First Reactions and Attitudes of Psychiatric Workers in Budapest Psychiatric Care Units Regarding the COVID-19 Pandemic.

OBJECTIVE: To focus on the first feelings, attitudes, and planned reactions of psychiatric workers in Hungary to the news of the appearance of coronavirus disease 2019 (COVID-19) and to examine any differences between psychiatrists/psychologists and nurses/other professionals regarding these attitudes. METHODS: Hungarian psychiatric workers (N = 119) including psychiatrists/psychologists (n = 78) and nurses/other professionals (n = 41) participated in the study. To measure attitudes, a questionnaire was designed consisting of 7 questions and filled out within 1-3 days after the declaration of emergency in response to COVID-19 in Hungary on March 11, 2020. RESULTS: Psychiatric workers, especially psychiatrists/psychologists, regarded information gathering from valid sources as important. When examining the first feelings, we found that the psychiatrists/psychologists group tended to feel higher extent of anxiety, while the nurses/other professionals group showed higher extent of hope. When investigating willingness to work in the pandemic situation, a lower percentage of Hungarian psychiatric workers (58%) would choose to continue working compared to previous research. Answers to open-ended questions revealed that denial was the most frequent coping reaction. CONCLUSIONS: These differences could be attributed to the finding that psychiatrists/psychologists, who had faced the reality of the virus situation via the news, tended to have more realistic attitudes toward the virus, while nurses/other professionals, who had avoided valid information, tended to have less realistic attitudes.

[Telephone information service for psychiatric patients during the COVID-19 pandemic: Experience with a direct phone line in the Nyíro Gyula National Institute of Psychiatry and Addictions in Hungary]. / Beteginformációs telefonvonal a COVID-19-járvány idején: a Nyíro Gyula-OPAI-ban muködtetett közvetlen vonallal szerzett tapasztalataink.

The COVID-19 epidemic has had an extraordinary impact on mental health. In addition to the direct effect of the virus, we must take into account increasing disease anxiety due to the risk of infection, insecurity, confusing media activity, social isolation due to quarantine, socioeconomic impact, and the reduced capacity of the health-care system. In this paper, we present our experiences with the patient information telephone service operated by the psychotherapy department of the Nyíro Gyula National Institute of Psychiatry and Addiction (Nyíro-OPAI). Clinical psychologists and psychotherapists received the calls. The vast majority of the 264 phone calls registered during the two months of the pandemic (62%) were initiated by treated patients (availability of a doctor, questions related to the operation of the health-care system, prescribing medications). Still, we could also help patients and their families in potentially dangerous situations (21%): suicidal intentions, alcohol- and drug-related crises, severe neurocognitive disorders (dementias) with acute behavioural and psychological symptoms. In all cases, the telephone consultation led to the successful resolution of the crisis (low-threshold psychological intervention, counselling, assistance in admission to the institution). A relatively small number of calls (7%) were related to more complex psychotherapeutic needs. In summary, our experience shows that in extreme social situations, direct telephone assistance is suitable for supporting registered patients in the mental health system. This type of service also provides an opportunity to address acute crises and cases requiring more complex psychotherapeutic interventions.

Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders.

Previous studies that aimed to support emotion recognition deficits and alexithymia in B cluster personality disorders have mainly focused on borderline personality disorder (BPD), and resulted in mixed findings. In our study we examine emotion recognition and alexithymia in patients with histrionic (HPD), narcissistic (NPD) and borderline (BPD) personality disorders compared to each other and healthy controls. Furthermore, the possibility is investigated that it is not the type of PD but the severity of psychopathology which predicts the severity of emotion recognition deficits and alexithymia. Patients with HPD, NPD, BPD and healthy controls (N = 20 for each group) were examined by using the Ekman 60 Faces Test (FEEST) and the Toronto Alexithymia Scale (TAS-20). To measure the extent and severity of psychopathology, the Symptom-Checklist-90 Revised (SCL-90-R) was used. Patient groups performed significantly worse compared to healthy controls on the Ekman test and TAS-20, while we found no significant differences among patient groups in emotion recognition and alexithymia. Furthermore, higher scores on the SCL-90-R predicted poorer emotion recognition performance and higher alexithymic features. The empirical data supports the conclusion that the severity of psychopathology plays an important role in predicting emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders.

Automated Neuropsychological Test Battery in depression -- preliminary data.

AIMS: Studies have demonstrated neuropsychological deficits across a variety of cognitive domains in patients with major depressive disorder (MDD) during acute episode. However, limited data are available concerning whether these abnormalities persist in the remission phase. METHODS: In the present study CANTAB (Cambridge Automated Neuropsychological Test Battery) was used to evaluate the cognitive impairment associated with depression during acute episode and in remission. 25 patients with MDD during an acute episode and 11 patients also during remission were tested with CANTAB. RESULTS: During the acute episode, Delayed matching to sample, Paired associate learning, Spatial recognition memory, Rapid visual processing and Visuospatial planning were impaired. In remission the improvement of visual learning ability, spatial recognition memory, psychomotor speed, and executive function was observed. CONCLUSIONS: The results suggest that MDD is associated with neurocognitive dysfunctions in different domains, the most prominent deficit was found in the Paired associate learning test, which requires both the elaboration of "frontal strategies" and the "mnemonic processes". Cognitive impairment was found to improve partly in remission, suggesting that an individual's current mood interacts with the ability to perform a cognitive task. Besides these state markers, trait deficits are important because cognitive impairments which do not improve in remission might serve as endophenotypes of depression.