Impact of COVID-19 on mental health and psychosocial support services in the Eastern Mediterranean Region - results of a rapid assessment.

Background: Mental health has been identified by the World Health Organization as an integral component of the COVID-19 response. Aims: This study aimed to estimate the impact of COVID-19 pandemic on mental, neurological and substance use disorders (MNS) services in the Eastern Mediterranean Region. Methods: The assessment was conducted through a web-based survey that was completed by national mental health focal persons and was analysed between June and August 2020. Results: School and workplace mental health services were wholly or partially disrupted in more than 70% of reporting countries. Fewer than 20% of the countries in the Region reported full operations of mental health services for children and adolescents or for older adults. The main reasons were travel restrictions, decreases in inpatient volumes due to the cancellation of elective care, decreases in outpatient volumes due to patients not presenting, and health authority directives for the closure of outpatient services. The majority (85%) of countries responded by establishing MNS helplines using telemedicine/teletherapy and digital psychological interventions. The fragile and conflict-affected states relied mostly on implementing infection prevention and control measures at MNS service facilities. Gaps were identified in the areas of addictive behaviours, substance use and neurology research related to the pandemic. Conclusion: The assessment highlights the need to strengthen capacities for monitoring changes in service delivery and utilization, and documents evidence on what works in different settings during the different phases of the pandemic to facilitate informed decisions related to the nature and timing of adaptations to service delivery.

Association between chronic psychoactive substances use and systemic inflammation: A systematic review and meta-analysis.

This systematic review and meta-analysis assess the change in inflammation biomarkers level among chronic psychoactive substance users. To meet the required inclusion criteria, all studies had to describe human participants with an age ≥18y., experiencing chronic psychostimulant (nicotine, amphetamine, cocaine), sedative (benzodiazepine, opioids) and/or cannabinoid use. The comparison group was defined as healthy participants. Studies where included if they reported at least one of the pro/inflammatory biomarkers. Study bias was examined by Funnel plots and heterogeneity by computing the I2 statistics. Only 21 eligible studies were selected based on 26,216 study participants. A small and significant effect size of 0.18 mg/l (95 % CI:0.10-0.27) was detected in favour of chronic smokers (z = 4.33;P < 0.0001). There was evidence of publication bias for studies measuring IL-6 and IL-10 association with cocaine and IL-6 in association with cannabis. In summary, except for chronic tobacco users, there was no evidence of association between other chronic substances abuse and inflammatory levels. More studies are needed to inform policy and decision makers about the utility of anti-inflammatory based targeted intervention programmes.

Depression among medical students in Alexandria, Egypt.

BACKGROUND: Depression is a common illness worldwide with high rate among medical students. The objectives were to estimate the prevalence of depression among medical students in Alexandria, and identify its correlates. METHODS: A cross-sectional study design was used. The study was conducted at the Faculty of Medicine, Alexandria University. Using a systematic random sampling technique, 390 students attending 4th, 5th, and 6th academic years were included. Data was collected using the Arabic version of the BDI-II and a predesigned structured self-administered questionnaire, including questions about the students' personal and social characteristics and academic environment. RESULTS: Moderate and severe depression accounted for 27.9% and 17.2%, respectively. Logistic regression analysis results showed that the independent predictors for moderate and severe depression were female gender, the presence of mental illness, not having someone to talk to when under stress, experiencing stressful life event(s) during the previous 6 months, not being satisfied with the socioeconomic level, reporting that the surrounding environment is not suitable for studying, not specifying a grade to achieve, and extreme dissatisfaction with the student's result. CONCLUSION: Prevalence of moderate and severe depression was high among medical students, calling for actions to help those students and to prevent new cases.