Healthcare professionals' perception and satisfaction with mental health tele-medicine during the COVID-19 outbreak: A real-world experience in telepsychiatry.

Background: The use of telemedicine is increasingly being implemented, showing numerous benefits over other methods. A good example of this is the use of telemedicine following the breakdown caused by the COVID-19 pandemic. Previous experiences with telemedicine (TM) have not been significantly explored in relation to the professionals' own perspectives. Objective: Identify and explore the perceptions and interests of mental health professionals who have performed TM during the period of pandemia. Methods: A questionnaire on mental health professionals' perceptions of and satisfaction of TM, the Font Roja Work Satisfaction Questionnaire, was adapted and used. Data collected included 112 Psychiatric Service professionals who conducted TM in March 2020, after the country had been under lockdown for 10 weeks. Over 12.000 medical consultations were carried out by the phone, showing an overwhelming response to this method. Results: High levels of satisfaction were recorded amongst professionals. TM would function as a complement to the traditional system of face-to-face visits (n-112, f-109, 96.5%). Only 9.7% (f-11) believed that digital or virtual interventions would completely replace face-to-face visits. 60.8% did not consider this monotonous work. The older the health workers were, the more satisfied they felt during their follow-up telephone consultation. The greater the previous experience, the more satisfaction was shown. There were gender differences: female mental health workers reported a greater level of comfort. Conclusion: TM can be implemented with less effort, but it requires time, methods, and resources to be managed. Satisfaction among professionals is high, especially among those with more clinical experience. Patient satisfaction must be contrasted against this.

Increased incidence of high-lethality suicide attempts after the declaration of the state of alarm due to the COVID-19 pandemic in Salamanca: A real-world observational study.

The coronavirus pandemic has led to people getting involved in harmful behaviors. In our observational study, we assessed 241 patients with suicidal thoughts or behaviors in the emergency room before, during, and after the lockdown, from January to July 2020. After the lockdown, retired patients made higher-lethality attempts, and consultations related to suicide were less frequent, but active suicidal behaviors were more frequent. Men tended to use more lethal methods, and women made more suicidal gestures and had more suicide-related consultations. We observed an increase in the lethality of the attempts after the declaration of the state of alarm.

A real-world ten-week follow-up of the COVID outbreak in an outpatient drug clinic in Salamanca (Spain).

OBJECTIVE: To compare over ten weeks the number of relapses, hospital admissions, calls made, admissions to therapeutic communities, face-to-face visits, treatment adjustment, number of injectables administered, and number of emergencies attended due to emotional and behavioral alterations and/or substance use disorder, and to describe and quantify social emergencies in an outpatient drug clinic (ODC) in Salamanca (Spain) from March 16, 2020, to May 22, 2020. METHODS: This is an ecological study of the COVID pandemic over ten weeks. The study examines the set of alcohol or other drug-dependent or dual disorder patients in the population of Salamanca, Spain. The measurements were: professionals; calls made; percentage of successful calls; face-to-face visits; first visits made; reviews made; techniques; injectable treatments; other treatments; evolution; relapses. The ODC includes about 375 new patients each year and another 650 other patients annually. RESULTS: The study found the number of relapses to be greater in the last five weeks of the 10-week study period. Patients' psychopathological instability also increased, and face-to-face visits were necessary. The most frequent psychopathology that required face-to-face intervention was depressive disorder. The number of interventions with patients increased. In parallel, social workers' efforts were greater after the seventh week. There was a decrease in response to calls. Throughout this time, the ODC attended to patients who needed to be treated for the first time. CONCLUSIONS: Confinement due to the coronavirus pandemic generated maladaptive emotional responses and other behaviors, such as excessive alcohol consumption. The number of face-to-face consultations, admissions, and referrals to therapeutic communities increased. Patients under stress and in social isolation resorted more often to substance use. The ODC had to adopt a flexible approach to evaluate patients with more serious problems, by using face-to-face assessments.

The Relevance of Dual Diagnoses among Drug-Dependent Patients with Sleep Disorders.

BACKGROUND: Sleep disorders are often associated with drug use. Nearly 70% of patients admitted for detoxification report sleep problems. Dual disorder (DD) is the comorbidity between mental disorders in general and disorders related to psychoactive substance use. The association between substance use and sleep disorders (SD) appears to be bidirectional. Our objective is to analyze the association between sleep disturbance history and drug use pattern (alcohol, cannabis, opioids, and cocaine). METHODS: Analysis of data in the first interview at the Addictions Unit of the Department of Psychiatry at the University of Salamanca Health Care Complex between October 2017 and January 2020. The sample consists of 398 patients. We studied the association between different variables: origin of patients (Inpatient Dual Diagnosis Detoxification Unit (IDDDU) vs. Outpatient Drug Clinic (ODC), presence of affective disorder, psychotic disorder, type of drug used, and treatment. RESULTS: Of patients with DD, 62% had more delayed sleep induction, sleep fragmentation, early awakening, and nightmares. Outpatients had more difficulty falling asleep because, in many cases, they had not previously sought any medical assistance. On the other hand, 67% of the patients with insomnia presented depression. CONCLUSIONS: There is evidence of a harmful association between DD and SD.

Verbal memory and voxel based morphometry in first episode non-affective psychosis: A process oriented approach.

OBJECTIVE: The present study aimed to comprehensively study the specific neurocognitive constructs underlying verbal memory deficits and their neuroanatomical correlates in first episode psychosis (FEP) patients. METHOD: A total of 218 FEP patients and 145 healthy participants were examined with the Rey Auditory Verbal Learning Test (a widely used verbal memory measure that provides a range of performance indexes to evaluate memory) and voxel-based morphometry (a neuroimaging analysis technique that allows investigation of focal differences in brain anatomy). RESULTS: The analyses showed that the FEP group presented significantly lower scores on acquisition/learning, F(1, 566) = 40.7; p < .001, and delayed recall, F(1, 570) = 74.12; p < .001, as well as higher rates of forgetting, F(1, 566) = 20.03; p < .001. They also exhibited a significant sensitivity to retroactive, F(1, 554) = 8.74; p = .003, but not to proactive interference. Neuroimaging analyses found significant interactions between bilateral frontal lobe morphometry and proactive interference (ρFWE = 0.023). Rate of forgetting also significantly interacted with right occipital cortex morphometry (ρFWE = 0.033). Patients with higher rates of forgetting, proactive and retroactive interference demonstrated further gray matter reductions in frontal and occipital cortical areas. CONCLUSIONS: These findings emphasize the anterior orbitofrontal cortex as the brain region that contributes to verbal memory deficits in FEP patients, and suggest specific relationships between different neuroanatomical structures and discrete verbal memory processes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).