Psychological support during a pandemic: an intervention for hospital teams.

BACKGROUND: The COVID-19 pandemic placed unprecedented stress on healthcare professionals and resulted in teams being scattered by shielding, working from home and redeployment. The Recovery, Readjustment and Reintegration programme (R3P) was implemented and evaluated in an acute NHS hospital Trust with the aim of supporting those staff involved. AIMS: To explore the impact of offering themed reflective sessions to staff in an acute hospital and to disseminate this learning for application in other settings and future pandemics. METHODS: During the initial recovery phase of the pandemic, all Trust staff were invited to attend an R3P where themed discussions were facilitated by psychologists. Feedback was requested pre- and post-session, and a mixed-methods design was followed to gain quantitative and qualitative information. RESULTS: A total of 430 staff members attended an R3P between April 2021 and January 2022. A significant majority found attendance helpful and agreed that it had provided them with the opportunity to reflect on their own and their teams' experience of pandemic working and led them to feel more supported by their organization. CONCLUSIONS: Finding meaning in experiences through facilitated reflective discussion can help limit the negative psychological impact of working in an acute hospital during a pandemic. Staff are likely to benefit from such opportunities in any future pandemic recovery phase.

Repetitive transcranial magnetic stimulation reduces cortisol concentrations in bulimic disorders.

BACKGROUND: In people with bulimic eating disorders, exposure to high-calorie foods can result in increases in food craving, raised subjective stress and salivary cortisol concentrations. This cue-induced food craving can be reduced by repetitive transcranial magnetic stimulation (rTMS). We investigated whether rTMS has a similar effect on salivary cortisol concentrations, a measure of hypothalamic-pituitary-adrenal axis (HPAA) activity. METHOD: We enrolled twenty-two female participants who took part in a double-blind randomized sham-controlled trial on the effects of rTMS on food craving. Per group, eleven participants were randomized to the real or sham rTMS condition. The intervention consisted of one session of high-frequency rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC). Salivary cortisol concentrations were assessed at four time points throughout the 90-min trial. To investigate differences in post-rTMS concentrations between the real and sham rTMS groups, a random-effects model including the pre-rTMS cortisol concentrations as covariates was used. RESULTS: Salivary cortisol concentrations following real rTMS were significantly lower compared with those following sham rTMS. In this sample, there was also a trend for real rTMS to reduce food craving more than sham rTMS. CONCLUSIONS: These results suggest that rTMS applied to the left DLPFC alters HPAA activity in people with a bulimic disorder.

[Sociopsychiatric care as a municipal problem]. / Sozialpsychiatrische Leistungserbringung als kommunale Aufgabe.

Because of their disease mentally ill persons are often unable to request and receive necessary help on their own. Hence, local authorities have the legal duty to offer support in subsidiary or complementary ways or to organize help together with other participants concerned with psychiatric care. If the transition from community care to the differently structured regular health care system is too fast there is a danger of worsening of the symptoms. In the city of Bochum health insurance bodies agreed to take over the costs of therapy for mentally ill people via the sociopsychiatric services within the scope of crisis intervention. Background information on the sociopsychiatric services of the city of Bochum is given.