mean improvement [95% CI] = 0.9 [0.6 to 1.2]). FCs with higher anxiety (differential effect [95% CI] = 0.3 [0.1 to 0.4]), depression (0.4 [0.2 to 0.6]), and loneliness (0.4 [0.1 to 0.6]), but lower levels of mindfulness (CAMS-Rfocus: 1.0 [0.4 to 1.6]; CAMS-Raccept: 1.3 [0.7 to 2.0]) and self-compassion (0.4, [0.1 to 0.8]) at baseline experienced greater benefits in perceived stress coping from the SMART-3RP. Baseline health uncertainty along with sociodemographic and work characteristics did not moderate stress coping. DISCUSSION: Results highlight particular sub-populations of FCs that may benefit more from a stress management intervention, especially during emergency responses (e.g., COVID-19 pandemic).


Subject(s)
COVID-19 , Resilience, Psychological , Adaptation, Psychological , Humans , Pandemics , SARS-CoV-2 , Stress, Psychological/epidemiology , Stress, Psychological/therapy
9.
Curr Psychiatry Rep ; 23(7): 44, 2021 06 19.
Article in English | MEDLINE | ID: covidwho-1274938

ABSTRACT

PURPOSE OF REVIEW: We aim to review evidence of the psychological impact of the COVID-19 pandemic on healthcare professionals and the effects of the psychological crisis interventions and measures implemented to manage stress. RECENT FINDINGS: Mental health problems are frequently encountered in health professionals during emergencies and often prevail over the following years. Results show health professionals exhibited symptoms of depression, anxiety, emotional distress, burnout, post-traumatic stress and poor sleep quality. In response to acute responses to stress, it is crucial to provide psychoeducation, mindfulness and coping resources. These interventions can improve resilience and self-efficacy of professionals, as well as help to prevent anxiety, depression and quality of sleep. The need for intervention programmes targeting the mental health of vulnerable populations has been widely acknowledged. We described a psychological support plan designed and implemented with the aim of providing mental health care for health professionals. Such programmes should be easily accessible to professionals, preferably in their own work environments.


Subject(s)
COVID-19 , Pandemics , Anxiety , Depression , Health Personnel , Hospitals , Humans , SARS-CoV-2 , Spain , Stress, Psychological/epidemiology , Stress, Psychological/therapy
10.
Int Tinnitus J ; 25(1): 29-33, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1256967

ABSTRACT

BACKGROUND: Covid-19 pandemic has caused a profound impact on the lives of people and has given rise to many mental health issues like anxiety and stress which eventually has given rise to bothersome tinnitus. In case of people having pre-existing tinnitus, the pandemic has raised the problem of tinnitus and the co-morbid issues related to tinnitus and severely affected the overall quality of life. Hence, we need to find a mean for home-based management of tinnitus and its associated problems. OBJECTIVE: To understand the mechanism of mental health and to compare between the mindfulness-based tinnitus reduction and tinnitus retraining therapy on android-based application. DESIGN: Comparative and Experimental design. METHOD: The study was conducted on 60 participants and was divided into two groups. Detailed audiological assessment, tinnitus assessment and Tinnitus Handicap Inventory (THI) and Tinnitus Cognitions Questionnaire (TCQ) were administered. Group-I was provided with tinnitus retraining therapy and group-II was provided with mindfulness based tinnitus stress reduction. After the post therapy evaluation the data were compiled for statistical analysis in SPSS software 20.0. Results: It was found that there were significant difference between the pre and post therapy scores of TRT and MBTSR in both THI and TCQ (p<0.001). CONCLUSION: Home-based management of tinnitus during the COVID-19 pandemic using both TRT and MBTSR were highly successful and had similar results MBTSR was found to be more useful as it had better outcome in reducing the tinnitus related annoyance and shown better improvement in QOL examination.


Subject(s)
COVID-19/epidemiology , Mindfulness , Stress, Psychological/etiology , Tinnitus/therapy , Adult , Audiometry, Pure-Tone , Female , Humans , Male , Middle Aged , Mindfulness/methods , Mobile Applications , Smartphone , Stress, Psychological/therapy , Surveys and Questionnaires , Tinnitus/complications , Tinnitus/diagnosis , Tinnitus/psychology , Young Adult
12.
Eur Rev Med Pharmacol Sci ; 25(6): 2808-2821, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1173131

ABSTRACT

OBJECTIVE: In response to the COVID-19 disaster, people have developed several psychological problems mainly stress, anxiety, and depression. These psychological problems have been seen in either normal people during the lockdown (who are waiting to get infected with COVID-19) and patients with COVID-19 (who are waiting for death). These psychological problems adversely affect immune functions causing more increase in the severity of COVID-19 associated disorders and death rates. Increasing the aerobic capacity is one of the effective methods that could be used to decrease stress, anxiety, and depression. Besides, increasing the aerobic capacity increases immune functions through autonomic regulation. Thus, this review was developed to summarize the effect of increasing the aerobic capacity on psycho-immune hormones commonly disturbed in people during the lockdown or patients with COVID-19 infection. MATERIALS AND METHODS: This review was carried out by searching through Web of Science, Scopus, EBSCO, Medline databases. The search was conducted over clinical trials, literature reviews, and systematic reviews. The search included the possible effects of increasing the aerobic capacity on the functions of psycho-immune hormones. RESULTS: This review found that increasing the aerobic capacity can decrease psychological problems commonly seen in people with COVID-19 and increase immune functions by modulating the levels of glucocorticoid, oxytocin, insulin, thyroid hormones. CONCLUSIONS: This review demonstrated that increasing the aerobic capacity is a recommended treatment for decreasing the psychological problems commonly seen in people with COVID-19 because it has the potential for decreasing psychological problems and improving immune functions which would help counter COVID-19.


Subject(s)
Anxiety/therapy , COVID-19/psychology , Depression/therapy , Exercise Therapy/methods , Stress, Psychological/therapy , Anxiety/epidemiology , Anxiety/virology , COVID-19/transmission , COVID-19/virology , Depression/epidemiology , Depression/virology , Humans , Oxygen Consumption , SARS-CoV-2/isolation & purification , Stress, Psychological/epidemiology , Stress, Psychological/virology
13.
Trials ; 22(1): 171, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1112447

ABSTRACT

BACKGROUND: The coronavirus-19 (COVID-19) has reached pandemic status and is affecting countries all over the world. The COVID-19 pandemic is accompanied by various stressors that require adjustment in everyday life and possibly changes in personal future prospects. While some individuals cope well with these challenges, some develop psychological distress including depressive symptoms, anxiety, or stress. Internet-based self-help interventions have proven to be effective in the treatment of various mental disorders such as depression and anxiety. Based on that, we developed an internet-based self-help program for individuals with psychological distress due to the situation surrounding the COVID-19 pandemic. The 3-week self-help program consists of 6 modules comprising texts, videos, figures, and exercises. Participants can request guidance within the self-help program (guidance on demand). The primary aim of this study is to evaluate the efficacy and feasibility of the self-help program compared to a waiting control condition. METHODS: The design is a parallel group randomized controlled trial. Participants are allocated to a 3-week self-help intervention plus care as usual or a 3-week waiting period with only care as usual. There are follow-ups after 6 weeks and 18 weeks. At least 80 participants with COVID-19 pandemic related psychological distress will be recruited. Primary outcome are depressive symptoms. Secondary outcomes include anxiety and chronic stress, suicidal experiences and behavior, health-related quality of life, generalized optimism and pessimism, embitterment, optimistic self-beliefs, emotion regulation skills, loneliness, resilience, and the satisfaction with and usability of the self-help program. DISCUSSION: To the best of our knowledge, this is one of the first studies investigating the efficacy of an internet-based self-help program for psychological distress due to the situation surrounding the COVID-19 pandemic. Thus, the results of this study may give further insight into the use of internet-based self-help programs in pandemic-related psychological distress. TRIAL REGISTRATION: ClinicalTrials.gov NCT04380909 . Retrospectively registered on 8 May 2020.


Subject(s)
Anxiety/therapy , COVID-19 , Depression/therapy , Internet-Based Intervention , Self Care , Stress, Psychological/therapy , Anxiety/psychology , Depression/psychology , Emotional Regulation , Humans , Loneliness , Optimism , Patient Health Questionnaire , Patient Satisfaction , Pessimism , Psychological Distress , Quality of Life , Randomized Controlled Trials as Topic , Resilience, Psychological , SARS-CoV-2 , Self Efficacy , Self-Management , Stress, Psychological/psychology , Suicidal Ideation
14.
BMC Psychiatry ; 21(1): 93, 2021 02 11.
Article in English | MEDLINE | ID: covidwho-1083915

ABSTRACT

BACKGROUND: There is evidence suggesting that quarantine might have undesirable psychological impacts on the patients. Therefore, it is important to seek for ways to increase the resilience and alleviate the psychological pressure of the patients who are quarantined due to infection with COVID-19. The present study was conducted to assess an online multimedia psychoeducational intervention regarding the feasibility, adherence, patient satisfaction and effectiveness on resilience and perceived stress of patients hospitalized with confirmed COVID-19. METHOD: This was a pilot cluster randomized parallel-controlled trial with hospital wards as the units of randomization. Participants in this fully online trial were 50 consecutive patients who were hospitalized in 2 hospitals in Shiraz, after being diagnosed with COVID-19. Before the beginning of the intervention, four inpatient wards inside two of the hospitals were randomly assigned to either intervention or control conditions. All eligible participants in the wards allocated to the intervention condition received online multimedia psychoeducational interventions during the 2 weeks, whilst the patients in the wards allocated to the control condition were offered the opportunity to receive telephone-based psychological counseling if needed. Psychoeducational interventions mainly included cognitive-behavioural techniques, stress management techniques, mindfulness-based stress reduction and positive psychotherapy. The patients were assessed regarding resilience and perceived stress at baseline and after two weeks. RESULTS: Of 27 patients starting multimedia psychoeducational interventions, 26 (96.29%) completed post-assessments. A high level of adherence (80.76%) and satisfaction (Mean = 29.42; SD = 4.18) with the online multimedia psychoeducational interventions was found. Compared with the control group, the patients who used online multimedia psychoeducational interventions reported greater resilience (Meanintervention = 81.74; Meancontrol = 72.86; adjusted t (46) = 2.10; p = 0.04; CI: 0.39 to 17.38; dppc2 = 0.83) and fewer perceived stress (Meanintervention = 22.15; Meancontrol = 29.45; adjusted t (46) = 2.66; p = 0.01; CI: - 12.81 to - 1.78; dppc2 = - 0.77) after 2 weeks. DISCUSSION: The findings of the present study provided a successful first attempt at implementing feasible online multimedia psychoeducational interventions to promote resilience and mitigate stress among the patients who were hospitalized due to infection with COVID-19. The present results could help mental health professionals to determine which psychological techniques should be emphasized to promote patients' resilience in the context of COVID-19 disease. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20201001048893N1 . Retrospectively registered, 29 Jan 2021.


Subject(s)
COVID-19 , Internet-Based Intervention , Resilience, Psychological , Stress, Psychological , Humans , Iran , Multimedia , SARS-CoV-2 , Stress, Psychological/therapy
16.
J Am Acad Child Adolesc Psychiatry ; 60(1): 2-6, 2021 01.
Article in English | MEDLINE | ID: covidwho-1065243

ABSTRACT

Families of children with neurodevelopmental disorders are especially vulnerable during the COVID-19 pandemic. Physical distancing requirements and closure of schools and services in the context of the COVID-19 pandemic are likely challenging to everyone but may be particularly impactful for families with children with neurodevelopmental disorders ([NDDs], eg, intellectual disability, attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder [ASD]). Although a small number of children may experience less stress or anxiety due to reduced social and academic expectations,1 for many children with NDDs, and particularly those with ASD, carefully developed behavioral and environmental supports, and consistent and predictable routines and expectations, are vital for their mental well-being.2 Consequently, abrupt discontinuation of these supports during quarantine and prolonged isolation creates a real risk for behavioral exacerbations in this vulnerable population.3-6 Possible consequences for family members include physical and mental strain,7 whereas for the child with an NDD, increased emotional distress and challenging behavior may create safety concerns and the need for hospitalization.4,6 Children with NDDs may be at increased risk for COVID and COVID-related complications,8 emphasizing the need for preventive and/or crisis behavioral health care availability outside of emergency and hospital settings.


Subject(s)
COVID-19/prevention & control , Neurodevelopmental Disorders/therapy , Telemedicine/methods , Adaptation, Psychological , Adolescent , COVID-19/complications , COVID-19/epidemiology , COVID-19/psychology , Caregivers/psychology , Child , Child, Preschool , Female , Humans , Male , Neurodevelopmental Disorders/complications , Neurodevelopmental Disorders/psychology , Ontario/epidemiology , Pandemics , Parents/psychology , Program Evaluation , Stress, Psychological/etiology , Stress, Psychological/therapy
17.
Encephale ; 46(3S): S81-S84, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065055

ABSTRACT

OBJECTIVES: The sudden changes of healthcare system due to COVID-19 particularly affect the organization of psychiatry. The objective of this review is to examine the adaptations of psychiatric care in France during this pandemic. METHOD: This narrative review is based on the observation of changes made in French psychiatric hospitals and on an analysis of the literature. RESULTS: Regarding psychiatric hospitalization, the COVID-19 epidemic required rapid measures that profoundly modified the conditions of patients' reception, forcing the medical staffs to adapt their methods of care. The authors noted the creation of at least 89 wards specifically dedicated to patients with COVID-19 needing psychiatric hospitalization, allowing dual care of general medicine and psychiatry. Regarding ambulatory care, maintaining patients with long-term follow-up was a priority. Patients recalling and teleconsultation have been precious resources but cannot entirely replace face-to-face consultations. DISCUSSION: COVID-19 epidemic created unprecedented situation of large-scale upheavals in the healthcare system and in society. Despite the absence of previous recommendations on the subject, French psychiatry has shown great adaptability. Some changes could inspire post-COVID-19 care.


Subject(s)
Betacoronavirus , Coronavirus Infections , Hospital Restructuring , Hospitals, Psychiatric/organization & administration , Mental Health Services/organization & administration , Pandemics , Pneumonia, Viral , Psychotherapy/organization & administration , Ambulatory Care/organization & administration , Bed Conversion , COVID-19 , France/epidemiology , Health Personnel/psychology , Health Services Accessibility , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Mental Health Services/supply & distribution , Occupational Health , Patients' Rooms , Psychotherapy/statistics & numerical data , SARS-CoV-2 , Social Change , Stress, Psychological/etiology , Stress, Psychological/therapy , Telemedicine
18.
Encephale ; 46(3S): S66-S72, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065052

ABSTRACT

OBJECTIVE: The COVID-19 pandemic affected today more than 3,000,000 worldwide, and more than half of humanity has been placed in quarantine. The scientific community and the political authorities fear an epidemic of suicide secondary to this crisis. The aim of this review is to analyze the impact of the COVID-19 pandemic on the dimensions of the suicidal process and its interaction with the various risk factors. We also propose innovative strategies to manage suicidal behavior in the context of pandemic. METHODS: We carried out a narrative review of international publications dealing with major pandemics (COVID-19, SARS) and their influence on suicidal vulnerability. RESULTS: Many factors are likely to increase the emergence of suicidal ideation and suicide attempts during this crisis. Social distancing and quarantine could increase the feeling of disconnection and the perception of social pain in vulnerable individuals. Some populations at high suicidal risk could be further impacted by the current pandemic: the elderly, medical staff and individuals exposed to economic insecurity. Several innovative tools adapted to the constraints of social distancing and quarantine may prevent suicide risk: e-health, VigilanS, buddhist-derived practices and art engagement. CONCLUSIONS: This unprecedented crisis may interact with certain dimensions of the suicidal process. However, it is time to innovate. Several suicide prevention tools all have their place in new modes of care and should be tested on a large scale.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Suicide/psychology , Alcoholic Intoxication/psychology , Artificial Intelligence , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Cost of Illness , Crisis Intervention/instrumentation , Economic Recession , France/epidemiology , Humans , Inflammation , Loneliness/psychology , Models, Neurological , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , Psychotherapy/methods , Psychotic Disorders/etiology , Psychotic Disorders/physiopathology , Psychotic Disorders/virology , Quarantine/psychology , Renin-Angiotensin System/physiology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/psychology , Social Isolation/psychology , Stress, Psychological/etiology , Stress, Psychological/therapy , Suicidal Ideation , Suicide/prevention & control , Suicide/statistics & numerical data , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Telemedicine , Vulnerable Populations
19.
Encephale ; 46(3S): S3-S13, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065044

ABSTRACT

OBJECTIVE: The lack of ressources and coordination to face the epidemic of coronavirus raises concerns for the health of patients with mental disorders in a country where we keep in memory the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims at proposing guidance to ensure mental health care during the SARS-CoV epidemy in France. METHODS: Authors performed a narrative review identifying relevant results in the scientific and medical literature and local initiatives in France. RESULTS: We identified four types of major vulnerabilities in patients suffering from mental disorders during this pandemic: (1) medical comorbidities that are more frequently found in patients suffering from mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which represent risk factors for severe infections with Covid-19; (2) age (the elderly constituting the population most vulnerable to coronavirus); (3) cognitive and behavioral troubles which can hamper compliance with confinement and hygiene measures and finally and (4) psychosocial vulnerability due to stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly adapted to psychiatric establishments in a context of major shortage of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds are closed, wards have a high density of patients, mental health community facilities are closed, medical teams are understaffed and poorly trained to face infectious diseases. We could also face major issues in referring patients with acute mental disorders to intensive care units. To maintain continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of Covid+ units. These units are under the dual supervision of a psychiatrist and of an internist/infectious disease specialist; all new entrants should be placed in quarantine for 14 days; the nurse staff should benefit from specific training, from daily medical check-ups and from close psychological support. Family visits would be prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management should be organized with the possibility of home visits, in order to support them when they get back home and to help them to cope with the experience of confinement, which is at risk to induce recurrences of mental disorders. The total or partial closure of mental health community facilities is particularly disturbing for patients but a regular follow-up is possible with telemedicine and should include the monitoring of the suicide risk and psychoeducation strategies; developing support platforms could also be very helpful in this context. Private psychiatrists have also a crucial role of information with their patients on confinement and barrier measures, but also on measures to prevent the psychological risks inherent to confinement: maintenance of sleep regularity, physical exercise, social interactions, stress management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. DISCUSSION: French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.


Subject(s)
Betacoronavirus , Continuity of Patient Care/organization & administration , Coronavirus Infections/epidemiology , Mental Disorders/therapy , Mental Health Services/organization & administration , Pandemics , Pneumonia, Viral/epidemiology , Aftercare , Age Factors , Aged, 80 and over , Antiviral Agents/pharmacokinetics , Antiviral Agents/therapeutic use , COVID-19 , Child , Cognition Disorders/epidemiology , Cognition Disorders/therapy , Comorbidity , Coronavirus Infections/psychology , Drug Interactions , France/epidemiology , Hospital Units/organization & administration , Hospitals, Psychiatric/organization & administration , Humans , Infection Control/methods , Mental Disorders/epidemiology , Mental Disorders/etiology , Mental Health Services/supply & distribution , Patient Care Team , Patient Compliance , Pneumonia, Viral/psychology , Prisoners/psychology , SARS-CoV-2 , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/therapy , Stress, Psychological/etiology , Stress, Psychological/therapy , Substance-Related Disorders/epidemiology , Substance-Related Disorders/therapy , Suicide/prevention & control , Vulnerable Populations
20.
Am J Obstet Gynecol MFM ; 2(4): 100229, 2020 11.
Article in English | MEDLINE | ID: covidwho-1064757

ABSTRACT

Both acute and chronic stress can cause allostatic overload, or long-term imbalance in mediators of homeostasis, that results in disruptions in the maternal-placental-fetal endocrine and immune system responses. During pregnancy, disruptions in homeostasis may increase the likelihood of preterm birth and preeclampsia. Expectant mothers traditionally have high rates of anxiety and depressive disorders, and many are susceptible to a variety of stressors during pregnancy. These common life stressors include financial concerns and relationship challenges and may be exacerbated by the biological, social, and psychological changes occurring during pregnancy. In addition, external stressors such as major weather events (eg, hurricanes, tornados, floods) and other global phenomena (eg, the coronavirus disease 2019 pandemic) may contribute to stress during pregnancy. This review investigates recent literature published about the use of nonpharmacologic modalities for stress relief in pregnancy and examines the interplay between psychiatric diagnoses and stressors, with the purpose of evaluating the feasibility of implementing nonpharmacologic interventions as sole therapies or in conjunction with psychotherapy or psychiatric medication therapy. Further, the effectiveness of each nonpharmacologic therapy in reducing symptoms of maternal stress is reviewed. Mindfulness meditation and biofeedback have shown effectiveness in improving one's mental health, such as depressive symptoms and anxiety. Exercise, including yoga, may improve both depressive symptoms and birth outcomes. Expressive writing has successfully been applied postpartum and in response to pregnancy challenges. Although some of these nonpharmacologic interventions can be convenient and low cost, there is a trend toward inconsistent implementation of these modalities. Future investigations should focus on methods to increase ease of uptake, ensure each option is available at home, and provide a standardized way to evaluate whether combinations of different interventions may provide added benefit.


Subject(s)
COVID-19 , Complementary Therapies/methods , Pregnancy Complications , Pregnancy Outcome/epidemiology , Psychotherapy/methods , Stress, Psychological , COVID-19/epidemiology , COVID-19/psychology , Female , Humans , Infant, Newborn , Mental Health , Pregnancy , Pregnancy Complications/psychology , Pregnancy Complications/therapy , SARS-CoV-2 , Stress, Psychological/etiology , Stress, Psychological/therapy
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