Educational Initiative about the COVID-19 Pandemic-Related Neuropsychiatry for Early Career Professionals in EU: The Impact of the Novel Virus on Brain, Mind, and Society.

BACKGROUND: The COVID-19 pandemic brought challenges to governments, healthcare systems (including, mental healthcare services), clinicians and researchers in the EU and worldwide. A range of neurological (e.g., brain fog, encephalitis, myalgia) and psychiatric (e.g., affective disorders, delirium, cognitive disturbances) complications of a novel nature have been observed in patients during the acute phase of illness, which often persist as a Long-COVID state for months after the primary recovery. The pandemic has progressed to a psychodemic and syndemic, affecting communities with social distress, panic, fears, increased home violence, and protest movements that derive from conspiracy theories and hostile attitudes towards vaccination and lockdown measures. In response to this complex scenario of major social changes, universities must face the need to equip the new generation of doctors with novel special skills. SUBJECTS AND METHODS: The study course (50 hours duration; 20 lectures, three webinars, three e-discussion forums, five local seminars, two social events, three intermediate assessments and a final test for certification; bilingual Russian/English hybrid format, information materials, video-content, interactive web-page and social media) was developed by the team of the International Centre for Education and Research in Neuropsychiatry (ICERN), and is unique for the EU. The course integrates the most relevant data on SARS-Cov-2-related neuropsychiatry, and COVID-19' pandemic impact on mental health and society, including assignment of the vulnerable groups of students and healthcare professionals. The major topics covered during the course are (i) Novel virus, (ii) Brain, (iii) Society. The project takes place originally in Samara State Medical University. The ICERN Faculty includes academic staff from France, Hungary, Italy, Russia, Switzerland, invited speakers from the WHO Regional Office for Europe and World Psychiatric Association (EU Zones) members, some of them employed at ICERN by remote work contracts. The format of the educational process for students is hybrid suggesting both remote and face-to-face events. Distant learning participants and EU lecturers are to attend on-line via zoom platform, whereas local participants and staff work face-to-face in the ICERN video-conference room. The course is addressed to a broad audience of doctors, undergraduate and postgraduate students, and researchers from EU wishing to upgrade their knowledge in the pandemic-associated neuropsychiatry. RESULTS: The evaluation process supposes three intermediate assessments and a final test for certification. On-line assessment is to be performed at the project web-page - 10 randomly selected questions with scoring from 1 to 10 each. The Pass Score is 70-100. At the end of the course all the participants receive certificates of Samara State Medical University according to the ERASMUS policy book, as planned in 2021. CONCLUSIONS: We formatted this course as essential for the target audience to improve their resources of professional adaptability in the field of neuropsychiatry and mental healthcare management during challenging times. The ICERN course in pandemic-related neuropsychiatry is essential for early career health professionals and targets the principles of "academia without borders" in the context of international medical knowledge exchange. In the conditions of the changing social situation this educational content is necessary for the young doctors to acquire the add-on skills on flexibility to switch toward new professional approaches in the times of need. The long-term outcomes in pandemic-related neuropsychiatry are still to be seen, though the first feedback on the course content is already promising for the academic community.

Virtual Reality-Based Interventions for Treating Depression in the Context of COVID-19 Pandemic: Inducing the Proficit in Positive Emotions as a Key Concept of Recovery and a Path Back to Normality.

BACKGROUND: During the COVID-19 pandemic as much as 40% of the global population reported deterioration in depressive mood, whereas 26% experienced increased need for emotional support. At the same time, the availability of on-site psychiatric care declined drastically because of the COVID-19 preventive social restriction measures. To address this shortfall, telepsychiatry assumes a greater role in mental health care services. Among various on-line treatment modalities, immersive virtual reality (VR) environments provide an important resource for adjusting the emotional state in people living with depression. Therefore, we reviewed the literature on VR-based interventions for depression treatment during the COVID-19 pandemic. SUBJECTS AND METHODS: We searched the PubMed and Scopus databases, as well as the Internet, for full-length articles published during the period of 2020-2022 citing a set of following key words: "virtual reality", "depression", "COVID-19", as well as their terminological synonyms and word combinations. The inclusion criteria were: 1) the primary or secondary study objectives included the treatment of depressive states or symptoms; 2) the immersive VR intervention used a head-mounted display (HMD); 3) the article presented clinical study results and/or case reports 4) the study was urged by or took place during the COVID-19-associated lockdown period. RESULTS: Overall, 904 records were retrieved using the search strategy. Remarkably, only three studies and one case report satisfied all the inclusion criteria elaborated for the review. These studies included 155 participants: representatives of healthy population (n=40), a case report of a patient with major depressive disorder (n=1), patients with cognitive impairments (n=25), and COVID-19 patients who had survived from ICU treatment (n=89). The described interventions used immersive VR scenarios, in combination with other treatment techniques, and targeted depression. The most robust effect, which the VR-based approach had demonstrated, was an immediate post-intervention improvement in mood and the reduction of depressive symptoms in healthy population. However, studies showed no significant findings in relation to both short-term effectiveness in treatment of depression and primary prevention of depressive symptoms. Also, safety issues were identified, such as: three participants developed mild adverse events (e.g., headache, "giddiness", and VR misuse behavior), and three cases of discomfort related to wearing a VR device were registered. CONCLUSIONS: There has been a lack of appropriately designed clinical trials of the VR-based interventions for depression since the onset of the COVID-19 pandemic. Moreover, all these studies had substantial limitations due to the imprecise study design, small sample size, and minor safety issues, that did not allow us making meaningful judgments and conclude regarding the efficacy of VR in the treatment of depression, taking into account those investigations we have retrieved upon the inclusion criteria of our particularistic review design. This may call for randomized, prospective studies of the short-term and long-lasting effect of VR modalities in managing negative affectivity (sadness, anxiety, anhedonia, self-guilt, ignorance) and inducing positive affectivity (feeling of happiness, joy, motivation, self-confidence, viability) in patients suffering from clinical depression.