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INTRODUCTION: The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania. MATERIALS AND METHODS: Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients' degree of satisfaction. Data extracted covered a period of two years (1 March 2019-28 February 2021) before and during the first year of the COVID-19 pandemic. RESULTS: We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased. CONCLUSIONS: The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.
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Introduction: The search for biomarkers has been central to efforts of improving clinical diagnosis and prognosis in psychopathology in the last decades. The main approach has been to validate biomarkers that could accurately discriminate between clinical diagnoses of very prevalent forms of psychopathology. One of the most popular electrophysiological markers proposed for discrimination in depressive disorders is the electroencephalography (EEG)-derived frontal alpha asymmetry. However, the validity, reliability and predictive value of this biomarker have been questioned in recent years, mainly due to conceptual and methodological heterogeneity. Methods: In the current non-experimental, correlational study we investigated relationship of resting-state EEG alpha asymmetry from multiple sites (frontal, frontolateral, and parietal) with different forms of depressive disorders (varying in type or severity), in a clinical sample. Results: Results showed that alpha asymmetry in the parietal (P3-P4) was significantly higher than in the frontal (F3-F4) and frontolateral sites (F7-F8). However, we did not find significant relations between alpha asymmetry indices and our depressive disorder measures, except for a moderate positive association between frontolateral alpha asymmetry (eyes-closed only) and depressive disorder severity (determined through clinical structured interview). We also found no significant differences in alpha asymmetry between participants, depending on their depression type. Discussion: Based on results, we propose the parietal and frontolateral asymmetry indices to form hypotheses that should not be abandoned in the depression markers research, but worth for further experimental research. Methodological and clinical implications of the current findings are discussed.
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The spread of the COVID-19 virus created more than a medical crisis, while it also negatively affected the mental health of the general population. This context increased the vulnerability of the psychiatric population. While research interest highly targeted vaccine hesitancy and acceptance, many studies focused on trust issues-both in vaccine efficacy and in communication with authorities. Less is known about the psychological underpinnings of the COVID vaccination decision, specifically in the high-uncertainty circumstances due to the novelty of the virus. In a cross-sectional study, we investigated the predictive value of several cognitive (perceived risk, vulnerability, uncertainty, and trust in one's decision) and behavioral (previous vaccinations, social media use, and practicing preventive behavior) factors, for the vaccination decision against COVID-19, for 252 psychiatric inpatients (data collected between September 2021 and February 2022). Demographics and diagnostics were also considered. We found a significant relationship between the "Perceived risk of vaccination" and the choice of vaccination (χ2(2, N = 252) = 58.59, p ≤ 0.001), and between the "Trust in own decision to vaccinate" and the decision to vaccinate (χ2(2, N = 252) = 31,5, p ≤ 0.001). The overall regression model was statistically significant (χ2 (9, N = 252) = 97.1, p < 0.001), with between 30% and 45% of the variance in the odds of a positive decision explained by the predictor set. The model coefficients analysis showed that an individual with a psychiatric disorder but with higher confidence in their decision had significant (p < 0.001) increased odds of the decision to vaccinate against COVID-19 by 893%. A former voluntary vaccination did not significantly associate with the decision to vaccinate against COVID-19 (χ2(1, N = 252) = 2.74, p > 0.05) in this special population. No other behavioral factors, diagnosis, or demographics were significant as predictors, for the clinical psychiatric population surveyed, except the educational level. Implications for future vaccination acceptance of this special population are discussed.
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The coronavirus disease 2019 (COVID-19) pandemic and the related lockdown measures have had intense negative impacts on the psychological well-being of both adults and children. Among such impacts is a significant increase in mortality salience and changes in how people deal with grief and losses. This qualitative research used semi-structured interviews with 23 Italian parents to draw insights on the impact of the pandemic on children aged 5-15 years with regard to their representation of death and the eventual role that family spirituality/ religiosity played in helping them understand both the concept of dying and possibly the pandemic itself. From the data analysis, four main thematic areas emerged: "Lockdown experience," "Fears and worries related to COVID-19," "Emergence of thoughts on the process of dying," and "Representation of death and the impact of religious beliefs." The participants highlighted how stressful the lockdown measures have been for their children and the anxiety that their children have experienced because of fears related to the pandemic. The interviews also surfaced how living in a religious family has contributed significantly to shaping children's representation and understanding of death and sometimes even helped both the parents and their children to face difficult moments such as those caused by the pandemic.
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In Italy, the problem of asbestos pollution is increasing in severity. In fact, in recent years, the number of people affected by asbestos-related illnesses has been growing because of the fibre's slowly evolving effects and its progressive pollution in the environment adjacent to the places where it is processed. Even though the physical consequences of asbestos are now quite clear, few studies have examined the psychological consequences of this kind of disaster. Since it is difficult to perceive its pathogenicity in daily life, this study was conducted in the affected areas of north-eastern Italy, using the qualitative research in psychology with 51 persons who experienced asbestos-related illnesses (19 sick persons and 37 relatives of sick persons). Their narratives described being rooted in a space contaminated by an invisible enemy. In particular, attention was paid to the consequent solastalgia, a kind of mourning arising from loss of place attachment. Results of the qualitative analysis revealed how the different phases of the Elisabeth Kubler-Ross DABDA (Denial Anger Bargaining Depression Acceptance) model of coping with death constitute such feelings, whereas the dual-process model of Stroebe and Schut emphasised how these people seem to be loss oriented because of their perceived lack of community restoration. A discussion of the relationships between attribution of responsibility, entirely external and mostly inscribed in the DABDA categories of ?anger' and ?acceptance', is presented, with further considerations about mourning and the need to improve specific psychological support in this field of environmental disaster.
