PREVALENCE OF ANXIETY SYMPTOMS AMONG HEALTH CARE WORKERS IN COLOMBIA DURING THE COVID-19 PANDEMIC.

OBJECTIVE: This study aimed to determine the prevalence of anxiety symptoms in a Colombian HCW sample during the COVID-19 pandemic. METHODS: A cross-sectional study was carried out by means of an online survey (May-June 2020). Respondents were HCWs in Colombia reached by a nonprobability sample. Zung's self-rating anxiety scale allowed the estimation of prevalence and classification of anxiety symptoms. RESULTS: A total of 568 HCWs answered the questionnaire, 66.0% were women, the mean age was 38.6±11.4 years. 28.9% presented with anxiety symptoms, of whom 9.2% were moderate-severe. Characteristics such as living with relatives at higher risk of mortality from COVID-19 infection (OR:1.90; 95% CI: 1.308-2.762), female sex (OR:2.16; 95% CI: 1.422-3.277), and personal history of psychiatric illness (OR:3.41; 95% CI: 2.08-5.57) were associated with higher levels of anxiety. Access to sufficient personal protective equipment (OR:0.45; 95% CI: 0.318-0.903) and age >40 years (OR:0.53; 95% CI: 0.358-0.789) were associated with lower anxiety levels. CONCLUSIONS: Anxious symptoms are common in the population of HCWs faced with patient care during the COVID-19 pandemic. Different strategies are required to intervene with subgroups at risk of developing higher levels of anxiety during the pandemic.[[[es]]]ResumenObjetivo: Determinar la prevalencia de síntomas de ansiedad en una muestra de personal de salud (PDS) colombianos durante la pandemia por COVID-19-.Métodos: Se llevó a cabo un estudio de corte transversal, mediante una encuesta en línea (mayo a junio 2020). Los encuestados fueron PDS en Colombia reclutados mediante una muestra no probabilística. La escala de autoevaluación de ansiedad de Zung permitió la estimación de la prevalencia y clasificación de los síntomas de ansiedad. RESULTS: Un total de 568 PDS respondieron el cuestionario, 66.0% fueron mujeres, la edad promedio fue 38.6±11.4 años. 28.9% presentaron síntomas de ansiedad, de los cuales 9.2% fueron moderados-severos. Características como vivir con familiares con mayor riesgo de mortalidad por infección por COVID-19 (OR:1.90; 95% IC: 1.308-2.762), sexo femenino (OR:2.16; 95% IC: 1.422-3.277), y la presencia de historia personal de patología psiquiátrica (OR:3.41; 95% IC: 2.08-5.57) se asociaron con mayores niveles de ansiedad. El acceso a elementos de protección personal suficientes (OR:0.45; 95% IC: 0.318-0.903) y las edades >40 años (OR:0.53; 95% IC: 0.358-0.789) se correlacionaron con menores niveles de ansiedad. CONCLUSIONES: Los síntomas ansiosos son comunes en la población de PDS enfrentados al cuidado de pacientes durante la pandemia por COVID-19. Diferentes estrategias se requieren para intervenir los subgrupos en riesgo de desarrollar mayores niveles de ansiedad durante la pandemia.

Cannabinoids for major neurocognitive disorder: case report and literature review.

INTRODUCTION: Major neurocognitive disorder (MNCD) affects millions of people worldwide. However, the pharmacological options for its management are limited, ineffective and frequently associated with severe adverse reactions. CASE REPORT: An 85-year-old man with history of multiple chronic brain injuries (alcohol-use disorder, haemorrhagic stroke, brain trauma, chronic use of benzodiazepines) developed an MNCD, reaching 7 points on the Reisberg Global Deterioration Scale. He had minimal response to antidepressants, antipsychotics and anticholinergic medications. After the use of mother tincture of Indian hemp (cannabis), a significant improvement was found in his cognitive function, ability to carry out activities of daily living and independence. DISCUSSION: The endocannabinoid system seems to be implicated in age-related cognitive decline. In addition, the evidence derived from in-vitro and animal models suggest that this system could play an important role in the management of MNCD of different causes. CONCLUSIONS: Cannabinoid treatment for MNCD emerges as a promising therapeutic approach that may benefit a growing number of patients who do not have other treatment options. It is therefore necessary to encourage more research efforts that will help to remove political and scientific barriers to its clinical use.

Cannabinoids for major neurocognitive disorder: case report and literature review / Uso de cannabinoides en trastorno neurocognitivo mayor: reporte de un caso y revisión de la literatura

ABSTRACT Introduction: Major neurocognitive disorder (MNCD) affects millions of people worldwide. However, the pharmacological options for its management are limited, ineffective and frequently associated with severe adverse reactions. Case report: An 85-year-old man with history of multiple chronic brain injuries (alcohol-use disorder, haemorrhagic stroke, brain trauma, chronic use of benzodiazepines) developed an MNCD, reaching 7 points on the Reisberg Global Deterioration Scale. He had minimal response to antidepressants, antipsychotics and anticholinergic medications. After the use of mother tincture of Indian hemp (cannabis), a significant improvement was found in his cognitive function, ability to carry out activities of daily living and independence. Discussion: The endocannabinoid system seems to be implicated in age-related cognitive decline. In addition, the evidence derived from in-vitro and animal models suggest that this system could play an important role in the management of MNCD of different causes. Conclusions: Cannabinoid treatment for MNCD emerges as a promising therapeutic approach that may benefit a growing number of patients who do not have other treatment options. It is therefore necessary to encourage more research efforts that will help to remove political and scientific barriers to its clinical use.

RESUMEN Introducción: El trastorno neurocognitivo mayor (TNM) afecta a millones de personas a nivel mundial. Sin embargo, las opciones farmacológicas para su manejo son limitadas, poco efectivas y se asocian a importantes reacciones adversas. Caso clínico: Se presenta el caso clínico de un hombre de 85 años, con antecedente de múltiples lesiones cerebrales crónicas (abuso de alcohol, enfermedad cerebrovascular, traumatismo cerebral, uso crónico de benzodiacepinas), quien desarrolló un TNM clasificado con 7 puntos en la Reisberg Global Deterioration Scale. Tuvo poca respuesta al manejo con antidepresivos, antipsicóticos y anticolinérgicos. Tras el uso de tintura madre de cáüamo índico (cannabis), se evidenció una mejoría en la función cognitiva, la capacidad de cuidado para las actividades de la vida diaria y la independencia. Discusión: El sistema endocanabinoide parece estar relacionado con los procesos de deterioro cognitivo asociados con la edad. Además, la evidencia derivada de modelos in vitro y animales sugiere que podría tener un papel importante en el manejo del TNM de diferentes etiologías. Conclusiones: El uso de cannabinoides en el TNM se presenta como una pista terapéutica prometedora. Por lo tanto, es necesario promover procesos de investigación que contribuyan a eliminar las barreras políticas y científicas para su uso clínico, beneficiando a un número creciente de pacientes que no poseen opciones terapéuticas eficaces.