The cost of caring during recent epidemics: a rapid review of risk factors, psychological manifestations, and strategies for its treatment

BACKGROUND: During epidemics, health care workers (HCWs) are particularly exposed to the risk of secondary trauma. If not effectively addressed, the consequences of such psychological distress can progress to more severe conditions. METHODS: A systematic search of several databases on the effect of SARS, MERS, and COVID-19 epidemics on the mental health of HCWs was performed according to both the Cochrane Handbook for Systematic Reviews of Interventions and the WHO Rapid Review Guide for Health Policy and Systems Research. RESULTS: The 77 reviewed studies highlighted that work organization and individual characteristics can add to mental health risk. Providing adequate training to prevent infection and prepare HCWs to handle the epidemic, strengthening team work to improve organization, and ensuring appropriate protective equipment is available can help prevent risk of psychiatric illness. CONCLUSIONS: Monitoring and addressing through tailored interventions the mental health consequences of pandemics in HCWs is necessary

Anxiety, Depression, and Pain in Burning Mouth Syndrome: First Chicken or Egg?

BACKGROUND: Burning mouth syndrome (BMS) is an idiopathic and chronic pain condition for which patients may experience high levels of pain, anxiety, and depression. So far, it has not yet been well investigated whether specific psychiatric features (anxious traits, personality disorder, or somatization) may play a role in the BMS pathogenesis or whether some BMS symptoms, or BMS itself, may cause secondary psychiatric symptoms. OBJECTIVE: The aim of this study was to evaluate the relationship between pain, depression, and anxiety in BMS and healthy patients in order to hypothesize a possible underlying pathogenetic model. METHODS: Fifty-three patients with BMS and 51 healthy volunteers matched for sex and age were enrolled. All patients underwent a physical examination, laboratory screening tests, and psychiatric assessment with the following instruments: Visual Analog Scale, the Hamilton Rating Scale for Depression, the State-Trait Anxiety Inventory Form Y 1-2 (STAI Y1-Y2), and the Symptom Checklist-90-Revised (SCL-90-R). RESULTS: BMS patients and healthy volunteers showed a statistically significant difference in psychiatric features: Regression analysis showed that pain is affected by depression (R = 0.373; R(2) corrected = 0.123; F = 8.563; P < .005), and depression is affected by anxiety (R = 0.512; R(2) corrected = 0.248; F = 18.519; P < .001). BMS patients have statistically significant higher scores of anxiety (STAI Y1, P = .026 and STAI Y2, P = .046) and depression (P < .001), and higher SCL-90-R scores on somatization (P = .036) and hostility dimensions (P = .028) than the control group. CONCLUSIONS: We may hypothesize that anxiety could determine a secondary demoralization in BMS patients (depression) and depressive symptoms could contribute to pain, accordingly. Therefore, pain could be a somatic feature of depression. Our findings provide an example of a possible pathogenetic model for BMS

REFOCUS. Promuovere la recovery nei servizi di salute mentale di comunità. Edizione Italiana

Cos’ e’ Rethink Mental Illness Rethink Mental Illness, è il principale ente onlus inglese che si occupa di salute mentale, opera per consentire a chiunque sia affetto da una malattia mentale grave di recuperare la migliore qualità di vita possibile. Rethink Mental Illness tramite servizi efficaci e attività di supporto, da’ speranza e la possibili-tà di acquisire autonomia a tutti coloro che ne hanno necessità, inoltre si impegna attivamente per favorire il cambiamento nell’opinione pubblica promuovendo una maggiore consapevo-lezza e comprensione delle malattie mentali. Cos’ e’ REFOCUS REFOCUS è un progetto di ricerca quinquennale, finanziato dal National Institute of Health Research (Ref RP-PG-0707-10040), che mira a sostenere lo sviluppo di un approccio orien-tato alla recovery nelle equipes della salute mentale di comunità. Una parte del progetto REFOCUS è lo studio REFOCUS (ISRCTN02507940), che ha lo scopo di valutare l’efficacia dell’intervento REFOCUS nelle equipes della salute mentale di comunità. L’intervento previsto dallo studio ha una durata di 18 mesi ed e’ descritto in questo manuale (Capitolo 6)

Terapia cognitivo comportamentale per i sintomi psicotici. Manuale per i terapisti. Edizione italiana

Cognitive Behavioural Therapy for Psychotic Symptoms Preface A substantial body of evidence now documents the significant prevalence of psychotic disorders mental health problems in the Australian community. The recent “NationalSurvey of Mental Health and Wellbeing” reported that 4 to 7 people per 1000 of the Australian adult population have a psychotic disorder. This statistic translates to morethan 100,000 Australian adults and clearly indicates that that there are a significantnumber of people who are struggling with the severely debilitating symptoms andexperiences associated with psychosis. Unfortunately people with psychosis in oursociety also carry a significant burden of distress, disability and social dysfunction andthere is an identified lack of community based rehabilitation programmes that could help address these issues (Jablensky, et al 1999).The extent and complexity of mental health and psychosocial problems, places enormouspressure on treatment facilities to provide appropriate and effective interventions. Thistreatment protocol helps address this need. It was developed by the Centre for ClinicalInterventions (CCI), which provides specialist clinical treatments, training and clinicallyapplied research programs. CCI was established to provide a scientific environmentwithin which evidence supported clinical practice and the theoretical understanding ofpsychopathology are investigated, with the aim of decreasing patient distress andincreasing patient empowerment. The establishment of CCI has allowed clinical practice,training and research to be mutually interactive and balanced.This treatment protocol is the application of evidence based psychological practice toPsychotic Disorders. The manual has been written by clinicians for clinicians and presentsa clinical guide based on empirical foundations and clinical evaluation.The treatment protocol provides the therapist with a comprehensive, detailed and systematic approach to treatment delivery. The manual is divided into modules, whichdescribe the treatment components of this individual therapy. Importantly, the manualdoes more than describe the content of ‘what to do’, but also describes the process by which each treatment component is delivered. Details about evaluation procedures arealso included, as are activities and handouts for clients, self-monitoring diaries andmaterials to be used by the clinician.I would like to express our gratitude to the Office of Mental Health of the Department of health for their support of the quality improvement work carried out at CCI.I would especially like to express our respect and gratitude to the clients who have so courageously participated in our interventions and thus traveled with us along the path to scientific discovery.Whilst this manual provides a comprehensive guide to mental health practitioners, key competencies are required, and it is highly recommended that in order to apply the protocol most effectively appropriate training and supervision is undertake

Psicosi all’esordio: intervenire prima per migliorare gli esiti. Informazioni di base per i nuclei di cure primarie.

In salute mentale si considera di buona qualità un intervento che si realizzi il più precocemente possibile mantenendo quanto più solido possibile il legame tra la persona che presenta il disturbo e il suo contesto di vita e restituisca comprensibilità ai sintomi. Questo intervento, che punta alla ripresa, ad una buona qualità della vita, alla guarigione, è la strategia più efficace per prevenire la stigmatizzazione delle persone con disturbi psichiatrici. Per centrare questo importante bersaglio è necessaria una interazione positiva tra tutti gli attori sanitari e sociali, in particolare coloro che sono in prima linea a fianco di pazienti e familiari: i Medici di Medicina Generale e i Pediatri di Libera Scelta