Coping of Chronically-Ill Patients during the COVID-19 Pandemic: Comparison between Four Groups.

In many countries, the COVID-19 pandemic led to healthcare reorganization limiting access to diagnostic or therapeutic procedures for chronically-ill patients. In this article, we describe the psychological consequences and coping strategies of several groups of chronically-ill patients. During the cross-sectional survey conducted in 2020, we enrolled 398 patients with four different chronic conditions (psoriasis, multiple sclerosis, and patients who have undergone a kidney transplant or received dialysis). The study sample was examined regarding the experienced stress levels (Perceived Stress Scale) and coping strategies (Brief-COPE). All four groups of patients most commonly declared using problem-focused coping strategies and least commonly reported the use of avoidant coping. Higher levels of perceived stress strongly correlated with self-blaming. The participants who declared previous psychiatric treatment or psychotherapy were more likely to use self-blaming, behavioral disengagement, substance use, and avoidant coping, while previous psychotherapy additionally correlated with emotion-focused coping. Group comparison identifies patients with a chronic neurological disease, such as multiple sclerosis, at higher risk of a less beneficial coping profile than kidney transplant recipients. Further focus on education and early interventions in at-risk individuals is needed, and widely targeted mental health programs are indicated in order to improve the mental health of patients suffering from chronic diseases.

Novel psychopathological picture during the COVID-19 pandemic based on a first episode of psychotic depression. / Nowy obraz objawów psychopatologicznych w dobie pandemii COVID-19 na podstawie pierwszego epizodu depresji psychotycznej.

The emerging SARS-CoV-2 pandemic is known to take a toll on both physical and mental health. We present a case of a patient with a first episode of severe depression with COVID-19-related psychotic features. A patient with no history of mental disorders was admitted to the Psychiatric Unit due to the symptoms of severe depressive episode with psychotic features. Progressive deterioration of his mental health, behavior and activity was observed in March of 2020. He was not infected nor exposed to infectious agents but presented delusions about being infected with SARS-CoV-2 and being a source of transmission to other people. He suffered from Hashimoto disease and recently diagnosed lymphoma which further diagnosis was postponed. He was administrated venlafaxine 150 mg and mirtazapine 45 mg with addition of olanzapine up to 20 mg and risperidone up to 6 mg per day. No side effects were reported. The patient reached a full recovery with the exception of slightly blunted ability to feel pleasure, minor problems with concentration and occasional pessimistic thoughts. Discussion: The social distancing recommendations put a psychological strain related to alienation and negative emotions which can favor development of depressive symptoms. Analysis of psychological mechanisms related to the pandemic and restrictions is significant for limiting negative influence of global crisis on individual mental well-being. Conclusions: In this case the impact of global anxiety and its integration into the developing psychopathological symptoms is especially significant. The circumstances surrounding an episode of affective disorder may shape its course and thought content.

Neuroinflammation in Dementia-Therapeutic Directions in a COVID-19 Pandemic Setting.

Although dementia is a heterogenous group of diseases, inflammation has been shown to play a central role in all of them and provides a common link in their pathology. This review aims to highlight the importance of immune response in the most common types of dementia. We describe molecular aspects of pro-inflammatory signaling and sources of inflammatory activation in the human organism, including a novel infectious agent, SARS-CoV-2. The role of glial cells in neuroinflammation, as well as potential therapeutic approaches, are then discussed. Peripheral immune response and increased cytokine production, including an early surge in TNF and IL-1ß concentrations activate glia, leading to aggravation of neuroinflammation and dysfunction of neurons during COVID-19. Lifestyle factors, such as diet, have a large impact on future cognitive outcomes and should be included as a crucial intervention in dementia prevention. While the use of NSAIDs is not recommended due to inconclusive results on their efficacy and risk of side effects, the studies focused on the use of TNF antagonists as the more specific target in neuroinflammation are still very limited. It is still unknown, to what degree neuroinflammation resulting from COVID-19 may affect neurodegenerative process and cognitive functioning in the long term with ongoing reports of chronic post-COVID complications.

SARS-CoV-2 pandemic and the population with dementia. Recommendations under the auspices of the Polish Psychiatric Association. / Pandemia SARS-CoV-2 a populacja osób z otepieniem. Rekomendacje pod patronatem Polskiego Towarzystwa Psychiatrycznego.

SARS-CoV-2 poses a particular risk to the elderly and people with many comorbidities. In the case of people with dementia, the compliance with sanitary recommendations and the necessary physical isolation can have far-reaching negative consequences in terms of limiting the continuation of tailored care, support and treatment. The recommendations related to the SARS-CoV-2 pandemic must take into account not only the medical consequences of lack of access to medical care, but also their long-term effects and the disease progression in accordance with the concept of social health. A plan of action for the psychoeducation of informal carers, adapted to the elderly group (including people with dementia), is also necessary. Prepared under the auspices of the Polish Psychiatric Association, the recommendations for people living alone, with their family and in long-term care facilities are intended to draw attention to key epidemiological issues that can be planned by medical staff within the organization of patient care. However, mental and social needs of patients, whose fulfilment is particularly significant in times of restrictions related to everyday activities, are of equal importance. Further monitoring of the epidemiological situation and scientific reports related to the SARS-CoV-2 pandemic are necessary to verify and update the guidelines.