The wide spectrum of COVID-19 neuropsychiatric complications within a multidisciplinary centre.

A variety of neuropsychiatric complications has been described in association with COVID-19 infection. Large scale studies presenting a wider picture of these complications and their relative frequency are lacking. The objective of our study was to describe the spectrum of neurological and psychiatric complications in patients with COVID-19 seen in a multidisciplinary hospital centre over 6 months. We conducted a retrospective, observational study of all patients showing neurological or psychiatric symptoms in the context of COVID-19 seen in the medical and university neuroscience department of Assistance Publique Hopitaux de Paris-Sorbonne University. We collected demographic data, comorbidities, symptoms and severity of COVID-19 infection, neurological and psychiatric symptoms, neurological and psychiatric examination data and, when available, results from CSF analysis, MRI, EEG and EMG. A total of 249 COVID-19 patients with a de novo neurological or psychiatric manifestation were included in the database and 245 were included in the final analyses. One-hundred fourteen patients (47%) were admitted to the intensive care unit and 10 (4%) died. The most frequent neuropsychiatric complications diagnosed were encephalopathy (43%), critical illness polyneuropathy and myopathy (26%), isolated psychiatric disturbance (18%) and cerebrovascular disorders (16%). No patients showed CSF evidence of SARS-CoV-2. Encephalopathy was associated with older age and higher risk of death. Critical illness neuromyopathy was associated with an extended stay in the intensive care unit. The majority of these neuropsychiatric complications could be imputed to critical illness, intensive care and systemic inflammation, which contrasts with the paucity of more direct SARS-CoV-2-related complications or post-infection disorders.

[When burnout sweeps into CMPs]. / Quand le burnout fait son entrée au CMP.

There have been significant changes in recent years in what psychiatrists are expected to accomplish in CMP [centre médicopsychologique (medical-psychological centre)] consultations. Back in the 1980s, most of the patients seen were psychotic. Then, all of a sudden, psychiatrists began to see a whole new category of cases at CMPs: patients who were exhausted and no longer able to do their jobs properly. This included a wave of civil servants affected by restructuring, followed by private sector employees. These days, most of those who consult for burnout are health workers.

[Transcranial magnetic stimulation used in psychiatry]. / Stimulation magnétique transcrânienne en psychiatrie.

Repetitive transcranial magnetic stimulation is a non-invasive treatment technique, using electromagnetism properties. It has been used for around twenty years in neurology (treatment of neuropathic pain, certain abnormal movements, Parkinson's disease), and in psychiatry (obsessive compulsive disorder, hallucinations, mood disorders, etc.). The presence and support of a nurse during the sessions is essential.

[Suicide in elderly people, an underestimated public health phenomenon]. / Le suicide du sujet âgé, un phénomène de santé publique sous-estimé.

Although adolescent suicide is more widely spoken about, the suicide rate is actually higher among elderly people. Preventing elderly people from attempting suicide and raising awareness among family and friends are priorities for our nursing practices.