Catatonia during COVID-19 pandemic - diagnostic and therapeutic approach.

Catatonia can be defined as an etiologically heterogeneous syndrome, with predominant psychomotor disturbances. Historically, the concept of catatonia has been associated with mental disorders, especially schizophrenia. However, nowadays our understanding of catatonia has evolved to recognize it as neuropsychiatric syndrome that can arise from diverse etiological factors ranging from neurological to systemic diseases. Furthermore, there is now a recognized association between catatonia and a broader spectrum of mental disorders. Catatonia as a secondary neuropsychiatric syndrome may be a clinical manifestation of COVID-19 also due to the known neuroinvasive potential of the SARS-CoV-2 virus or in connection with the overall somatic alteration of the patient. In clinical practice, co-infection with SARS-CoV-2 could impede the process of diagnosing and treating catatonia as the primary psychopathological syndrome. The administration of benzodiazepines and electroconvulsive therapy could endanger the patient's physical health with active COVID-19 infection. Management of catatonic syndrome associated with COVID-19 is a challenge and requires a comprehensive therapeutic approach. The article demonstrates the above-mentioned difficulties of treatment through two case presentations (Tab. 2, Ref. 29). Text in PDF www.elis.sk Keywords: catatonia, COVID-19, SARS-CoV-2, neuropsychiatry, diagnosis, differential.

Connections between and within extended psychosis and autistic phenotypes and social relationships in the general population.

OBJECTIVES: Non - clinical individuals with higher levels of autistic traits and psychotic experiences also have problems in social relationships. Therefore, this study aimed to model complex associations between autistic and psychotic phenotypes and indicators of social relationships in the general population using a network approach. METHODS: The sample consisted of 649 participants with a mean age of M = 40.23 and SD = 13.09 sampled from the general population. The sample was representative for the 18-65 years old general population in the Slovak Republic. The following scales were administered: Community Assessment of Psychic Experiences, The Comprehensive Autistic Trait Inventory, and NIH Toolbox Adult Social Relationship Scales. Associations between variables and the presence of communities were identified using Exploratory Graph Analysis. RESULTS: Results revealed four highly stable and densely connected communities within the network: social relationships, autistic traits, positive symptoms, and the last one consisting of all negative symptoms, problems in social interactions, and depression. The most important variables in the network were difficulties in social interaction, perceived rejection, bizarre ideas, depression, and social withdrawal. CONCLUSIONS: The psychotic and autistic phenotypes in the general population showed a network of connections with characteristics of social relationships. Community detection revealed that autistic traits and psychotic-like experiences formed relatively independent communities. Further, there was substantial overlap between negative symptoms (e.g., social withdrawal), and core features of the autistic phenotype, especially social interaction difficulties.

What mental health experts in Slovakia are learning from COVID-19 pandemic?

INTRODUCTION: The COVID-19 pandemic was confirmed to have spread to Slovakia on 6th March 2020. To date of paper submission, it has very favorable course. However, since the beginning healthcare workers have been working under increasing pressure, anxiety and fear. AIM: Authors evaluated the psychosocial impact of COVID-19 pandemic on mental health experts and their clinical practice in Slovakia. MATERIALS AND METHODS: A total of 157 mental health experts (79% women) submitted their responses via online questionnaire. RESULTS: The most frequent occupation categories were 38.2% outpatient psychiatrists, 26.1% inpatient psychiatrists and 20.4% psychologists. The mental health experts felt maximum of stress during the peak of Slovak COVID-19 crisis, which was identified as the situation just after the declaring the state of emergency by Slovak government. The main sources of stress were statistical data, prognoses and other public presented information. Mental health experts felt mainly personal stress, then general and working stress. They identified also pathological effect of COVID-19 pandemic on the mental status of their patients, especially with anxiety and affective disorders and advantages of use of telemedicine. CONCLUSION: Psychosocial support in Slovakia was newly organized in COVID-19 pandemic for medical professionals, patients and other inhabitants under high stress within a very short time. This unexpected situation has revealed to Slovakia the need for reform of the mental healthcare system.