Post-COVID syndrome in psychiatric practice.

The novel coronavirus SARS-CoV-2 is associated with a significant incidence of neuropsychiatric disorders, which tend to have a long course in the post-COVID period. Objective(s): to study post-COVID mental disorders in clinical psychiatric practice. Patients and methods. 30 patients aged 37.75+/-14.07 years with anamnesis of SARS-CoV-2 infection were examined. Clinical scale assessment was carried out using the Hamilton Depression and Anxiety Scale. The Symptom-Checklist (SCL-90-R) was used to assess the psychopathological status of the patient. Patients' cognitive functioning was assessed using the Mini-Cog Cognitive Assessment Questionnaire. Patients' sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Results and discussion. Mental disorders associated with a previous coronavirus infection are observed in a wide time range from less than 1 month to a year after the previous disease, and in no case did the coronavirus infection have a severe course. Sleep disorders, anxiety and depressive disorders, which did not exceed a moderate degree of severity, and asthenia dominated in the structure of the post-COVID syndrome. The level of mental distress in patients with post-COVID syndrome increased 2 times. Post-COVID mental disorders are interrelated with female gender, age, and psychotraumatic factors associated with the pandemic. Cognitive impairment mediated by mental disorders was observed in approximately 60% of patients and did not reach the degree of dementia. Conclusion. The clinical picture of the post-COVID syndrome is represented by a wide range of mental disorders, the development of which involves not only biological, but also psychosocial factors associated with the COVID-19 pandemic, which determines the specifics of diagnostic approaches and the feasibility of complex treatment of the post-COVID syndrome.Copyright © 2022 Ima-Press Publishing House. All rights reserved.

Post-COVID syndrome in psychiatric practice

The novel coronavirus SARS-CoV-2 is associated with a significant incidence of neuropsychiatric disorders, which tend to have a long course in the post-COVID period. Objective(s): to study post-COVID mental disorders in clinical psychiatric practice. Patients and methods. 30 patients aged 37.75+/-14.07 years with anamnesis of SARS-CoV-2 infection were examined. Clinical scale assessment was carried out using the Hamilton Depression and Anxiety Scale. The Symptom-Checklist (SCL-90-R) was used to assess the psychopathological status of the patient. Patients' cognitive functioning was assessed using the Mini-Cog Cognitive Assessment Questionnaire. Patients' sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Results and discussion. Mental disorders associated with a previous coronavirus infection are observed in a wide time range from less than 1 month to a year after the previous disease, and in no case did the coronavirus infection have a severe course. Sleep disorders, anxiety and depressive disorders, which did not exceed a moderate degree of severity, and asthenia dominated in the structure of the post-COVID syndrome. The level of mental distress in patients with post-COVID syndrome increased 2 times. Post-COVID mental disorders are interrelated with female gender, age, and psychotraumatic factors associated with the pandemic. Cognitive impairment mediated by mental disorders was observed in approximately 60% of patients and did not reach the degree of dementia. Conclusion. The clinical picture of the post-COVID syndrome is represented by a wide range of mental disorders, the development of which involves not only biological, but also psychosocial factors associated with the COVID-19 pandemic, which determines the specifics of diagnostic approaches and the feasibility of complex treatment of the post-COVID syndrome.Copyright © 2022 Ima-Press Publishing House. All rights reserved.

Post-COVID syndrome in psychiatric practice.

The novel coronavirus SARS-CoV-2 is associated with a significant incidence of neuropsychiatric disorders, which tend to have a long course in the post-COVID period. Objective(s): to study post-COVID mental disorders in clinical psychiatric practice. Patients and methods. 30 patients aged 37.75+/-14.07 years with anamnesis of SARS-CoV-2 infection were examined. Clinical scale assessment was carried out using the Hamilton Depression and Anxiety Scale. The Symptom-Checklist (SCL-90-R) was used to assess the psychopathological status of the patient. Patients' cognitive functioning was assessed using the Mini-Cog Cognitive Assessment Questionnaire. Patients' sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Results and discussion. Mental disorders associated with a previous coronavirus infection are observed in a wide time range from less than 1 month to a year after the previous disease, and in no case did the coronavirus infection have a severe course. Sleep disorders, anxiety and depressive disorders, which did not exceed a moderate degree of severity, and asthenia dominated in the structure of the post-COVID syndrome. The level of mental distress in patients with post-COVID syndrome increased 2 times. Post-COVID mental disorders are interrelated with female gender, age, and psychotraumatic factors associated with the pandemic. Cognitive impairment mediated by mental disorders was observed in approximately 60% of patients and did not reach the degree of dementia. Conclusion. The clinical picture of the post-COVID syndrome is represented by a wide range of mental disorders, the development of which involves not only biological, but also psychosocial factors associated with the COVID-19 pandemic, which determines the specifics of diagnostic approaches and the feasibility of complex treatment of the post-COVID syndrome.Copyright © 2022 Ima-Press Publishing House. All rights reserved.

Mental health care for COVID-19 patients in a multidisciplinary hospital: managerial aspects

Introduction. COVID-19 affects not only the respiratory tract and lungs, but also the central nervous system. These organic lesions lead to the development of mental and neurological disorders. The structure of psychiatric disorders in COVID-19 is poorly understood, but the data are important for the management and planning of medical care. The purpose of the study. Analysis of the management of psychiatric care in a multidisciplinary hospital from the point of view of the algorithmization of the work of a psychiatrist and psychotherapist in the context of COVID-19. Material and methods. The relevant materials on the results of the activities of the psychiatric service of the hospital for war veterans in St. Petersburg during the coronavirus pandemic were analyzed. Results. Psychiatric and psychotherapeutic care was provided to COVID-19 patients or suspected of having the disease admitted to the hospital. As a result of a psychiatric examination, the observation mode was determined in the admissions department, the intensive care unit and the infectious diseases department. Indications for the provision of psychiatric and psychotherapeutic care and transfer to a psychiatric hospital with departments for patients with coronavirus infection have been developed. Limitations of the study. The results of this study cannot be extrapolated to the work of all multidisciplinary hospitals, because associated with the presence of a psychiatrist and a psychotherapist in the staff of the institution. A limitation can be considered the non-inclusion in the study of persons under 45 years of age. Conclusion. The experience of the psychiatric service of a multidisciplinary hospital reflects the need for the activity of the psychosomatic link in the context of the COVID-19 pandemic. © AUTHORS, 2023.

Neurocognitive Syndrome in COVID-19. Clinical Cases

More and more data indicate that SARS-CoV-2 infection causes neurocognitive deficits in a significant proportion of patients. The structure, mechanisms, and course of these disorders are currently unknown. The aim was to study phenomenological characteristics of cognitive impairment in patients with COVID-19. Patients and methods: a total of 2500 hospitalized patients with COVID-19 were examined by a psychiatrist. Clinical examination revealed cognitive decline of various origins in 540 (21.6%) patients, including disorders due to previous cerebrovascular accidents. Patients and their relatives didn’t observed cognitive impairments in patients before COVID-19 infection in 51 (2.4%) cases. These symptoms appeared only against the background of coronavirus infection. These patients were examined clinically and using MMSE in connection with complaints of “decreased memory”, “fog in the head”, “attention deficit”. In 37 (1.48%) patients, a decrease in MMSE score was not found, despite a clinically detectable slowing of mental activity, worsening of active attention, and signs of exhaustion. Decreased scores of the MMSE were found in 14 (0.56%) patients, among them 5 men and 9 women aged 62.57 ± 14.69 years, 95% confidence interval 54.08–71.05. These patients were included in the analysis. Results: the severity of cognitive impairment in patients with coronavirus infection varied over a wide range, and there was no parallelism between the severity of cognitive deficit and the severity of COVID-19. On the MMSE scale, at the first examination, an indicator corresponding to the gradation of the scale “mild dementia” was detected in 3, “moderate” — in 9, and “severe dementia” — in 2 patients. The structure of the neurocognitive syndrome was dominated by speech and attention disorders. All patients with cognitive impairment were characterized by the presence of concomitant somatic diseases. Conclusion: it is possible to identify the neurocognitive syndrome associated with COVID-19 when the following conditions are met: 1) occurrence against the background of coronavirus infection, 2) the absence of neurocognitive disorders before the viral infection, 3) the absence of symptoms of confusion, 4) the absence of parallelism between the severity of the physical state and the MMSE score. © 2022

Prevalence, Structure, and Risk Factors for Mental Disorders in Older People

This review focuses on assessing the prevalence and risk factors of mental disorders in older people in the modern era, including the COVID-19 pandemic. A systematic review of the literature was conducted in PubMed, Elsevier, and Google using keywords over the past 10 years. Substantial discrepancy of data on the prevalence of psychiatric disorders has been shown in the elderly population. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of nonpsychotic depressive and anxiety disorders is demonstrated for the elderly, along with the difficulty of diagnosing mental disorders associated with physical pathology and cognitive impairments. The risk factors for mental disorders in older adults are socio-demographic but also economic, psychological, and physical. The problem of mental health of the elderly is characterized for the conditions of the COVID-19 pandemic associated with specific risk factors for psychiatric disorders. The shortage of evidence-based research in the treatment of mental disorders in the elderly and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow optimizing the functioning of healthcare systems.

Impact of mental disorders on COVID-19 outcomes

Objective: to analyze clinical and follow-up indicators in patients with mental disorders and COVID-19 and to identify on their basis predictors of poor outcomes associated with mental state. Patients and methods. We conducted a prospective study in a multidisciplinary hospital. The severity of coronavirus infection was determined according to the temporary guidelines. Data collection was carried out using a patient chart consisting of 109 variables. Predictors of poor outcomes were determined using predictive models (logit regression, Cox model). The study included 97 patients: 41 men (42.3%) and 56 (57.7%) women, mean age - 62.3±15.3 years. 26 patients died;71 patients recovered. Results and discussion. The death occurred on 11.5 day. The mental state of these patients was severe, with a predominance of delirium cases. With increasing age, the probability of non-lethal outcome decreases [hazard ratio (HR) 1.03;95% confidence interval (CI) 1.00-1.06;p=0.037]. The risk of death increased by 1.03 (p=0.037) for each year of life. An improvement in the mental state of patients during psychotropic therapy is associated with an 11.11-fold decrease in the risk of poor outcome of coronavirus infection (HR 0.09;95% CI 0.01-0.76;p=0.027). Delirium is a predictor of low patient survival, especially in prolonged hospitalizations (HR 4.55;95% CI 1.66-12.48;p=0.003). The severity of coronavirus infection makes the greatest contribution to the poor outcome: the risk of death increases by 33.17 times (CR 33.17;95% CI 4.01-274.65;p<0.001). The severity of the mental disorder had a greater impact on the risk of death compared with age, increasing it by 4.55 times (p=0.003). Conclusion. We found significant differences between the groups of deceased and surviving patients with COVID-19 concerning the variables related to certain mental disorders, their severity and dynamics, and the severity of coronavirus infection. In addition, the age of the patients had a significant impact on the prognosis of COVID-19. The results reflect the special prognostic significance of delirium in the structure of mental disorders developing in patients with coronavirus infection.

[Prevalence, structure, and risk factors for mental disorders in older adults.]

This review focuses on assessing the prevalence and risk factors of mental disorders in older adults in the current era, including the COVID-19 pandemic. A systematic review of the literature in PubMed, Elsevier, Google, using keywords over the past 10 years was conducted. It is shown that data on the prevalence of psychiatric disorders in the elderly population, including in comparison with young adults, diverge significantly. The significant incidence of mental disorders among nursing home residents is highlighted. The relevance of non-psychotic disorders of the depressive and anxiety spectrum in older adults is demonstrated. The difficulty of diagnosing mental disorders associated with somatic pathology as well as cognitive disorders in elderly patients is demonstrated. Risk factors for mental disorders in older adults are socio-demographic as well as economic, psychological and somatic factors. The problem of mental health of the elderly under the COVID-19 pandemic associated with specific risk factors for mental disorders is characterized. The shortage of evidence-based research in the treatment of mental disorders in old age and the urgency to improve the organization of psychiatric care for such patients are noted. Understanding the structure and prevalence of mental disorders among the elderly will allow to optimize the work of the healthcare system.