Delusions with content related to COVID-19 pandemic, in non-infected psychiatric hospitalized patients: a six-case series.

We briefly present a case series of six patients hospitalized in the Department of Psychiatry, University General Hospital of Ioannina, between the first (starting March 23, 2020) and the second (starting November 7, 2020) lockdown in Greece who presented with COVID-19 - related delusional ideas. All patients had negative PCR prior to admission and no history of COVID-19 infection.The first three of our cases were admitted during the first lockdown, between March 23 and May 4, one involuntary and the other two voluntary. The first one was diagnosed with acute and transient psychosis (F23 - First Episode Psychosis) and the other two with psychotic depression (F32.3). Three additional patients were admitted voluntary after the end of the first lockdown. One was diagnosed with acute and transient psychosis (F23-First Episode Psychosis) and the other two were relapses of a known psychiatric disorder (Bipolar disorder F31.5 and Psychotic depression F32.3). At follow-up six months after discharge all patients were in remission following antipsychotic medication, among other medicines. These cases reveal that COVID-19 pandemic may have an impact on the delusional content of new or preexisting psychotic disorders during the COVID-19 pandemic.

Risk factors for gestational diabetes: An umbrella review of meta-analyses of observational studies.

BACKGROUND/OBJECTIVE: Gestational diabetes mellitus (GDM) is a common pregnancy complication, with complex disease mechanisms, and several risk factors may contribute to its onset. We performed an umbrella review to summarize the evidence from meta-analyses of observational studies on risk factors associated with GDM, evaluate whether there are indications of biases in this literature and identify which of the previously reported associations are supported by convincing evidence. METHODS: We searched PubMed and ISI Web of Science from inception to December 2018 to identify meta-analyses examining associations between putative risk factors for GDM. For each meta-analysis we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias. RESULTS: Thirty eligible meta-analyses were identified, providing data on 61 associations. Fifty (82%) associations had nominally statistically significant findings (P<0.05), while only 15 (25%) were significant at P<10-6 under the random-effects model. Only four risk factors presented convincing evidence:, low vs. normal BMI (cohort studies), BMI ~30-35 kg/m2 vs. normal BMI, BMI >35 kg/m2 vs. normal BMI, and hypothyroidism. CONCLUSIONS: The compilation of results from synthesis of observational studies suggests that increased BMI and hypothyroidism show the strongest consistent evidence for an association with GDM. Diet and lifestyle modifications in pregnancy should be tested in large randomized trials. Our findings suggest that women with known thyroid disease may be offered screening for GDM earlier in pregnancy.