Scaling Up Global Mental Health Services During the COVID-19 Pandemic and Beyond.

Every health care system requires an adequate health care workforce, service delivery, financial support, and information technology. During the COVID-19 pandemic, global health systems were ill prepared to address the rising prevalence of mental health problems, especially in low- and middle-income countries (LMICs), thereby increasing treatment gaps. To close these gaps globally, task shifting and telepsychiatry should be made available and maximized, particularly in LMICs. Task shifting to nonspecialist health workers to improve essential mental health coverage and encourage efficient use of the available resources and technology has become the most viable strategy.

Psychosocial predictors of mental health among pregnant women.

PURPOSE: The vulnerability and prevalence of common psychiatric illnesses, that is, anxiety and depression are very high at the time of pregnancy in the socio-cultural context of Southeast Asian low- middle-income countries' pregnant women. However, the issue remains poorly understood despite the fact that pregnancy can be stressful for women, their families and is strongly connected with marital quality and perceived social support. The present study examines the impact of anxiety proneness, marital satisfaction, and perceived social support on fear of childbirth and development of depression among pregnant women. DESIGN AND METHODS: Participants were purposively selected 136 pregnant women who were in the third trimester with ages ranging between 19 and 35 years and were selected through a purposive sampling technique from six hospitals in Pakistan. The STICSA, RAS, MSPSS, CAQ, and PADQ scales and questionnaires were used as study tools. FINDINGS: Anxiety proneness positively predicted childbirth fear and depression; marital satisfaction and perceived presence of social support were negative predictors among pregnant women. PRACTICE IMPLICATIONS: Obstetricians, nurses, midwives, and mental health professionals can imply these findings towards developing targeted antenatal programs that focus on the pregnant woman's mental health.

Suicidality and Self-Harming Behaviors in Patients with Prader-Willi Syndrome (PWS): Case Report and Literature Review.

Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder which is often associated with significant behavioral challenges and poor intellectual functioning. Research has shown that individuals with PWS are more likely to experience mental health problems, have higher relapse rates, and are at risk of self-harming behavior. Although PWS is associated with mild intellectual disability, which in itself confers a higher mortality rate, suicidality in this population is so far unreported in the literature. We present the case of an 18-year-old male patient who was admitted to our facility following exogenous insulin administration with suicidal intent. The main clinical characteristics, self-harming behaviors, and suicide risk factors of patients with PWS are discussed in this report. The article's objective is to redirect clinicians' attention to carefully screen and treat the underlying behavioral problems in PWS patients.

Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations.

BACKGROUND: With the uncertainties of COVID-19, people infected with coronavirus present with diverse psychiatric presentations. Some institutions have had to manage their patients with existing protocols, others have had to create them. In this article we aimed to report the challenges and good practices in the management of psychiatric conditions and delirium coexisting with COVID-19 across continents. METHODS: Early Career Psychiatrists (ECPs) from across five continents were approached to share their experiences on the management of psychiatric conditions in patients with COVID-19 during the current pandemic. RESULTS: We collected information about the experiences from sixteen countries. Commonalities were similar psychiatric presentations and poor preparedness across countries. Differences were varying adjustments made in the management of psychiatric conditions coexisting with COVID-19 and different innovations. Good practices which can be adopted by other countries are novel approaches such as telepsychiatry, proactive consultation-liaison units and enhanced community services targeted at circumventing challenges faced when providing mental health services. CONCLUSIONS: These findings highlight the need for global preparedness in the mental health sector during outbreaks of infectious diseases, and the need for concerted efforts targeted at global and locally sensitive adaptation of existing protocols and the development of new guidelines for the management of psychiatric conditions for the present pandemic and subsequent occurrences.

Enterococcus faecalis Septicemia and Vertebral Osteomyelitis after Transrectal Ultrasound Guided Biopsy of the Prostate.

Transrectal ultrasound guided prostate biopsy (TRUS) has rarely been associated with disseminated infection, yet the occurrence appears to be increasing. Resistance to fluoroquinolones, the most commonly used prophylaxis, is one of the likely causes, with Escherichia coli being the most commonly reported cause of these infections. Herein we present what is, to our knowledge, the first case of Enterococcus faecalis septicemia and vertebral osteomyelitis after TRUS. Previously reported cases of this condition are referenced also.