Findings from the ECHO Cohorts Regarding the Effects of the COVID-19 Pandemic

Background: Studies suggest perinatal infection with SARSCoV- 2 can induce adverse birth outcomes, but studies published to date have substantial limitations. Most have identified cases based upon their presentation for clinical care, and very few have examined pandemic-related stress which may also impact adverse birth outcomes. Objective(s): To evaluate the relationships between SARSCoV- 2 infection in pregnancy and pandemic-related stress with birth outcomes. Study Design: We conducted an observational study of 211 mother-newborn dyads in three urban cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program. Serology for SARS-CoV-2 was assessed in a convenience sample of prenatal maternal, cord serum or dried blood spots from births occurring between January 2020-September 2021. Specimens were assessed for IgG, IgM, and IgA antibodies to nucleocapsid, S1 spike, S2 spike, and receptor-binding domain. A Pandemic-related Traumatic Stress (PTS) scale was based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Acute Stress Disorder criteria. Result(s): 36% were positive for at least one antibody type, chiefly IgG. Self-report of infection was not significantly correlated with combined serology. There were no differences in gestational age (GA), birth weight, preterm birth (PTB), or low birth weight (LBW) among seropositive mothers. However, IgM seropositive mothers had children with lower BW (434g, 95% CI: 116- 752), BW Z score-for-GA (0.73 SD, 95% CI 0.10-1.36) and were more likely to deliver preterm (OR 8.75, 95% CI 1.22-62.4). Associations with LBW sustained in sensitivity analyses limited to pre-vaccine samples, and PTS symptoms were not associated with birth outcomes. The addition of PTS did not substantially change associations with BW, although associations with PTB attenuated to near-significance. Conclusion(s): We identified decreased birth weight and increased prematurity in mothers IgM seropositive to SARS-CoV-2, independent of PTS. Though there are limits to interpretation, the data support efforts to prevent SARS-CoV-2 infections in pregnancy.

Shakespeare as a vehicle for empathy and diagnostic skills training in undergraduate medical students in their psychiatry posting

Psychiatry undergraduate training has been significantly curtailed by the advent of the COVID-19 pandemic. This article examines the use of Shakespeare's Hamlet, especially via the characters of Hamlet and Ophelia, to impart two core skills in psychiatry, namely diagnostic abilities and empathy. Medical students undergoing the psychiatry posting watched Kenneth Branagh's Hamlet online, focusing on identifying psychopathology, forming diagnoses, identifying countertransferences, and developing empathy through acting out close passages. Students were able to identify the features of bipolar disorder in Hamlet, correlating his behavior with separate depressive and manic episodes. They were also able to appreciate the unique quality of dissociation in Ophelia, especially in Act 4 of Hamlet, and recognize it as a manifestation of post-traumatic stress disorder. Through acting out closed passages, students were also able to feel empathy by putting themselves into the shoes of Hamlet and Ophelia. Such a pedagogical approach has additional unexpected utility in view of the COVID-19 pandemic, which has significantly curtailed face-to-face medical education, leading to alternative online methods such as movies and Shakespearean plays in psychiatry education. In conclusion, though online methods cannot fully supplant face-to-face patient contact, they can be crucial tools in times of necessity and allow students to engage in interdisciplinary education, marrying the arts and the humanities.

Evusheld prophylaxis increases social interactions and improves anxiety, depression, agoraphobia and quality of life scores

Evusheld is a combination injection of tixagevimab/cilgavimab for pre-exposure COVID-19 prophylaxis and was made available to UK private clinics from October 2022. NICE review is ongoing. Whilst efficacy analysis of Evusheld has focused on the risk-reduction of contracting COVID-19, anecdotal reports suggest additional psychological benefits from Evusheld, although supportive objective data are lacking. In this study, we used 4 well-established psychological health questionnaires to assess different psychological parameters (EQ5D-3 L quality of life (QoL) score, DSM5 Agoraphobia score, Duke's Social Support Index (DSSI) and the hospital anxiety and depression score (HADS)) in blood cancer patients treated with Evusheld at the Genesis Care (GC) Clinic, Cambridge. Patient data (pre-and post-Evusheld) were compared with a control group of GC blood cancer patients who had not received Evusheld. The study was approved by GC and all patients had consented to email contact. Questionnaire replies were anonymised and free-text comments were invited. Questionnaires were completed by 29/40 Evusheld and 54/100 control patients. With EQ5D, Evusheld did not impact mobility, self-care and pain/discomfort scores and patient/ control groups scored at similar levels. EQ5D scores for 'usual activities' and 'anxiety/depression' improved post-Evusheld (patients reporting 'normal activities' increased from 52% to 76% (control = 78%);patients reporting 'no anxiety/ depression' increased from 45% to 66% (control = 65%)). The mean global EQ5D QoL score improved post-Evusheld [69.4% to 72.9% (control = 75.7%)]. With the DSM5 agoraphobia score, Evusheld treatment improved agoraphobia parameters, reducing the mean score from 15.7 to 5.1 (control = 3.7;max = 40) with certain striking changes;72% of pretreatment patients avoided crowded situations all of/most of the time, reducing to 14% post-Evusheld (control = 11%). The DSSI score assessed social/work interactions with external household contacts and post-Evusheld the mean number of interactions over 3 weeks increased from 1.48 to 3.37 (control = 3.77). Pre-Evusheld, 52% of patients had no interactions outside their household, dropping to 20% in the 3 weeks post-Evusheld (control = 17%). Using the HADS 14-point analysis of depression and anxiety revealed on average that each parameter was 25.3% 'significantly improved' and 25.4% 'a little improved' post-Evusheld. Accepting limitations of a small study and potential biases associated with a self-funding patient cohort, Evusheld treatment broadly improved all psychological scores assessed. Free-text comments clearly indicate that Evusheld had a major positive impact on QoL/social mobility for specific patients. The Evusheld patients had higher baseline scores for social isolation, anxiety, depression and agoraphobia compared with control patients, yet Evusheld treatment appeared to improve these parameters to a level similar to control patients.

Assessment of Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social interaction and communication and the presence of restricted interests and repetitive behaviors. The importance of early detection of ASD and subsequent early intervention is well documented. Efforts have been made over the years to clarify ASD diagnostic criteria and develop predictive, accurate screening tools and evidence-based, standardized diagnostic instruments to aid in the identification of ASD. In this article, we review the most recent changes in ASD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, summarize evidence-based instruments for ASD screening and diagnostic evaluations as well as the assessment of co-occurring conditions in ASD, the impact of COVID-19 on ASD assessment, and directions for future research in the field of ASD assessment.

Psychological Treatment of Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia Using an Integrative Approach.

Persistent genital arousal disorder/genitopelvic dysesthesia (PGAD/GPD) is characterized by persistent, unwanted physiological genital arousal (i.e., sensitivity, fullness, and/or swelling) in the absence of sexual excitement or desire which can persist for hours to days and causes significant impairment in psychosocial well-being (e.g., distress) and daily functioning. The etiology and course of PGAD/GPD is still relatively unknown and, unsurprisingly, there are not yet clear evidence-based treatment recommendations for those suffering from PGAD/GPD. We present the case of a 58-year-old woman with acquired persistent genital arousal disorder, which began in March 2020; she believed she developed PGAD/GPD due to a period of significant distress and anxiety related to the COVID-19 pandemic. After seeking medical diagnosis and treatment from multiple healthcare providers and trying a combination of pharmacological and medical treatment modalities, she presented for psychological treatment. An integrative therapy approach (3 assessment sessions, 11 treatment sessions), which included cognitive behavior therapy, distress tolerance and emotion regulation skills from dialectical behavior therapy, and mindfulness practice, was utilized. The patient reported improvements anecdotally (e.g., decreased impact on occupational and social functioning, greater self-compassion, less frequent and shorter duration of PGAD/GPD flare-ups, improved ability to cope with PGAD/GPD symptoms, and decreased need for sleeping medication) and on self-report measures (e.g., lower PGAD/GPD catastrophizing, lower anxiety and depression, and greater overall quality of life).We report the use of an integrative (i.e., psychoeducational, cognitive behavioral, dialectical behavioral, and mindfulness-based) intervention, which may be an effective psychological treatment for PGAD/GPD.

The Effects of Quarantine or Hospitalisation on Mental Health of Children and Parents with the COVID-19 Suspicion: A Case-Control Study

Background and Objectives: The aim of our study is to compare the children between the ages of 6 and 16 being in quarantine or hospitalised for at least 14 days with suspicion of COVID-19 and their parents and the children without suspicion of COVID-19 and their parents in terms of their mental exposure level. Method(s): A list of questions, investigating post-traumatic stress disorder (PTSD) symptoms in children and parents and prepared by arranging DSM-5 diagnostic criteria, The Revised Child Anxiety and Depression Scale - Parent Form, DSM-5 Level 2 Sleep Disorder Scale 6-17 Age Parents Form and Hospital Anxiety Depression Scale, were answered by parents. Result(s): The mean score of DSM-5 Level 2 Sleep Disorder Scale (respectively 16.72+/-8.31, 14.34+/-6.37) and the rate of confrontation of DSM-5 PTSD diagnostic criteria (respectively 8.5%, 2.9%) were statistically significantly higher in the study group of children compared to the control group (p<0.05). Mean score of the depression scale (respectively 8.37+/-3.70 and 6.97+/-3.63) and the rate of confrontation of DSM-5 PTSD diagnostic criteria (respectively 16.3%, 7.9%) were statistically notably higher in the parents of study group compared to the control group (p<0.05). In addition to this, a statistically important positive correlation was found between anxiety and depression levels of the parents and anxiety, depression and sleep scores of the children for all of them (p<0.05). Conclusion(s): Direct exposure to COVID-19 poses a higher risk for both children and their parents in the emergence of psychiatric symptoms than those without any direct exposure.Copyright © 2023, Medcom Limited. All rights reserved.

Tele-Psychiatry during COVID-19 at HMC Peshawar

OBJECTIVE: The main objectives of the current study were to find out the frequencies of Psychiatric disorders in the general population during COVID-19 and to compare the gender-based association between newly diagnosed patients during COVID-19 with already existing psychiatric patients in Peshawar to provide patient care on priority bases. METHODOLOGY: This Cross-sectional design study was carried out in the Department of Psychiatry and Behavioral Sciences, HMC/MTI, from May to August 2020. Those patients who approached psychiatry OPD through video/audio online calls and could understand and respond to suggestions were included. The bio-data was collected, and DSM-5 criteria were used for diagnosis. Descriptive statistics were used for statistical significance, and the statistical package of social sciences (SPSS-21) was used for analysis and results. RESULTS: The results findings of the current study revealed that 59.3% of the patients approached for telepsychiatry consultation were from the district of Peshawar. Among them, 54% were female, and most patients were young married females (50.7%) with no job outside the home. The finding further revealed that most of the sample affected by psychiatric illness were uneducated (31.3%) and unemployed (28%). Furthermore, in the present findings, 46% of patients were diagnosed with depression, and 12% had Dissociative disorders. CONCLUSION: It is concluded from the present study that in the Covid-19 Pandemic, primarily females who were married with no job description are more vulnerable to psychiatric illness. Furthermore, during Covid-19 mostly cases were reported with depression and dissociative disorders. © 2023, Liaquat University of Medical and Health Sciences.

Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents to Misophonia: A Case Example

Misophonia is a condition in which individuals suffer a wide range of intense emotions in response to sound triggers. Emotions such as anxiety, irritability, and disgust may lead individuals to engage in avoidance behaviors to escape or suppress sound triggers. Transdiagnostic treatment may serve as a practical intervention for misophonia as it addresses a broad scope of emotions and physiological sensations. This paper presents the first reported case example of misophonia treated with a transdiagnostic treatment protocol, the Unified Protocol for Emotional Disorders in Adolescents (UP-A). In this case, the UP-A was efficacious in treating a client with autism spectrum disorder, comorbid misophonia and anxiety symptoms. The client evidenced reliable change in misophonia and related problems. Future research should investigate the efficacy of the UP-A in a larger sample of youth with misophonia, as well as assess mechanisms of change in transdiagnostic treatment of this disorder in youth.Copyright © 2022 Society of Clinical Child & Adolescent Psychology.

Gaming behavior disorder and its association with social phobia during COVID-19 pandemic: A cross-sectional study among the young Arabs.

Background: Gaming addiction is a compulsive mental health condition that can have severe negative consequences on a person's life. As online gaming has increased during the COVID-19 pandemic, studies have shown a heightened risk of mental health issues. This study aims to assess the prevalence of severe phobia and addiction to online gaming among Arab adolescents and identify risk factors associated with these disorders. Methods: This cross-sectional study was conducted across 11 Arab nations. Participants were recruited using convenience sampling through an online survey distributed on social media platforms in 11 Arab countries. The survey included demographic questions, the Nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9) to measure participants' online gaming addiction, the Social Phobia Scale (SPS), and questions assessing the impact of the COVID-19 pandemic on the prevalence of internet gaming addiction. The data were analyzed using SPSS win statistical package version 26. Results: Out of 2,458 participants, 2,237 were included in the sample due to non-response and missing data. The average age of the participants was 19.9 ± 4.8 years, and the majority were Egyptian and unmarried. 69% of the participants reported playing more than usual since the COVID-19 pandemic, as they were confined to their homes. Higher social phobia scores were associated with being single, male, and Egyptian. Participants from Egypt and those who felt that the pandemic significantly increased their gaming time had higher scores for online gaming addiction. Several major criteria, such as playing hours per day and beginning gaming at an early age, were associated with a higher level of online gaming addiction with social phobia. Conclusion: The study's findings suggest that there is a high prevalence of internet gaming addiction among Arab adolescents and young adults who play online games. The results also indicate a significant association between social phobia and several sociodemographic factors, which may inform future interventions and treatments for individuals with gaming addiction and social phobia.

An approach for prevention planning based on the prevalence and comorbidity of neurodevelopmental disorders in 6-year-old children receiving primary care consultations on the island of Menorca.

BACKGROUND: Few studies have estimated the real prevalence of neurodevelopmental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) in Spain and worldwide. However, there are disparate prevalence figures. We consider research in this field essential to improve early detection, secondary prevention, and health planning. METHODS: The Minikid ADHD and TICS-Mini International Neuropsychiatric Interview for Children and Adolescents, the Autism Spectrum Quotient (Children's version, AQ- Child) and a protocol of general medical questions were administered for screening purposes. The PROLEXIA battery for children aged from 4 to 6 years was used for direct assessments. Parents provided information on emotional, medical, and school aspects. The final population evaluated using these tools consisted of 291 6-year-old subjects. RESULTS: The overall risk of presenting with a neurodevelopmental disorder was 55.4%. A 23.4% risk of presenting with attention-deficit/hyperactivity disorder (ADHD) in any modality (inattentive, hyperactive-impulsive and combined), a 2.8% risk of developing autism spectrum disorder (ASD), a 30.6% risk of presenting with a learning disorder with reading difficulties, a 5.5% risk of tics and a 22.5% risk of language problems (incomprehensible language or minor language problems) were detected in the sample. The most common combination of disorders was learning and language difficulties, accounting for 6.9% of the sample. The second most frequent combination was the presence of learning and language difficulties and ADHD, accounting for 4.5% of the sample. CONCLUSIONS: The prevalence of risks detected in our sample seems to be consistent with national and international studies. A significant proportion of our sample had never been previously diagnosed (85%), so early detection programs are recommended.

Interoceptive Abilities in Irritable Bowel Sydrome from Long Covid Disease

SCOPO DEL LAVORO: Long COVID is defined as the continuation of symptoms much longer than usually expected or the persistence of symptoms despite the recovery of the infection. While research on long COVID is in full swing, only little attention has been paid to the associated psychiatric symptoms. In particular, the association between long COVID and somatic symptom disorders (SSD) has been overlooked. Beyond anxiety and depression symptoms, patients with COVID-19 present a high risk to develop SSD. SSD, previously known as somatoform disorders, have been defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as persistent and clinically significant somatic symptoms accompanied by excessive and disproportionate health-related thoughts, feelings and behaviours regarding the symptoms. Noviello et Al (2021) in their study show that acute SARS-CoV-2 infection may affect the brain-gut axis. Five months after the acute infection, mild gastroenterological symptoms persist, in particular in patients reporting diarrhea in the acute phase of the infection. Infected patients are also at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal (like IBS) and somatoform disorders may have a common biological origin. IBS present an impairment in interoception and high levels of alexithymia. Interoception refers to the ability to accurately detect internal body changes. Alexithymia is a personality construct that implies difficulties identifying and describing one's own feelings, limited imaginative processes, an externally oriented cognitive style, and difficulties in distinguishing between feelings and bodily sensations. This construct is associated with many disorders, such as gastrointestinal pathologies. Given the relationship between long covid disease and gastrointestinal somatoform disorders (like IBS), and between interoceptive abilities and Irritable Bowel Syndrome, then it's conceivable a mediating role of interoceptive abilities in long covid IBS that deserves to be analyzed. MATERIALI E METODI: Subjects: All the patients aged between 18 and 60 years who tested positive at least 5 months before. Measures: - Toronto Alexithymia Scale - Hospital Anxiety and Depression Scale - Structured Assessment of Gastrointestinal Symptoms (SAGIS) questionnaire - Heart Rate Variability - Blood samples were collected between 8:30 am and 9:00 am. RISULTATI: There is a deficiency in interoceptive skills and high levels of alexithymia in patients with IBS and who have been infected with covid. CONCLUSIONI: In a current society, undermined by the psychophysical consequences of covid, Identifying factors that affect the well-being like Interoception training (as it is a learned skill), renders possible an intervention to modify some of these factors or promote a better understanding of patients with IBS who experience alternate periods of remission and relapse. .

Care and support for the covid - 19 bereaved family members: The counselor's role

Worldwide, COVID-19 outbreak has been impacting people. The death toll from Covid-19 has reached 57,50,868 globally, with 39,72,59,234 verified cases. In India, there are 4,24,10,976 confirmed cases of COVID-19, and the death toll has risen to 5,05,279. Everyone experiences bereavement at some point during their lifetime. It is a universal sensation. Many find that when they adjust and integrate their loss into their daily life, their level of sadness lessens over time. The grievers or carers may go through deep, persistent, and crippling grief that satisfies the DSM V criteria for Prolonged Grief Condition, a recognised mental disorder. The majority of people adjust after a loss, with two-thirds saying that their financial, emotional, and physical conditions remained unchanged. Severe dyspnea, patient seclusion, visitation limitations, death in intensive care units, anguish of patients/family members, and disruption of relatives' social support networks are the mourning risk factors. The following psychological interventions will be used in this study to attempt to illustrate the treatment, emotional support, and counselling available to bereaved family members and caregivers (Cognitive Behavior Therapy, Acceptance and Commitment Therapy, Art based therapy, Group Therapy, Traumatic Grief Therapy, Complicated Grief Therapy).Copyright © 2023, Anka Publishers. All rights reserved.

Simultaneous Individual Complicated Grief Treatment With a Couple

Persistent complex bereavement/complicated grief occurs when, after a period of 12 months following a death, there remains an ongoing intense yearning and sorrow for the deceased, preoccupation with the death and its circumstances, difficulty accepting its reality, and disruption in personal identity. This case study illustrates the successful application of Complicated Grief Treatment (CGT), a manualized research-supported intervention, with a husband and wife each receiving individual therapy simultaneously with separate clinicians. The core of CGT involves graded completion of imaginal and situational revisiting (i.e., exposure) exercises. To target maladaptive rumination and counterfactual thinking more explicitly, strategies from a research-based treatment for trauma, Cognitive Processing Therapy, were also incorporated for one member of the couple. To our knowledge, CGT has not been examined with couples receiving individual therapy delivered simultaneously. As such, practitioners have little information about how to proceed with cases where multiple members of the same family are experiencing complicated grief. We will detail the treatment provided, outlining the course of care for each member of the couple, highlighting unique adjustments made to tailor implementation to each individual and to deliver the intervention simultaneously. Quantitative and qualitative data show the effects of treatment on symptoms of complicated grief, depression, and relationship satisfaction.Copyright © The Author(s) 2022.

Preliminary Efficacy of Remote, Brief Telepsychotherapy for Covid-19 Patients and Their First-Degree Relatives

Introduction: Over the last two years, the COVID-19 pandemic has negatively impacted the mental health of both COVID-19 patients and the general population. Adults with COVID-19 risked their lives, lost their loved ones, struggled with comorbid clinical conditions to manage, and have been unable to enjoy the physical presence of their families during the infection, quarantine, and lockdown periods. During hospitalization and discharge, family members often did not receive clinical updates from providers and patients, were unable to offer in-person assistance, and to receive psychological support. Incidence and prevalence of depression and anxiety among COVID- 19 older adults and their family members skyrocketed beyond the possibilities of any mental health system to address psychological aftermath of this pandemic and intervene with in-person services. In response to the urgent need for treatments that could be remotely delivered at a large scale, we designed DigiCOVID, a digital mental health approach that offered remote brief tele-psychotherapy to COVID-19 patients and/or their first-degree relatives. The main goal of this single arm, naturalistic study was to evaluate the feasibility, acceptability and usability of DigiCOVID. Additionally, we assessed the impact of DigiCOVID on psychopathology by means of self-report questionnaires. Method(s): Participants underwent an initial phonebased screening to of inclusion and exclusion criteria. Inclusion criteria were: 18-80 years old;positive nasopharyngeal swabs or serology to COVID-19 (for the patients' subgroup);absence of visual/ motor deficits that might interfere with study participation;good level of Italian;and adequate tech literacy. Participants were excluded if they had a previous or actual DSM-5 diagnosis of bipolar disorder, psychotic disorder, or substance use disorder;if they had a diagnosis of dementia;or if they presented suicidal ideation assessed through the Columbia Suicide Severity Rating Scale. Next, they completed a neuropsychological test over video to assess IQ (if lower than 70 participants were excluded), and filled out online gold-standard selfreports for depression (PHQ-9), anxiety (GAD-7), insomnia (ISI), post traumatic symptoms (IES-R) and general wellbeing (GHQ-12). Participants were then assigned to a psychotherapist who remotely conducted eight remote tele-psychotherapy sessions. After treatment, online questionnaires were filled out again to collect data on preliminary efficacy. Result(s): Since November 2021, 138 patients were recruited, 83 completed the intervention (57 patients, 26 fist-degree relatives), and 55 dropped out. At a group level, participants showed significant improvements on all clinical outcomes (PHQ-9: R2=0.12, p=.0019;ISI: R2=0.15, p=.0004;IES-R: R2=0.11, p=.0003;GHQ- 12: R2=0.23, p<.0001;GAD-7: R2=0.12, p=.0011). Given the high heterogeneity in illness severity and psychopathology, we conducted clustering on baseline data coming from the five online questionnaires: 55% of the whole sample had no psychopathology (Cluster 1), whereas 45% showed severe psychopathology (Cluster 2). When clustering was conducted on post-treatment data, three clusters emerged: no psychopathology, residual psychopathology and severe psychopathology. 71% of Cluster 1 participants remained asymptomatic;25% of Cluster 2 participants showed full symptom remission, while 48% and 28% of Cluster 2 participants showed partial symptom remission and no significant effect of treatment, respectively. Conclusion(s): Remote brief tele-psychotherapy for COVID-19 patients and their first-degree relatives is feasible and preliminary efficacious at reducing COVID-related psychopathology. Further research is needed to investigate distinct profiles of treatment response.

Are Pid-5 Personality Traits and Self-Harm Attitudes Related? A Study on a Young Adult Sample Pre-Post Covid-19 Pandemic

Introduction: More evidence confirms a link between maladaptive personality traits and Non-suicidal Self-injury (NSSI). Research suggests that individuals with NSSI were found to have higher levels of negative affect, detachment, antagonism, and psychoticism. Additionally, the interest in the relationship between COVID-19 and NSSI is growing. The present study aims (a) to investigate differences in personality traits between individuals with NSSI, suicidal ideation, NSSI and suicidal ideation co-occurrence and none;(b) to observe which personality traits predominantly influence the occurrence of self-harm acts;(c) to investigate the effects of COVID-19 on selfharm attitude. Method(s): 270 (108 males and 172 females) participants aged between 18-25 were included in the study. Each individual participated in a clinical interview and completed an assessment consisting of the Personality Inventory for DSM-5 (PID-5) and the Health of the Nation Outcome Scales (HoNOS). A multivariate analysis of variance (MANOVA) was conducted to test the differences in personality traits between the groups. Moreover, a multiple hierarchical regression analysis, controlling for age and gender, was performed to measure the association between personality traits and self-harm attitude (HoNOS item 2). Finally, to investigate whether there was a difference in self-harm attitude before and after the pandemic, a T-test was conducted. Result(s): The individuals with the highest levels of negative affectivity, detachment, antagonism, and psychoticism are those who simultaneously present suicidal ideation and NSSI. Additionally, age and detachment predicted higher scores in self-harm attitudes. Our results unexpectedly do not confirm an upward trend of NSSI and suicidal ideation in the pandemic period. Conclusion(s): The study shows that personality, particularly maladaptive traits, is fundamental to a greater understanding of NSSIs. Furthermore, as NSSIs and suicidal ideation are predictive (although not determinative) of suicidal attempts, implementing psychotherapeutic treatments would have a conspicuous impact on self-harm attitudes, thereby reducing suicidal ideation and suicide attempts.

Challenges of Singapore's First Acute Geriatric Isolation Facility During the COVID-19 Pandemic

Aim: The COVID-19 pandemic has seen hospitals isolating suspect cases. Geriatric populations are at a risk of severe COVID-19 disease and often present with concomitant geriatric syndromes requiring holistic interdisciplinary care. However, isolation of older people poses challenges to care delivery. This study shares the experience of Singapore's first acute geriatric isolation facility geriatric PARI (Pneumonia-Acute Respiratory Infection) ward and describes the geriatric-related outcomes and pitfalls in care delivery. Method(s): This is a retrospective cross-sectional study performed in 7 negative pressure isolation rooms in an acute care public hospital in Singapore. 100 patients admitted consecutively to the geriatric PARI ward were included. Patient demographics, presenting symptoms and geriatric-related adverse outcomes associated with hospitalisation were collected and analysed. Result(s): Patients' mean age was 86.4 years (standard deviation [SD]: 6.8) with significant comorbidities being hypertension (81%), hyperlipidaemia (74%) and renal disease (70%). 51% of patients had dementia and 24% had behaviour and psychological symptoms of dementia (BPSD). 27% of patients presented atypically with delirium and 15% presented with a fall. Delirium was associated with restraint use (OR: 3.88;p-value 0.01). Falls rate was 1.64 per 1000 occupied bed. 1 patient screened positive for COVID-19. Conclusion(s): The geriatric PARI ward is essential for curbing nosocomial transmission of COVID-19. This is important in the older people with comorbidities who are more likely to develop morbidity and mortality. Our study reveals challenges in delivering person-centred care to the older patients in isolation rooms, especially in the management of delirium and falls prevention. Innovative strategies should be developed to minimise isolation-related adverse outcome.Copyright © The Author(s) 2022.

To Compare The Coping Strategies, Emotional Reactions, Burnout And Resilience In Doctors Caring And Not Caring For Covid19 Patients

Background: Rapid transmission of novel coronavirus (COVID-19) causing severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) occurred all across the world in few months causing a pandemic. Frontline medical staff as a result of heavy workload, insufficient protective equipment, a lack of information of the pathogen, and direct contact with patients faced the fear of getting infected themselves and their family. Anxiety, stress, and other negative emotions have led to a series of psychological crises in them. Aim(s): To compare the coping strategies, emotional reactions, burnout and resilience in doctors caring and not caring for COVID19 patients. Materials And Methods: Total 304 Doctors in tertiary care hospitals out of which 163 were caring and 141 were not caring for COVID19 patients participated in our study. Both groups were assessing and compared using The Fear of COVID-19 Scale, the coronavirus anxiety scale (CAS), Patient Health Questionnaire-2 (PHQ-2), Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), Brief COPE, Connor-Davidson Resilience Scale abbreviated, Abbreviated Maslach Burnout Inventory, Two-Item Conjoint Screen (TICS) Results: All participants those who did COVID duty and those who did not do it showed high level of resilience though on comparison no significant different was found between two groups. Those who did not do COVID duty were scored higher in emotion focused coping strategies whereas who did not do COVID duty scored higher in avoidant coping strategies. Abbreviated version of Maslach Burnout Inventory indicated a great personal accomplishment, less depersonalization and low emotional exhaustion in all the participants irrespective of their duty status. Conclusion(s): On comparing those who did COVID duties against those who haven't, it was found that those who did not do COVID duty used more emotion-focused ways to cope and those who were doing COVID duties were using harmful avoidant coping to manage their daily chores. All the doctors participating in study showed high resilience irrespective of whether they did COVID duty or not.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Personality, Defenses, Mentalization, and Epistemic Trust Related to Covid-19 Containment Strategies: A Psychodynamic Perspective

Introduction: The COVID-19 pandemic has considerably influenced all the domains of people's lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning. Method(s): The sample consisted of 367 Italian individuals (68.1% women, 31.9% men;M age=37, SD=12.79) who completed an online survey including an instrument assessing four response styles to the pandemic and lockdown(s) (RSPL;Tanzilli et al., 2021), the Personality Inventory for DSM-5-Brief Form (PID-BF;Krueger et al., 2013), the Defense Mechanisms Rating Scales-Self-Report-30 (DMRS-SR-30;Di Giuseppe et al., 2020, 2014), the Reflective Functioning Questionnaire (RFQ;Fonagy et al., 2016), and the Epistemic Trust, Mistrust, Credulity Questionnaire (ETMCQ;Campbell et al., 2021). Result(s): Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology was predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others' mental states, and high epistemic credulity. Conclusion(s): Recognizing and understanding dysfunctional psychological pathways associated with individuals' difficulties in dealing with the pandemic are crucial for developing tailored mental health interventions and promoting best practices in healthcare services.

The Psychological Sequelae of COVID-19 Among Disease Survivors in Argentina

Background: While more than a year has passed since the COVID-19 outbreak, it is still a growing health concern. Moreover, ample consensus exists for the presence of not only a physical but also a psychological impact of the COVID-19 pandemic. Those reported as hardest hit were individuals who had been infected with COVID-19. Survivors have exhibited a higher prevalence of psychological morbidity i.e., PTSD, depression, and anxiety-as compared with the general population and health workers. Additionally, COVID-19 patients and survivors have been psychologically impacted by a staggering number of disease-related stressors. Objective(s): The study was aimed at analyzing COVID-19's impact on the psychological state of Argentinian disease survivors. Method(s): Two hundred and ninety-six COVID-19 survivors (67.2% female;Mage = 44.81;SDage = 12.16) from a major Buenos Aires hospital completed a questionnaire and a set of psychological measures-COVID-19 emotional impact, psychological sequelae, disease-related stressors, PTSD, and psychological distress. Result(s): The most impactful psychological sequelae and disease stressors revolved around having the disease awaiting test results, fear of infecting loved ones, being apart from family and friends during the disease, fear of physical sequelae and symptoms, and returning to isolation. PTSD prevalence rates were 33.8%. Survivor's psychological distress levels were moderately higher than pre-COVID-era general population levels, yet not significantly different from preCOVID-era clinical inpatients. Female gender, age, and hospital admission emerged as significant predictors of increased adverse psychological outcomes. Conclusion(s): Intervention for COVID-19 survivors is urgently needed, with particular attention to the alarming PTSD prevalence rates, as discussed in the study.Copyright © 2023 Bentham Science Publishers.

Prevalence and Predictors of Sleep and Trauma Symptoms in Wildfire Survivors

Objective: This study aimed to establish the prevalence and to identify predictors of insomnia, nightmares and post-traumatic stress disorder (PTSD) in wildfire survivors. Method(s): A total of 126 (23 males, 102 females, and 1 nonbinary individual, Mage = 52 years, SD = 14.4) wildfire survivors from Australia, Canada and the USA took part in an online survey. Participants completed a demographic questionnaire and self-report measures including: The Insomnia Severity Index (ISI), PTSD Checklist for DSM-5 (PCL-5), and Disturbing Dream and Nightmare Severity Index (DDNSI). Result(s): Results showed that 49.2% of the sample reported clinical insomnia on the ISI, 28.7% reported nightmares on the DDNSI, and 77.88% reported PTSD symptoms on the PCL-5. Fear for life of others (Pearson's r = .40, .21, .31), and the impact of smoke (Pearson's r, .47, .25,.41) significantly correlated with insomnia, nightmares and PTSD symptoms, respectively. Hierarchical regression showed that smoke was a significant predictor of insomnia (beta = .17, p <.05, 95% CI, 0.15 - 1.49), and insomnia predicted both of PTSD (beta = .27, p <.05, 95% CI, 0.26 - 1.05), and nightmares (beta = .19, p = .04, 95% CI, 1.01 - 1.45) scores. Conclusion(s): Insomnia, nightmares and PTSD are highly prevalent in wildfire survivors. Smoke, one of the trauma-related factors, was found to be as a significant predictor of insomnia;and insomnia was a significant predictor of both PTSD and nightmares. Future longitudinal studies are needed to establish which disorder emerges first as a result of smoke.Copyright © 2022