Risk Factors for Psychiatric Disorders in Patients with Multiple Sclerosis-A Single-Center Study in the Polish Population.

Aim: The aim of this study was to determine the prevalence of mental disorders in a group of patients with multiple sclerosis (MS) during outpatient treatment. Additionally, an attempt was made to assess the influence of parameters related to patients and their clinical status on the prevalence of mental disorders. Materials and Methods: This study was conducted between 2017 and 2018 in a group of 103 patients with MS who underwent treatment at the Outpatient Clinic of Neurology at the Clinical Hospital No. 1 in Zabrze, Poland. Sociodemographic data were collected, and the course of the underlying disease and comorbidities underwent assessment. The Mini International Neuropsychiatric Interview (MINI) and psychiatric examination were used to assess the occurrence of mental disorders. Results: In this study, female subjects accounted for 67.96% of patients (mean age: 43 years). Of all patients, 67% of subjects were clinically diagnosed with mental disorders during their lifetime. The results of the MINI Questionnaire showed that 33% of MS patients had a history of a major depressive episode, while 8.7% of patients met the criteria for a depressive episode. The same number of patients were treated for recurrent depressive disorders. Generalized anxiety disorder was diagnosed in 10.7% of patients, agoraphobia in 8.7% and panic disorder in 7.8%. Most patients (94.2%) had a low risk of suicide, according to the MINI Questionnaire. This study did not show a significant influence of age, sex, duration of MS symptoms or severity of symptoms as expressed by the Expanded Disability Status Score (EDSS) on the prevalence of mental disorders (p = 0.05). However, a significantly higher median EDSS score was found in patients with a history of mental disorders (p = 0.03). Additionally, a significant negative correlation was found between having a family and a psychiatric diagnosis (p = 0.01). A statistically significant negative correlation was found between the level of education and the suicide risk as assessed by the MINI Questionnaire (p = 0.03). Conclusions: This study showed a high prevalence of mental disorders in patients with MS, of which depressive episodes and anxiety disorders were the most commonly reported. There may exist a relationship between the degree of disability of MS patients and a higher prevalence of mental disorders. Patients with MS who do not have a family may be more susceptible to mental disorders. In turn, patients with a lower level of education may show a higher risk of suicide. This suggests the need for psychological and psychiatric support for patients with MS, with particular consideration given to those who are alone, those with more severe disability and patients with a lower level of education.

Preliminary Assessment of Pre-Electroconvulsive Therapy Evaluation Practices in European Countries: The Need for Guidelines.

OBJECTIVES: Pre-electroconvulsive therapy (ECT) evaluation is an essential part of ECT preparation, a standard treatment in the psychiatric field. However, no routine pre-ECT evaluation has been published so far. This preliminary study aimed to explore different practices in pre-ECT evaluation across European countries. METHODS: The data were collected as a snowball sample approach using an online survey from September 2019 to April 2020. The final analysis included data from 18 clinics placed in 16 European countries. RESULTS: Regulations on the pre-ECT evaluation were found in 9 countries. All clinics reported doing complete blood count, serum electrolytes, and renal function analysis as a part of regular laboratory testing, alongside with a cardiovascular assessment. Ten clinics reported using psychiatric scales. Six clinics reported doing a cognitive assessment, of which all had regulations on the pre-ECT evaluation. Not one evaluation had the same sets of procedures and diagnostics. CONCLUSIONS: The differences in assessment approaches mirror high variability of the pre-ECT evaluation practice across Europe. Cognitive assessment and objectification of psychiatric symptoms should be a regular part of the pre-ECT evaluation because of the monitoring of the most common adverse effect and observing the clinical response to ECT. Standardization of the pre-ECT evaluation and ECT in general would remove criticisms and opposition to the treatment, make it based on the best of our knowledge, and provide a method respectful of patients' best interests and rights.

Violence Against Psychiatric Trainees: Findings of a European Survey.

OBJECTIVES: Violence by patients against health care professionals has been widely described. Although psychiatric trainees are particularly exposed, little is known about the extent, context, and impact of violence toward them in Europe. METHODS: A cross-sectional online survey was distributed between June 2018 and December 2019 among European psychiatric trainees through professional networks, using a snowball approach. The questionnaire asked about experiences of verbal abuse and physical and sexual assaults, as well as their context and impact. Descriptive analyses of the obtained data were conducted. RESULTS: The survey was completed by 827 trainees from 39 countries (68.4% females). Most (83.6%) reported having been abused/assaulted at least once (of these, 92% verbally, 44.1% physically, and 9.3% sexually). Emergency rooms and inpatient units were the most frequent settings. Psychological impact of these events was commonly reported. Most respondents did not report abuses and assaults to their supervisors. They also described a lack of training for staff and aggression management plans at their institutions or of being unaware of their existence. CONCLUSIONS: Violence from patients is reported by many psychiatric trainees across countries in Europe, with very frequent verbal abuse and worrisome figures of physical and sexual assaults. Particularly concerning are the low proportion of trainees reporting to authorities, the lack of staff training and management protocols, and trainees' lack of awareness about those resources. Despite the study limitation of a small response rate, these results support a call for urgent efforts to address this problem in Europe, and possibly beyond.

Services for patients with intellectual disability and mental health problems in Poland.

BACKGROUND: Poland is a democratic, sovereign state in Central Europe, member of the European Union. The healthcare in Poland is delivered to patients mainly through a public contributor called the National Health Fund, supervised by the Ministry of Health. The care for people with disabilities, including intellectual disabilities in Poland is coordinated by the Governmental Program on Activities for People with Disabilities and their Integration with the Society. The system of care for people with intellectual disability in Poland is constitutionally guaranteed. The aim of this review was to analyze the different forms of care for persons suffering from intellectual disability and mental health problems in our country. METHODS: Analysis of available documents on the policy and organizations of systems of services for this group of patients was performed. RESULTS: Non-governmental organizations play an important role in taking care of people with disabilities. In Poland there are no special psychiatric services dedicated for patients with intellectual disabilities. The comorbid psychiatric disorders are treated in general psychiatric wards or hospitals or in outpatient settings. Offenders with intellectual disabilities in the penitentiary system are referred to therapeutic settings in wards for convicts with non-psychotic mental disorders and intellectual disabilities. Training of medical students and young doctors offers only very limited basic knowledge on intellectual disability within psychiatry curriculum. The is no separate specialty in mental health in intellectual disability within psychiatry. CONCLUSIONS: The main conclusion of this review is that the specialist working with persons suffering from intellectual disabilities in Poland face many challenges regarding the need to introduces positive changes in this field.

Occurrence of Clostridium difficile ribotype 027 in hospitals of Silesia, Poland.

Clostridium difficile is an important healthcare-associated pathogen, responsible for a broad spectrum of diarrheal diseases. The aim of this prospective study was to determine the occurrence of C. difficile infection (CDI), to characterize cultured C. difficile strains and to investigate the association of fecal lactoferrin with CDI. Between January 2013 and June 2014, 148 stool samples were obtained from adult diarrheal patients (C. difficile as a suspected pathogen) hospitalized in different healthcare facilities of 15 Silesian hospitals. Out of 134 isolated C. difficile strains, 108 were ribotyped: 82.4% belonged to Type 027, 2.8% to Type 176, 2.8% to Type 014, 1.9% to Type 010 and 0.9% to Types 001, 018, 020 and 046 each. In total, 6.5% non-typable strains were identified. All Type 027 isolates contained both toxin genes tcdA & tcdB, and binary toxin genes (cdtA &cdtB). Susceptibility testing revealed that all Type 027 isolates were sensitive to metronidazole and vancomycin and resistant to moxifloxacin, ciprofloxacin, imipenem and erythromycin. Of 89 Type 027 strains, 16 had a ermB (688 bp) gene coinciding with high levels of erythromycin resistance (MIC >256 µg/mL). Of 16 ermB positive strains, 14 demonstrated also high level of resistance to clindamycin (>256 µg/mL). A significant difference (p = 0.004) in lactoferrin level was found between C. difficile toxin-positive (n = 123; median 185.9 µg/mL; IQR 238.8) and toxin-negative (n = 25; median 22.4 µg/mL; IQR 141.7) fecal samples. Stool samples from n = 89 patients with CDI caused by Type 027 demonstrated significantly higher (p = 0.03) lactoferrin level (median 173.0 µg/mL; IQR 237.3) than from patients with CDI caused by other ribotypes and non-typable C. difficile strains (median 189.4 µg/mL; IQR 190.8).

Suicidality and nonsuicidal self-injury in females diagnosed with attention-deficit hyperactivity disorder - a narrative review.

PURPOSE OF REVIEW: Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder and is associated with an increased risk of suicidal behavior, especially in females. The differences in the presentation of ADHD in females, factors contributing to suicidality and the effects of therapeutic interventions are presented in this review to highlight the relationship between ADHD and suicidality and self-harm behavior. RECENT FINDINGS: Impulsivity, an inherent symptom of ADHD, commonly acts as a risk factor of suicidality and is associated with both suicidal behavior and nonsuicidal self-injury. The combined subtype of ADHD, which typically is characterized by significant impulsivity, is linked with the highest vulnerability to suicide attempts. Female gender, lower educational attainment, comorbid substance abuse, a history of depression, and experience of childhood maltreatment were singled out as distinct factors that were independently linked to lifetime suicide attempts. SUMMARY: The association of the ADHD and suicidality is gaining an increasing interest in recent years. Active suicide prevention is required in this population and it is crucial for clinicians and researchers to have access to the most current information in this field.

Problems associated with the use of social networks--a pilot study.

BACKGROUND: The definition of addiction is that it is an acquired, strong need to perform a specific activity or continued use of mood alerting substances. Increasing discussion about the development of Internet addiction, which like other addictions, have their roots in depression, impaired assessment esteem and social anxiety shows that it affects all users of the global network, regardless of gender or age. The aim of the study was to assess the impact of social networking on the ongoing behavior of respondents- the first step of a study on the possibility of dependence on social networks. SUBJECTS AND METHODS: The study was based on an authors questionnaire placed on popular polish websites on February 2013. Questions related to the types and frequency of specific activities undertaken by the private profiles of users. RESULTS: The study involved 221 respondents, 193 questionnaires were filled in completely and correctly, without missing any questions. 83.24% admitted to using social networking sites, 16.76% indicated that they never had their own profile. An overwhelming number of respondents are a member of Facebook (79.17%), specialized portals related to their profession or work were used by only 13.89%, Our-class (6.25%) and Twitter was a primary portal for one person only. Nobody marked a participation in dating services. CONCLUSION: There is a big difference between the addiction to the Internet and addictions existing within the Internet; the same pattern applies to social networking. There is a need to recognize the "social networking" for a particular activity, irrespective of Facebook, Twitter and Nasza-Klasa, which are commercial products.

General level of knowledge about Brief Solution Focused Therapy (BSFT) in Polish addiction treatment centers.

BACKGROUND: The aim of this study was to estimate the level of knowledge about Brief Solution Focused Therapy (BSFT) among therapists and patients during treatment and identification of existing barriers to the introduction of the method. SUBJECTS AND METHODS: 64 therapists were examined in total; 37 women (57%) and 27 males (43%). The study involved also 191 patients, 160 men (83.77%) and 31 women (16.23%). All the surveys were anonymous and were collected in health centers within the province of Silesia. RESULTS: More than 2/3 of therapists have heard of the method, but do not know the specifics of it. The most important sources of knowledge are other therapists, literature, and mass media. According to the respondents the most important barriers to alcohol addiction treatment include cultural barriers, such as embarrassment or fear of stigmatization. Younger Patients and those treated for a shorter period, state that they know the name of the current method of treatment to a lesser extent than other subgroups. About 10% of people have not heard about the BSFT method of treatment. CONCLUSIONS: The level of knowledge about the BSFT method suggests the need to promote this model among both therapists and patients. An introduction of BSFT can improve the treatment of alcohol addiction.

Violence against psychiatric trainees from Asian countries: A pilot online survey.

Background: Violence against psychiatry trainees is an important issue to the medical profession. However, this matter has been under researched, especially in Asian countries. Aim: We aimed to explore the rates and factors associated with violence against psychiatric trainees in Asian countries. Methods: An online, 15 item cross sectional pilot survey was designed and disseminated among psychiatric trainees in Asia through the World Network of Psychiatric Trainees, national and local networks of trainees, and social media. The questionnaire sought to enquire about the experience of physical, verbal, and sexual assaults and its impact. Data were analyzed using Statistical Package for the Social Sciences (SPSS) V20.0. Results: A total of 467 responses were obtained from psychiatric trainees in 16 countries in Asia. More than two thirds of participants (n = 325, 69.59%) reported a history of assault. Psychiatry inpatient units were the most common setting (n = 239, 73.54%). A relatively lower proportion of participants from the East Asian countries reported an assault, compared to other countries (χ2 = 13.41, P = 0.001). Sexual assault was more common among women compared to men (χ2 = 0.94, P = 0.002). Conclusion: Violence against psychiatric trainees seems common across Asian countries. Our findings call for further systematic investigation of the phenomenon and suggest the need to develop programs to protect psychiatric trainees against the threat of violence and its subsequent psychological complications.

Eating disorders in Silesian schools - pilot study.

BACKGROUND: Modern media have a huge impact on eating habits, which result in pathologies among young people, especially females. Fashion models have become a pattern for ordinary women, however the difference in a mean weight between these two groups is increasing. The aim of the study was to assess the correlation between school students' results in EAT-26 self-report questionnaire and their daily diet behavior and to analyze the occurrence of eating disorders among students in schools of the region of Silesia in Poland. SUBJECTS AND METHODS: Our survey was based on the EAT-26 (Eating Attitude Test) and Behavioral Four Questions Test. 150 questionnaires were given to students of Secondary Schools, 116 were filled out correctly. The interviewed group consisted of 85 girls and 31 boys. Average age was 17.24±1.18. All of the data were analyzed statistically. RESULTS: Average BMI was 21,06; half of the recruited subjects had correct BMI whereas over 40% of them presented underweight. Within 116 responses from the EAT-26 nearly 93% belonged to the group with a small risk of the development of future eating disorders. Nevertheless, over 6% of the survey participants were in the group at high risk. In the Behavioral Four Questions Test 10% participants turned out to be in the compulsive overeating group, other ones in the group of a probable development of anorexia (7%) or bulimia nervosa (3%). CONCLUSIONS: There is a strong correlation between particular daily activities and the score achieved in EAT-26, however there is no significant correlation between the calculated BMI and EAT-26 results. Specific socio-cultural factors are faced by public services. They refer both to health promotion programs and the organization of spare time spent by teenagers outside schools.

Aggression in the work environment of physiotherapists.

BACKGROUND: Aggression in the medical environment can take on different forms. It can be inflicted both by patients and workmates and may also cause a rise of aggressive behavior performed by the physiotherapists themselves. The aim of the study was to evaluate possible danger that may occur in the working environment of physiotherapists as well as to assess the correlation between such factors as the length of professional experience and exposure to the aggression inflicted by patients and workmates in the workplace with the level of aggression occurring within the professional group of physiotherapists. SUBJECTS AND METHODS: The study was conducted among 50 physiotherapists from Opole and the Silesian Voivodships in Poland. Two types of questionnaires were used: the author's own questionnaire, assessing exposure of the physiotherapists to aggression in the workplace, and the Buss-Perry Aggression Questionnaire. The results were analyzed with the Statistica 8.0 application. RESULTS: 60% of participants suffered from patients' verbal aggression, 8% from physical aggression and 26% from the patients' emotional self-aggression at least twice a month. The study showed a minor correlation between the duration of the length of professional experience and the level of hostility (r=0.2; p>0.05). There is a considerable impact of negative emotions present in relations with workmates at the workplace causing mainly increase of general aggression among physiotherapists and hostility. Similarly, negative emotions that may appear in relations between psychiatrists and patients show a positive correlation with the level of general aggression developed by doctors. CONCLUSIONS: It can be observed that there is a huge impact of the impulsive behaviour and attitude (presented both by patients and workmates in the workplaces) on the appearance of aggressive actions by physiotherapists (especially anger and hostility). Further research in this field is needed.

Reasons for the choice to specialize in psychiatry - a retrospective study.

BACKGROUND: Providing the mental health service is one of the main tasks of every state. Its implementation obviously depends on the number of professionally active psychiatrists. The aim of the study was to analyze the motives in the choice of the specialization in psychiatry from the perspective of physicians-practitioners. SUBJECTS AND METHODS: An original questionnaire, containing 22 questions, was implemented. The study group was created by recruiting 132 psychiatrists participating in the International Scientific-Training Conference in Wisla, Poland in 2011. The obtained results were analyzed statistically. RESULTS: The majority of the respondents decided to become psychiatrists during their university studies (43.61%) and just after their studies (37.59%). Only 9.02% knew before starting university, which field of medicine to select, and 8.27% were originally practitioners in a different medical specialization. The factors having the greatest influence on making the decision were: self-esteem (58.64%), practical classes in college and the experience of special types of work with a patient (the percentage for both factors was 33.83%). Prestige (3%) and media influence (3.76%) seem to be the least important factors. 81% of respondents admitted that it was their own independent decision. In the group of those who were influenced by others, the strongest source of advice was the opinion of a partner (4.51%), while the opinion of the family and a well-known specialist in the field turned out to be much less important (the percentage for both factors was 1.5%). 94.73% participants said that they would choose the same specialization once again. CONCLUSIONS: Public perception of psychiatry is still not satisfactory and may have little impact on the popularity of this specialization. The form of teaching at universities is important in the selection process of the specialization. The results of our questionnaire may be a helpful tool to improve the image of psychiatry as an attractive path of professional career, and become an essential argument during the discussion about current problems in psychiatry.

Different dimensions of aggression occurring in the work environment of psychiatrists.

BACKGROUND: The term "aggression" refers to forceful behavior, action, or attitude that is expressed physically, verbally, or symbolically. Aggression in the medical environment can have different forms. The interactions between psychiatrists and patients may be one of the reasons for the appearance of symptoms of aggression in the behaviour of the physicians. The main aim of the study was to evaluate different aspects of aggression among psychiatric professionals. SUBJECT AND METHODS: The study was conducted among 132 psychiatrists (97 women and 34 men) from all over Poland. The average age was 43.1±9.48, the average professional experience was 15.76±10.09 years. Authors' original questionnaire and Buss-Perry Aggression Questionnaire were used to evaluate different aspects of aggression. RESULTS: The study showed a correlation between the length of professional experience and the level of verbal aggression (p=0.022) as well as with the level of hostility (p<0.05) presented by psychiatrists. Negative emotions appear in relations with workmates and causes the increase of general aggression among psychiatrists. These negative emotions are also present in relations with patients. The exposure to verbal aggression inflicted by patients causes the increase of verbal aggression, anger and hostility among psychiatrists. CONCLUSIONS: Significant occurrence of general aggression among psychiatrists caused by difficult relations with co-workers and patients suggests the importance and necessity of providing appropriate support for this professional group in their work environment.

Proprietary Model of Qualification for In-Hospital Rehabilitation after COVID-19.

BACKGROUND: Since the beginning of the SARS-CoV-2 epidemic in Poland, 6,128,006 people have been diagnosed, of which 116,798 died. Patients who recovered from COVID-19 and require rehabilitation due to varied impairments should be provided an opportunity to participate in an individualized, complex rehabilitation program starting from acute care and being continued in the post-acute and long-term rehabilitation phase. It is recommended to offer out-patient and in-hospital rehabilitation procedures depending on the type and persistence of symptoms and dysfunctions. The aim of this paper is to present the qualification process of post-COVID19 patients for an in-hospital complex rehabilitation program developed on the basis of pulmonary physical therapy. METHODS: The presented qualification program was developed on the basis of clinical experience of over 2000 patients participating in the pilot program of in-hospital rehabilitation launched in September 2020 and based on the Regulation of the Polish Minister of Health of 13 July 2020. RESULTS: The proposed model of patients' qualification rests on well-known and validated tools for functional assessment: exercise tolerance assessment, dyspnea intensity assessment, functional fitness assessment, assessment of arterial blood saturation, lung ventilation function assessment, assessment of long-lasting COVID-19 symptoms, and patient's basic mental health condition. CONCLUSIONS: The proposed qualification model for the post-COVID rehabilitation program allows us to introduce adequate qualifications followed by much needed assessment of the health effects.

Prevalence of Insomnia in the Early Post-COVID-19 Recovery Period.

BACKGROUND: Sleep is a complex, reversible process that is responsible for the modulation of various physiological mechanisms. COVID-19-related sleep disorders are affecting different populations with a heterogenous prevalence, yet high rates among infected patients are frequently reported. The aim of the study is to assess the prevalence of insomnia in the early post-COVID-19 recovery period and explore the differences in the results acquired by the Athens Insomnia Scale (AIS) by gender and selected infection severity parameters. METHODS: The data presented in the paper come from a prospective, observational study on COVID-19 complications (SILCOV-19) consisting of 200 COVID-19 patients. The AIS was used for the quantitative measurement of insomnia symptoms based on ICD-10 criteria. RESULTS: 32% (n = 64) of all patients in the study group obtained results indicating sleep disturbances (>5 points on the scale), while 21.5% (n = 43) obtained results indicating insomnia (>10 points on the scale). The analysis of the results obtained by all patients in the AIS showed a significant correlation with the duration of symptoms (Spearman's rank-order: R = 0.18; p < 0.05), but not with the number of days spent in the hospital or age. Women achieved a higher score in overall AIS, as well as in questions assessing total sleep time, well-being the next day, physical and mental fitness the next day, and sleepiness during the day (p < 0.05). CONCLUSIONS: the prevalence of insomnia in the early post-COVID-19 recovery period is high.

The Quality of Sex Life Among Patients Before and After Lung Transplantation: A Single-Center Study.

BACKGROUND: Lung transplantation (LTx) is the only effective method of treatment for patients with end-stage lung diseases; LTx prolongs and increases the quality of life (QoL). An important aspect of QoL that changes in the course of severe diseases is the quality of sex life. This aspect is yet to be discussed in relationship to LTx. We aim to compare patients' quality of sex life at the qualification process with patients' who underwent LTx. METHODS: The studied group consisted of 100 patients (24 women before and 16 after LTx, 39 men before and 21 after LTX) who were admitted to the lung transplantology department for qualification or to control the function after LTx. To assess the patients' quality of sex life, we used The Changes in Sexual Functioning Questionnaire (CSFQ) and World Health Organization (WHO) QoL-BREF. To assess lung function, patients underwent a 6-Minute-Walk-Test (6MWT). RESULTS: Patients after LTx obtained higher results-compared to patients qualified for LTx-in the WHO QoL-BREF in every domain (somatic, psychological, social, and environment). Men after LTx got more points in every domain and better total score (53 ± 5.62 vs 44.23 ± 10.28 point; P < .05) in CSFQ. Women before and after LTx obtained comparable results in CSFQ. Results of 6-Minute-Walk-Test were better among patients after LTx than in qualified patients (523.62 ± 95.71 vs 333.14 ± 145.38 and 524.12 ± 56.17 vs 317.20 ± 141.6, respectively for men and women). CONCLUSIONS: Patients after LTx show better pulmonary function and quality of sex life than qualified. Preliminary results encourage us to conduct research on a larger group.

Cross-cultural measurement invariance of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short form across ten countries: the application of Bayesian approximate measurement invariance.

BACKGROUND: The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) is the most frequently used generic quality of life (QOL) measure in many countries and cultures worldwide. However, no single study has been carried out to investigate whether this questionnaire performs similarly across diverse cultures/countries. Accordingly, this study aimed to assess the cross-cultural measurement invariance of the Q-LES-Q-SF across ten different countries. METHODS: The Q-LES-Q-SF was administrated to a sample of 2822 university students from ten countries: Bangladesh, Brazil, Croatia, India, Nepal, Poland, Serbia, Turkey, the United Arab Emirates, and Vietnam. The Bayesian approximate measurement invariance approach was used to assess the measurement invariance of the Q-LES-Q-SF. RESULTS: Approximate measurement invariance did not hold across the countries for the Q-LES-Q-SF, with only two out of 14 items being non-invariant; namely items related to doing household and leisure time activities. CONCLUSIONS: Our findings did not support the cross-cultural measurement invariance of the Q-LES-Q-SF; thus, considerable caution is warranted when comparing QOL scores across different countries with this measure. Item rewording and adaptation along with calibrating non-invariant items may narrow these differences and help researchers to create an invariant questionnaire for reliable and valid QOL comparisons across different countries.

Post-COVID-19 rehabilitation - a Polish pilot program.

The current spread of SARS-CoV-2 indicates a long-term fight against the widespread and exponential increase in morbidity and mortality across the globe. A variety of non-pharmacological strategies to mitigate and suppress virus transmission have been investigated and introduced. Currently, emerging studies focus mostly on the management of hospital-treated patients in the acute phase of the disease, including the legitimacy of using physiotherapeutic procedures. However, current literature lacks guidelines for rehabilitation related to maintaining continuity and universality of the therapy after the end of the acute phase of the disease and discharge from hospital. The authors suggest implementing an immediate rehabilitation program in post-infection patients as data from previous epidemics of respiratory-related viral diseases shows that COVID-19 survivors should be expected to have impaired lung ventilation function, and reduced exercise tolerance and muscular weakness, and prolonged return to work and participation. It should be assumed that only the introduction of immediate recommendations for the implementation of rehabilitation procedures based on simple and well-known tests, as well as their obligatory regime, can contribute to the reduction of respiratory disability leading, in a short time, to infections recurrence and, in the long run, to a lower quality of life and socioeconomic burden on the population. This article presents a respiratory rehabilitation program for COVID-19 survivors, recommended by the Polish Society of Physiotherapy. This program was approved by the Polish Minister of Health and implemented as a pilot program at the Hospital of the Ministry of the Interior and Administration in Glucholazy, Poland. Med Pr. 2021;72(5):611-6.

Assessment of the Impact of a Daily Rehabilitation Program on Anxiety and Depression Symptoms and the Quality of Life of People with Mental Disorders during the COVID-19 Pandemic.

Community psychiatry is a modern and effective form of care for patients with mental disorders. The aim of the study was to assess the impact of a rehabilitation program at the Mental Health Support Centre in Tarnowskie Góry (Poland) on reducing severity of anxiety and depression symptoms, as well as improving overall quality of life during the COVID-19 pandemic. The study involved 35 patients, examined with an authors' questionnaire on sociodemographic data, the Hospital Scale of Anxiety and Depression (HADS) and the Short Form Health Survey (SF-36). Data was obtained during the first national lockdown and compared to data gathered before the pandemic on the same study group. Imposed restrictions, negative emotional state during lockdown, subjectively assessed higher health risk and a low level of knowledge about the COVID-19 pandemic did not significantly correlate with a severity of depression and anxiety, as well as general quality of life. However, the comparison of the results obtained in HADS and SF-36 scales show a significant improvement in both categories. Rehabilitation activities, including physical training, cognitive exercise and social therapy, reduce the severity of the symptoms and have a positive effect on the overall quality of life in patients suffering from schizophrenia and affective disorders. Therefore, holistic mental health support services may positively affect building an individual resilience. The severity of anxiety symptoms during the COVID-19 pandemic shows a negative correlation with the patient's age.