Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them

Staging of Schizophrenia with the Use of PANSS: An International Multi-Center Study

Introduction: A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method.Methods: Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed.Results: Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients.Discussion: This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.<br /

THE PREVALENCE OF EMOTIONAL DISTRESS FACTORS ASSOCIATED WITH STRESS AMONG NURSES

The purpose of this study was to determine the incidence of emotional distress associated with stressors among nurses. 70 nurses were selected according to the department in which they work: Hematology, Pediatrics, Cardiology, Intensive Therapy and the Emergency section, ranging from 23 to 58 years, and the average age of 35.3 ani. For data collection, the following questionnaires were used: Stress Perception Scale and Affective Distraction Scale. The results obtained show significant differences between the different groups: Hematology, Pediatrics, Cardiology, Intensive Therapy and Emergencies regarding both the perception of stress and emotional distress. The study may be useful in setting preventive measures and finding ways to combat stress

FIRST EPISODE PSYCHOSIS AND TREATMENT DELAY – CAUSES AND CONSEQUENCES

Introduction: According to the clinical perspective, early diagnosis of the prodromal phase and early treatment provision in the first episode of psychosis (FEP) is able to prevent or reduce morbidity. The main aim of this study is to inventory and analyze the most important causes of treatment delay from the perspective of patients, families and healthcare providers. The secondary aim is to point out the most important consequences of treatment delay. Subjects and methods: The study was conducted on 28 patients hospitalized for FEP of a schizophrenia spectrum disorder in the Psychiatry Clinic of Timisoara and Day-care center 2009. The corresponding sample of relatives consisted of 25 relatives, and the sample of health care providers of 10 general practitioners and 11 psychiatrists. A semi-structured interview with open-ended questions was used. Results: Data analysis generated the following themes: society’s beliefs and attitude about mental illness; fear of stigma and labeling, insufficient information, lack of infrastructure from the perspective of the professionals, and modified threshold for treatment initiation. Conclusions: Efforts at the level of Communities as well as efforts at the level of psychiatry specialists could help individuals and their families to overcome the illness situation and improve their quality of life

Cardiovascular Abnormalities and Mental Health Difficulties Result in a Reduced Quality of Life in the Post-Acute COVID-19 Syndrome

(1) Background: Post-acute COVID-19 syndrome, characterized by persisting symptoms up to 12 weeks after the acute illness, impairs numerous people’s physical and mental health. (2) Methods: 64 inpatients and 79 outpatients, aged under 55 years, with post-acute COVID-19, were evaluated by a transthoracic echocardiography (TTE), mental health examination, Quality of Life (QoL) questionnaire, post-COVID-19 functional status scale (PCFS) and Hospital Anxiety and Depression Scale (HADS). (3) Results: all inpatients had mild/moderate pulmonary injury during acute COVID-19, in contrast to 37.97% of outpatients. Inpatients who reported an average of 5 persisting symptoms, had, predominantly, level 3 PCFS and a median QoL of 62, compared to outpatients, who reported an average of 3 symptoms, level 1 PCFS and a median QoL score of 70. Increased pulmonary artery pressure was detected in 28.11% of inpatients, compared to 17.72% of outpatients, while diastolic dysfunction was diagnosed in 28.12% of inpatients, in comparison with 20.25% of outpatients (p = 0.02). Abnormal systolic function was assessed in 9.37% of inpatients, and 7.58% of outpatients. According to the HADS depression subscale, 46.87% of inpatients and 27.84% of outpatients had clinical depression. Concomitantly, anxiety was detected in 34.37% of inpatients and 40.5% of outpatients (4) Conclusions: cardiovascular and mental health difficulties were frequently detected in patients with post-acute symptoms of COVID-19, which correlated with the number and intensity of persisting symptoms and reduced QoL scores

Well-Being, Depression, and Anxiety following Oncoplastic Breast Conserving Surgery versus Modified Radical Mastectomy Followed by Late Breast Reconstruction

Breast cancer requires complex clinical care. Well-being is an intricate concept, encompassing physical, functional, emotional, and social aspects. Background: This study aims to evaluate the relationship between the type of surgery our patients underwent and the timing of the reconstructive surgery with physical, emotional, social, and functional well-being. Furthermore, through our research we tried to identify potential mental health comorbidities in patients with breast cancer, clinical symptoms, and well-being in women with breast cancer, depending on the type of required surgery. Methods: The study included 69 women diagnosed with breast cancer, in stages I to III, divided in two groups: I—patients with oncoplastic breast-conserving surgery and contralateral correction surgery, for symmetry reasons; II—patients who underwent modified radical mastectomy and late breast reconstruction with contralateral symmetrisation. We evaluated socio-demographic aspects, alongside depression, anxiety, stress (DASS 21), and well-being (FACT-B). Data were statistically processed; statistical significance was set at p &lt; 0.05. Results: Clinical elements of depression, anxiety, and stress were noted in both groups, without statistical significance (p &gt; 0.05). Significant differences were found regarding psycho-emotional (p = 0.035) and functional well-being (p = 0.001), with higher scores for group I. The chi-square test indicated statistically significant differences (at p &lt; 0.01) between the groups, regarding the frequency of scores on items B4 and B9 (FACT-B items, related to feminine aesthetics and desirability), with evidently higher scores in group I than in group II. Conclusions: The state of well-being, as well as the items related to femininity and sexuality had higher values in the group of women treated by oncoplastic conservative surgery compared to late reconstruction after modified radical mastectomy

ATTRIBUTIONAL STYLE AND REACTION TO FRUSTRATION IN DELUSIONAL DISORDERS

REZUMAT Scopul: Stilul atribuţional şi reacţiile la frustrare joacă un rol important atât în depresie cât şi în paranoia. Aceste aspecte reprezintă elemente caracteristice cogniţiei sociale. Ultimele studii în acest sens (există studii doar pe stilul de atribuire) au demonstrat deficite semnificative ale stilului atribuţional, deficite ce se reflectă apoi în mecanismul de producere şi menţinere a simptomatologiei delirante precum şi în funcţionarea socială a deliranţilor. Obiectivul acestei lucrâri a fost de a studia stilul de atribuire şi reacţiile la frustrare în cadrul deliranţilor persistenţi cu şi fără depresie asociată, în scopul unei mai bune înţelegeri a cogniţei sociale a acestora. Instrumente şi metodă: Un grup de 40 de subiecţi, diagnosticaţi după ICD 10 cu tulburare delirantă şi având o perioadă de evoluţie de 8 ani au fost împărţiţi în doua loturi : a) cu depresie şi b) fără depresie. Toate cazurile fac parte din Proiectul Timişoara de Studiu al Tipologiei Psihozelor Endogene ce monitorizează psihozele funcţionale cu debut de după 1985. Pentru fiecare subiect au fost aplicate în perioada de remisie BPRS (Brief Psychiatric Rating Scale), ASQ (Attributional Style Questionnaire) şi Rosenzweig frustration test. Rezultate: Deliranţii depresivi fac atribuiri stabile pentru ambele tipuri de evenimente, însă pentru cele negative atribuirea este predominant externă, iar pentru evenimentele pozitive, atribuirea este internă. În cazul reacţiilor de frustrare aceştia reacţionează mai frecvent extrapunitiv şi de tipul persistenţei necesităţii. Deliranţii simpli pentru evenimentele de viaţă negative fac atribuiri externe şi particulare, iar pentru cele pozitive interne şi stabile. În cazul situaţiilor frustrante, aceştia dau frecvent răspunsuri fără pedeapsă şi de tipul persistenţei necesităţii. Concluzii: În ciuda coloraturii depresive, deliranţii depresivi fac atribuiri externe pentru evenimentele negative, iar, spre deosebire de cei fără coloratură depresivă, aceştia reacţionează extrapunitiv în situaţiile frustrante. Cuvinte cheie: atribuire, reacţie la frustrare, delir, depresie ABSTRACT Background: The attribution style and the reactions to frustration play an important role both in depression and paranoia. These aspects are characteristic elements of social cognition. The latest studies done in this area (there are studies only related to attribution) proved significant deficiencies to the attribution style, that later reflect in the mechanism of production and manifestation of delusional symptomatology and also in the social functionality of the delusional. The objective of this paper is to study the attribution style and the reactions to frustration in the persistent delusional patients with and without an associated depression, in order to better understand their social cognition. Material and methods: Forty patients diagnosed with ICD 10 delusional disorder with a period of evolution of 8 years, were grouped into 2 subgroups: a) patients with depression and b) patients without depression. They are all part of the Case Register of Timisoara Psychiatric Clinic (CRPTC), which monitors the functional psychoses since 1985. ASQ (Attribution Style Questionnaire) and Rosenzweig frustration test was applied for each patient in the period of remission BPRS (Brief Psychiatric Rating Scale). Results: Depressive delusional patients make stable attributions for both type of events, but for the negative ones, the attribution is prevalently external and for the positive events the attribution is internal. Common delusional patients make external and particular attributions for negative life events, while for the positive events the attributions are internal and stable. Concerning the response to frustrating situations, persistent delusional psychosis patients with depression give answers which are prevailing extra punitive, whereas those without depression give prevailing need-persistence answers. There are significant similarities between the two groups concerning the type of persisting necessity. Conclusions: Among the persistent delusional psychosis patients, those with depressive features demonstrate an aggression directed mostly towards the exterior in frustrating situations, while associating less the negative events to their own personality, compared to the pure persistent delusional patients