Mental Health and Quality of Life of Frontline Health Care Workers After One Year of Covid-19 Pandemic

Abstract Aim: This study aimed to investigate the impact of more than one year of COVID-19 pandemic on the quality of life and mental health (in terms of depression, anxiety, stress, fear, burnout – workload) among Frontline Health Care Workers (HCWs). Subjects and methods: This is a cross-sectional survey based on 1,479 frontline HCW participants aged 20-65 years in Turkey who completed a survey including the 21-item Depression, Anxiety, Stress Scale (DASS-21), Burnout, Fear of COVID-19 Scale (FCV-19S), and WHO (World Health Organization) Quality of Life instruments during March-July 2021. Bivariate, factorial and multivariate statistical analyses were performed. Results: Statistically significant differences were found between three frontline groups of HCWs (Physicians, Nurses, Others) including: age (p<0.001), gender (p<0.001), educational level (p<0.001), income (p<0.001), number of calls per week (p<0.001). There were significantly high scores of fear of COVID-19 for all items among physicians. The findings also showed that the prevalence of depression (p=0.002), anxiety (p<0.001), and stress (p<10.005) and Pittsburgh Sleep Quality Index (p=0.011) were significantly different among the three groups of frontline HCWs. The work-related burnout was over 30% in general. The Kaiser-Meyer-Olkin Measure was 0.840 and indicated that the data of the study were suitable for a factor analysis. The factor analysis found out three factors with eigenvalue greater than one. These factors were consistent with the original scale. The multiple linear regression analysis revealed anxiety (p<0.001), stress(p<0.001), fear of COVID-19 and Burnout (p=0.008), depression (p=0.004), lack of sleeping- Pittsburgh Sleep Quality Index (p=0.014) and feeling exhausted (p=0.025) were associated with the quality of life during the COVID-19 pandemic after adjusting for the age and gender. Conclusion: The findings of this study show that fear and burnout related to COVID-19 were significantly associated with high scores of depression, anxiety, stress, and burnout after one year of pandemic among frontline-HCWs, with poor quality of life and sleep

Psychological Therapies and Non-Suicidal Self Injury in LGBTIQ in Accident and Emergency Departments in the UK: A scoping review

This is an Accepted Manuscript of an article published by Taylor & Francis in International Review of Psychiatry on 25/08/2022, available online: https://doi.org/10.1080/09540261.2022.2108313Background: To identify psychological interventions that improve outcomes for those who overdose, especially amongst Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning populations. Objective: To recognise and assess the results from all studies including randomised control trials that have studied the efficiency of psychiatric and psychological assessment of people who have depression that undergo Non-Suicidal Self Injury (NSSI) by self-poisoning, presenting to UK A & E Departments Method: A scoping review of all studies including randomised controlled trials of psychiatric and psychological therapy treatments. Studies were selected according to types of engagement and intervention received. All studies including Randomised Controlled Trials (RCTs) available in databases since 1998 in the Willey version of the Cochrane controlled trials register in 1998 till 2021, Psych INFO, Medline, Google Scholar and from manually searching of journals were included. Studies which included information on repetition of NSSI behaviour were also included. Altogether this amounts to 3,900 randomised study participants with outcome data. Results: 7 trials reported repetition of NSSI as an outcome measure which were classified into 4 categories. Problem solving therapy (PST) is indicated as a promising therapy and has shown to significantly reduce repetition in participants who NSSI by overdosing than patients in the control treatment groups consisting of standard after care. Conclusion: The data shows that Manualised Cognitive Therapy (MACT) psychological intervention was more effective than TAU after care. However, these differences are not statistically significant with p = 0.15; CI 0.61, 1.0 which crosses the line of no effect. And Psychodynamic Interpersonal Therapy (PIT) is more effective than standard treatment. Despite being only one study in this subgroup the analysis shows a statistically Significance with p = 0.009, CI0.08; 0.

Affective Temperaments and Somatization Among Unipolar Depression Patients and Healthy Controls

Introduction Literature describes important comorbidity rates between somatization and mood disorders. Furthermore, there are data suggesting an association between affective temperament and somatization traits in healthy subjects. Objective In the present observational study, we investigated affective temperaments and somatization aspects in clinical and healthy samples. Aim The study focused on differences between unipolar depressive inpatients (DEP) and controls (C). Method We administered to 20 DEP and 20 C following questionnaires: Mini International Neuropsychiatric Interview (MINI), 17-item Self Rating Depression Scale (SDS), Hypomania check list 32(HCL-32), Self Rating Anxiety Scale (SAS), DCPR diagnostic criteria for psychosomatic research, Brief TEMPS-A, Modified Somatic Perception Questionnaire (MSPQ), Somatosensory Amplification Scale-SSAS. DEP and C were matched for age, sex and marital status. Result About temperaments, ANOVA showed that DEP were more cyclothymic (p Conclusion Our data suggest that DEP present an important affective temperamental dysregulation. Relative to somatization aspects, DEP show a greater vulnerability than C

CO-MORBIDITY BETWEEN MAJOR DEPRESSION AND SCHIZOPHRENIA: PREVALENCE AND CLINICAL CHARACTERISTICS

Backround: The aim of this study was to explore the co-morbidity between Major Depressive Disorder (MDD) and Schizophrenia (SZ) among a large number of patients describing their clinical characteristics and rate of prevalence. Subjects and methods: A cohort-study was carried out on 396 patients affected by MDD and SZ who consecutively attended the Department of Psychiatry, Rumeilah Hospital in Qatar. We employed the World Health Organization - Composite International Diagnostic Interview (WHO CIDI) and the Structured Clinical Interview for DSM-5 (SCID-5) for diagnoses. Patients were also grouped in MDD patients with and without co-morbid SZ (MDD vs MDD/SZ) for comparisons. Results: A total of 396 subjects were interviewed. MDD patients with comorbid SZ (146(36.8%)) were 42.69±14.33 years old whereas MDD without SZ patients (250 (63.2%)) aged 41.59±13.59. Statistically significant differences between MDD with SZ patients and MDD without SZ patients were: higher BMI (Body Mass Index) (p=0.025), lower family income (p=0.004), higher rate of cigarette smoking (p<0.001), and higher level of consanguinity (p=0.023). Also, statistically significant differences were found in General Health Score (p=0.017), Clinical Global Impression-BD Score (p=0.042), duration of illnesses (p=0.003), and Global Assessment of Functioning (p=0.012). Rates of anxiety dimensions (e.g.: general anxiety, agoraphobia, somatisation, etc.), mood dimensions (e.g.: major depression, mania, oppositional defiant behaviour, Bipolar disorder), Attention Deficit Hyperactivity Disorder, psychotic and personality dimensions were higher among MDD with SZ patients than MDD without SZ. Conclusion: This study confirms that MDD with SZ is a common comorbidity especially among patients reporting higher level of consanguinity. MDD/SZ comorbidity presents unfavourable clinical characteristics and higher levels of morbidity at rating scales

Screening of minor psychiatric disorders and burnout among a sample of medical students in St. Petersburg, Russia: a descriptive study

Abstract Background Despite the general interest of researchers around the world, there are few studies on the psychological wellbeing and burnout among medical students in Russia. The aim of this study was to perform screening for minor psychiatric disorders, burnout, problematic alcohol use, and quantify the psychological issues and stress among a sample of medical students in St. Petersburg, Russia. Results According to the GHQ-12, screening for minor mental disorders was positive in 140 students (85%). Screening for burnout using the OLBI showed positive results in 121 (73%) students for disengagement and 132 (80%) students for exhaustion. Screening with the CAGE tool identified a risk of alcohol consumption in 33 students (20%). Most students reported academic studies as the main source of stress in their life (n = 147; 89.1%). Conclusions This study identified very high levels of stress, burnout, risk of minor mental disorders, and problematic alcohol use among medical students in St. Petersburg, Russia. These findings suggest more attention is needed to the poor mental wellbeing and health in medical students in Russia

Migrant Women-experiences from the Mediterranean Region

Introduction: The phenomenon of migration is characterized and influenced by a number of different variables; and the different stages of journey are related to different levels and types of psychological distress. Women, in particular, are exposed to further specific risks during migration.Aim: To determine the factors that affect the psychological health of migrant women during the different stages of the migration journey.Methods: We provide a narrative review of the literature around the experiences of women during migration process, with a geographical focus on women migrating to the Mediterranean area.Results: Little data is currently available on the burden of mental health disorders for female migrants. Most studies about the mental health status of migrants were not gender-disaggregated or focused specifically on migrant women's experiences of violence. Sexual and Gender-Based Violence (SGBV) was found to be a common risk factor faced by all the women who leave their native country to migrate to other countries.Conclusion: Despite the importance of the issue and the gender-specific variables related to the experience of migrant women, few studies have looked specifically at psychological variables and mental health status in the female migrant population. It is crucial that future studies are conducted around female migration, violence towards women, and women's mental health, in order to provide an evidence-base for promoting adequate policies and prevention/treatment programs for women

"Otherness", otherism, discrimination, and health inequalities: entrenched challenges for modern psychiatric disciplines

Identity is a complex concept that can be informed by various factors, involving biological, psychological, experiential, and social influences. Specifically, one’s social identity refers to the ways in which individuals can adopt attributes from established collective categories, like cultural identities, ethnic identities, gender identities, and class identities, amongst others. Social identity can encompass unique and diverse interactions at an individual level, known as micro-identities, that may be selectively expressed, hidden, or downplayed, contingent on distinct sociocultural settings. However, the formation of social identity is recurrently defined in opposition to perceptions of the Other, which can entail adverse paradigms of marginalisation, stigma, and discrimination. Although this theory of Otherness has been developed across different fields, particularly sociology, it may be important in psychiatric contexts as it can engender inherent risk factors and mental health inequalities. Consequently, this paper seeks to bring attention towards these issues, exploring the construction of Otherness and its detrimental outcomes for psychiatry, such as systemic discrimination and disparities in therapeutic support, alongside recommended initiatives to mitigate against the effects of Otherness. This may require multifactorial approaches that include cultural competency training, interventions informed by micro-identities and intersectionality, patient advocacy, and structural changes to mental health policy

Early age of onset of drug use in Paraguayan children and adolescents: a public health challenge: Edad temprana de inicio de uso de drogas en niños y adolescentes paraguayos: un desafío de salud pública

La edad de inicio del consumo de drogas legales e ilegales es una variable crucial en el campo de la salud mental. Permite a clínicos y a investigadores de todo el mundo intentar predecir el riesgo vital de trastornos por uso de sustancias, enfermedad mental y adaptación social, y a diseñar estrategias de prevención e intervenciones precoces para hacer frente a estas entidades. El uso de drogas legales o ilegales durante la infancia y la adolescencia ha sido asociado a un vasto rango de malos resultados por distintos autores. El efecto del uso de sustancias al parecer incluye no sólo resultados relacionados con la salud, sino que posee también implicancias sociales negativas a largo plazo que afectan el sustento de los individuos. El inicio temprano del uso de drogas legales e ilegales es una epidemia social en Paraguay (Sudamérica). En este breve artículo, nuestro objetivo es presentar los pocos estudios realizados en el país que muestran una edad extremadamente temprana de inicio del consumo de drogas y proporcionar algunos argumentos sobre por qué estos datos deberían ser motivo de preocupación para los responsables de la formulación de políticas en el país. Palabras clave: Edad de inicio; Uso de drogas; Niños; Adolescentes. ABSTRACT The age of onset of legal and illegal drugs use is a crucial variable in the mental health field. It enables clinicians and researchers across the world to try to predict the lifetime risk of substance use disorders, mental illness and social adaptation, and to tailor prevention strategies and early interventions to address these entities. The use of legal or illegal drugs during childhood and adolescence has been linked to a vast range of bad outcomes by different authors. The effect of substance use seems to include not only health-related issues, but it also has long-term negative social implications that affect the livelihood of the individuals. Early initiation of legal and illegal drug use is a social epidemic in Paraguay (South America). In this brief piece, we aim to present the few studies done in the country showing an extremely early age of onset of drug use and to provide some arguments for why this data should be of concern for policy makers in the country. Keywords: Age of onset; Drug use; Children; Adolescents

Diagnostic Stability of Major Depressive Disorder in hospitalized patients in a University Hospital: a Brief Report

Introduction: There may be a discordance between diagnoses at admission and discharge of mentally ill patients with major issues regarding their diagnostic stability. The objective of this brief report was to determine the diagnostic stability of major depressive disorder at patients’ discharge and if the diagnosis of their hospital admission had been retained. Methodology: This was a pilot, descriptive, cross-sectional, and retrospective observational study. A non-probabilistic sampling of consecutive cases was used.&nbsp; We reviewed the medical records, at admission and discharge, of patients with an initial diagnosis of major depressive disorder, hospitalized in the Department of Psychiatry of the ‘Hospital de Clínicas’ of the National University of Asunción, Paraguay, during the months of October to December 2020. Results: Fifty-three patients with a diagnosis of major depression on their hospital admission were included in the study (mean age = 35.7 ± 16.5 years). 79.2 % were women, 52.8 % were single, and 37.7 % were from the Central province of Paraguay. The most frequent diagnosis at discharge was borderline personality disorder, in 35.8% of cases. Major depressive disorder was confirmed in 15.1% of cases. No significant relationship was found between any discharge diagnosis and sociodemographic data. Conclusion: The results of this study, although preliminary, described the trajectories of diagnoses in the Psychiatry Department of a University hospital, but confirmatory studies are needed