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1.
Georgian Med News ; (306): 92-98, 2020 Sep.
Artigo em Russo | MEDLINE | ID: mdl-33130654

RESUMO

The goal is to develop and evaluate the effectiveness of a psychoeducational program (PP) aimed at timely detection, prevention of the formation and prevention of chronicity of mental disorders in internally displaced persons (IDPs). 414 IDPs took part in the research. A complex of clinical-psychopathological, psychometric, psychodiagnostic and statistical methods were used. It was found that the group of IDPs is heterogeneous and includes 3 categories of persons: group I - IDPs without signs of mental disorders (conditionally healthy) (53,86%), group II - IDPs with individual symptoms of mental disorders (risk group) (20,05%) and group III - IDPs with established mental disorders (26,09%). The examined IDPs of the III group were found mental disorders, predominantly of the anxiety-depressive spectrum. Factors of psychic traumatization (FPT) were assessed in a dynamic aspect: retrospectively (during of staying in the anti-terrorist operation (ATO) zone), 12 and 24 months after leaving the ATO zone and during of examination. The dynamics of FPT and their significance in time and with regard to gender specificity were shown. In order to timely identify and prevent the formation of mental disorders in IDPs and increase their adaptive capabilities, it is proposed to use PP, which had a group structured work format. The results of its approbation were presented and it were proved that the using of PP could significantly increase the level of psychological adaptation of IDPs by reducing the level of mental stress, reactive anxiety and the severity of negative perception of the future and improving the quality of life.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Saúde Mental , Qualidade de Vida , Estudos Retrospectivos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/prevenção & controle
2.
BMJ Case Rep ; 13(10)2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33130587

RESUMO

A previously fit and well 37-year-old male healthcare worker presented with confusion, psychotic symptoms and a suicide attempt in the context of a new COVID-19 diagnosis. Following surgical interventions and an extended admission to the intensive care unit, he made a good recovery in terms of both his physical and mental health. A number of factors likely contributed to his presentation, including SARS-CoV-2 infection, severe insomnia, worry, healthcare worker-related stress, and the unique social and psychological stressors associated with the COVID-19 pandemic. This case highlights the need to further characterise the specific psychiatric sequelae of COVID-19 in community settings, and should remind general medical clinicians to be mindful of comorbid psychiatric symptoms when assessing patients with newly diagnosed COVID-19.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Transtornos Psicóticos/complicações , Transtornos Psicóticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Tentativa de Suicídio/prevenção & controle , Adulto , Infecções por Coronavirus/psicologia , Humanos , Masculino , Enfermeiros/psicologia , Estresse Ocupacional/complicações , Estresse Ocupacional/diagnóstico , Pandemias/prevenção & controle , Pandemias/estatística & dados numéricos , Pneumonia Viral/psicologia , Prognóstico , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/fisiopatologia , Medição de Risco , Transtornos de Estresse Pós-Traumáticos/complicações , Estresse Psicológico , Resultado do Tratamento , Reino Unido
3.
Arch. argent. pediatr ; 118(5): 306-312, oct 2020. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1122006

RESUMO

Antecedentes. Los prematuros de muy bajo peso al nacer suelen generar estrés en sus madres, que puede persistir más de seis meses luego del nacimiento. Este trastorno se denomina estrés postraumático crónico (EPTC).Objetivo. Detectar frecuencia y síntomas del EPTC en madres de prematuros de muy bajo peso al nacer menores de 32 semanas de gestación.Métodos. Estudio transversal, mediante una encuesta voluntaria autoadministrada a madres con embarazo único. Se empleó la Escala de trauma de Davidson.Resultados. Se realizaron 172 encuestas; se eliminaron 26 incompletas. De 146 madres incorporadas, 64 (el 44 %) presentaron estrés. Las madres con EPTC tuvieron un 46,8 % de prematuros nacidos < 28 semanas vs. un 31,7 % en madres sin EPTC (p: 0,032). Los prematuros con peso < 1000 g fueron más frecuentes en madres con EPTC, el 53 % vs. el 34 %en madres sin estrés(p: 0,011). No hubo diferencias entre grupos de madres en morbilidad neonatal (p: 0,072). La morbilidad grave fue más frecuente en madres con EPTC, el 44 %. vs. el 28 % (p: < 0,004). Las madres con menor escolaridad tuvieron EPTC significativamente mayor (p: 0,013). No hubo diferencias en la edad materna (p: 0,313), edad de los niños (p: 0,405) y días de hospitalización en la Unidad (p: 0,316).Conclusión. El 44 % de las madres de prematuros de muy bajo peso al nacer tuvieron EPTC, significativamente más frecuente en prematuros ≤ 28 semanas, con peso < 1000 g, morbilidad grave y menor escolaridad materna


Background. The birth of very low birth weight (VLBW) preterm infants causes stress in mothers, which may continue for over 6 months. This is called chronic post-traumatic stress disorder (CPTSD).Objective. To detect CPTSD frequency and symptoms among mothers of VLBW preterm infants born before 32 weeks of gestation.Methods. Cross-sectional cohort study in mothers using a survey based on the Davidson Trauma Scale.Results. A total of 172 surveys were administered but 146 were included; 82 (56 %) did not have stress symptoms, while 64 (44 %) had CPTSD. Mothers with CPTSD accounted for 46.8 % of preterm infants born at ≤ 28 weeks versus 31.7 % in those without CPTSD (p = 0.032). Preterm infants with a birth weight < 1000 g were significantly more frequent among mothers with CPTSD, 53 % versus 34 % among those without stress (p = 0.011). No differences were observed in neonatal morbidity (p = 0.072). Severe morbidity in preterm infants was significantly more common among those with CPTSD, 43.8 % versus 28 % (p ≤ 0.004).Mothers who had a lower education accounted significantly for more cases of CPTSD (p = 0.013). No significant differences were seen in maternal age (p = 0.313), children's age (p = 0.405), and length of stay (p = 0.316).Conclusion. Among the mothers of VLBW preterm infants, 44 % had CPTSD, and this was significantly more common among those who had preterm infants born at ≤28 weeks, a birth weight <1000 g, severe morbidity, and a lower level of education.


Assuntos
Humanos , Feminino , Transtornos de Estresse Pós-Traumáticos , Estresse Psicológico , Estudos Transversais , Inquéritos e Questionários , Idade Materna , Recém-Nascido de muito Baixo Peso , Mães/psicologia
4.
Cancer Cytopathol ; 128(10): 679-680, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33006815
5.
Chron Respir Dis ; 17: 1479973120962800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000648

RESUMO

INTRODUCTION: The COVID pandemic has had a high psychological impact on healthy populations. Increased levels of perceived stress, depression, and insomnia are expected, especially in people with pre-existing medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD), who seem to be particularly vulnerable. However, the difference in psychological distress frequency between asthma and COPD patients is unknown. OBJECTIVE: To compare the prevalence of depression, perceived stress related to COVID, post-traumatic stress, and insomnia in asthma and COPD patients at a pulmonology clinic in Santa Marta, Colombia. METHODS: A cross-sectional study was designed. The patients were contacted by telephone. An electronic link was sent to those who accepted. The questionnaire asked for perceived stress related to COVID-19, post-traumatic stress symptoms, depressive symptoms, and insomnia risk. RESULTS: 148 asthma patients and 144 COPD patients participated in, between 18 and 96 years. The prevalence of high COVID-19 perceived stress was 10.6% (n = 31); post-traumatic stress risk, 11.3% (n = 33); depression risk, 31.5% (n = 92); and insomnia risk, 57.7% (n = 169). No significant differences were found between asthma and COPD in indicators of psychological distress. CONCLUSIONS: Asthma and COPD patients present similar frequencies of depression risk, COVID-19 perceived stress, post-traumatic stress risk, and insomnia risk during the Colombian lockdown. It is essential to evaluate and manage psychological distress among asthma and COPD patients. It can reduce the risk of exacerbation and improve the quality of life.


Assuntos
Asma , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono , Transtornos de Estresse Pós-Traumáticos , Asma/epidemiologia , Asma/psicologia , Betacoronavirus , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Depressão/psicologia , Autoavaliação Diagnóstica , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Angústia Psicológica , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pesquisa Qualitativa , Autoimagem , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
6.
Curr Psychiatry Rep ; 22(12): 66, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-33030637

RESUMO

PURPOSE OF REVIEW: The ability to effectively prepare for and respond to the psychological fallout from large-scale disasters is a core competency of military mental health providers, as well as civilian emergency response teams. Disaster planning should be situation specific and data driven; vague, broad-spectrum planning can contribute to unprepared mental health teams and underserved patient populations. Herein, we review data on mental health sequelae from the twenty-first century pandemics, including SARS-CoV2 (COVID-19), and offer explanations for observed trends, insights regarding anticipated needs, and recommendations for preliminary planning on how to best allocate limited mental health resources. RECENT FINDINGS: Anxiety and distress, often attributed to isolation, were the most prominent mental health complaints during previous pandemics and with COVID-19. Additionally, post-traumatic stress was surprisingly common and possibly more enduring than depression, insomnia, and alcohol misuse. Predictions regarding COVID-19's economic impact suggest that depression and suicide rates may increase over time. Available data suggest that the mental health sequelae of COVID-19 will mirror those of previous pandemics. Clinicians and mental health leaders should focus planning efforts on the negative effects of isolation, particularly anxiety and distress, as well as post-traumatic stress symptoms.


Assuntos
Infecções por Coronavirus/psicologia , Necessidades e Demandas de Serviços de Saúde , Saúde Mental , Pneumonia Viral/psicologia , Ansiedade , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Angústia Psicológica , Transtornos de Estresse Pós-Traumáticos
7.
Artigo em Russo | MEDLINE | ID: mdl-33081443

RESUMO

OBJECTIVE: To study a role of traumatic brain injury (TBI) in the development of posttraumatic stress disorder (PTSD) in ex combatants. MATERIAL AND METHODS: Eighty-seven ex combatants were studied. The duration of follow-up was 15-18 years. The diagnosis was established in accordance with ICD-10 criteria. Patients were stratified by diagnosis into main group (PTSD) and comparison group (organic brain injury with reduced symptoms of PTSD ). A psychopathological method and a battery of questionnaires and scales, including those adapted for assessment of consequences of combat trauma, were administered. RESULTS AND CONCLUSION: Clinical presentations of both groups in posttraumatic period show the similarity and homogeneity of posttraumatic disorders in these groups. In the future, the pathogenetic role of TBI severity appears more clearly, which, depending on the severity, leads to the formation of an organic lesion of the brain or performs only a pathoplastic role, giving some features to the clinical picture of PTSD. It was found that the more severe the injury, the greater the likelihood of PTSD transition to organic brain damage. It is emphasized that PTSD treatment is a continuous, long-term, complex and graded process that includes pharmacotherapy, psychotherapy, psychosocial interventions.


Assuntos
Lesões Encefálicas Traumáticas , Lesões Encefálicas , Transtornos de Estresse Pós-Traumáticos , Encéfalo , Lesões Encefálicas Traumáticas/diagnóstico , Humanos , Psicoterapia , Transtornos de Estresse Pós-Traumáticos/diagnóstico
8.
Psychiatr Danub ; 32(Suppl 3): 320-336, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030447

RESUMO

The war in Bosnia and Herzegovina (1992-1995) was an extremely hard traumatic event with different losses, separations of people, injuries, hard physical and psychical suffering of everyone. Children were especially in difficult conditions. One of the most remarkable things about children, as anyone who works with them soon finds out, is their resilience. While children are vulnerable to psychic damage and, if the damage is deep enough, to delays in emotional and even physical growth, they also have an astonishing capacity to bounce back. This is one of the most rewarding things about treating traumatized children. For many children, it takes very little, perhaps only some words of understanding, to help them tap into their own ability to heal. Taking care of child war psycho-trauma was a difficult task for me, as the war-time head of Department of psychiatry, without enough knowledge in child psycho-trauma and as person with a high responsibility, to organize together with other psychological caretakers of children, especially refugee children. This presentation will be some kind of my remembrance of period of 20-25 years ago when we, I think did good work of what we could and what we knew.


Assuntos
Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Guerra/psicologia , Adolescente , Adulto , Idoso , Bósnia e Herzegóvina , Criança , Família/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Refugiados/psicologia , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos/reabilitação , Adulto Jovem
9.
Psychiatr Danub ; 32(Suppl 3): 360-363, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030453

RESUMO

The establishment of the United Nations after World War II raised hopes of a new era of peace. This was over-optimistic. Between 1945 and 1992, there were 149 major wars, killing more than 23 million people. Recent developments in warfare have significantly heightened the dangers for children. During the last decade child war victims have included: 2 million killed; 4-5 million disabled; 12 million left homeless; more than 1 million orphaned or separated from their parents; some 10 million psychologically traumatized. Researches indicate that children do develop PTSD after experiencing very stressful, life-threatening events such as happen in war. Wars of 21st century are often guerrilla-type civil wars in which women and children are not only the main victims, but are deliberately targeted. Thousands are displaced both internally and across borders. Wars at the end of nineties of 20th century in the region of ex Yugoslavian countries brought all the cruelty of war vivid again on European ground. Population were exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. During the War in Bosnia and Herzegovina 1992-1995 there were about 100 000 people killed (20% woman and 3.5% children) and about 18 000 children were orphaned because of war. Children are not capable to regulate their emotions and hyper-arousal on their own. It depends of the way how their parents (caretaker) regulate her/his own emotions. During the war weak child's ego is paralyzed with intensive stimuli and floating anxiety, it does not manage to make constructive solution for traumatic experiences in such a short time. Mothers with small children are especially vulnerable group during the war time: they are supposed to take care about children and feel happiness, what is almost impossible Severe war experiences could cause depressive symptoms in mothers, what reduce their emotional disposability and could lead in different form of the child's neglecting. PTSD symptoms were lasting longer in children if their mothers have had functioning problems. Traumatization of mothers is connected with different behavior problems in their children. Wars are continuing all over the world and there is a continuity of researches about their consequences on children. Any programs that intend to mitigate the psychological effects of such trauma need to adopt a public health approach aimed at reaching many thousands.


Assuntos
Transtornos de Estresse Pós-Traumáticos/epidemiologia , Guerra/psicologia , Guerra/estatística & dados numéricos , Bósnia e Herzegóvina/epidemiologia , Criança , Humanos , Mães/psicologia , Comportamento Problema , Transtornos de Estresse Pós-Traumáticos/psicologia , Violência/psicologia , Violência/estatística & dados numéricos , Lesões Relacionadas à Guerra/epidemiologia , Lesões Relacionadas à Guerra/psicologia
10.
Psychiatr Danub ; 32(Suppl 3): 364-366, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030454

RESUMO

Post-traumatic stress disorder (PTSD) is a spectrum disorder whose symptoms show psychological, neurobiological dysregulation and poorer functionality of a person on the social plane. PTSD characteristics are symptoms from four clusters: symptoms of intrusiveness, avoidance, negative changes in cognition and mood and changes in excitability and reactivity. Traumatic experiences of war veterans can have an impact on the development of psychopathology in their children's lives. The impact of posttraumatic stress disorder of war veterans is negatively manifested in a broader sense through secondary traumatization and is manifested differently in relation to the period of childhood and adolescence. The period of childhood and adolescence represents a delicate and dynamic period that requires adaptation and functionality in adulthood. The epidemiological studies so far indicate the link between the post-traumatic stress disorder of war veterans with the mental problems of their children.


Assuntos
Filho de Pais Incapacitados/psicologia , Fadiga por Compaixão/psicologia , Psicologia do Adolescente , Psicologia da Criança , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adolescente , Bósnia e Herzegóvina , Criança , Feminino , Humanos , Masculino
11.
Psychiatr Danub ; 32(Suppl 3): 367-370, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33030455

RESUMO

Although family should be the basis for the development and formation of a child's personality, violence is mostly done in the family, and remains undiscovered for a long time. The real number of abused children is much more than that displayed in the registered cases. The secrecy of the problem is an important feature of this phenomenon. Families in which abuse takes place are mostly isolated. Social isolation does not come about by chance; secrecy is usually encouraged by an abuser to control over famoly members. In most cases, social reaction to violence is late, inadequate and focused on the consequences, but not on the causes. "Abuse implies an act of execution that directly inflicts damage, while neglect implies an act of non-fulfillment of something that is necessary for the well-being of a child". The most common forms of domestic violence are physical, emotional abuse in the presence of violence against the mother, and in a lesser extent sexual abuse. In addition, there is physical, emotional, educational and medical neglect. The presence of violence against the mother and the feeling of impotence leave the same consequences as the endured violence. It is considered that children living in violent families are likely to live under cumulative stress. Traumatic responses include a wide range of conditions from acute stress reactions through post-traumatic stress disorder to complex long-lasting, repeated trauma syndrome. All children will not react to this kind of experience in the same way, with the protective and risk factors in developmental psychopathology having a significant role to play. Because of their developmental vulnerability and dependency, children are at greater risk of violence than adults. Researches point to the need for a multidisciplinary approach to treatment and prevention of child abuse, with greater interaction between health institutions, relevant centers for social work, police, court, government and non-governmental sector, and the existence of adequate family and criminal laws.


Assuntos
Maus-Tratos Infantis/psicologia , Violência Doméstica/psicologia , Trauma Psicológico/psicologia , Adulto , Criança , Maus-Tratos Infantis/legislação & jurisprudência , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/terapia , Violência Doméstica/legislação & jurisprudência , Violência Doméstica/prevenção & controle , Feminino , Humanos , Masculino , Mães/psicologia , Trauma Psicológico/prevenção & controle , Trauma Psicológico/terapia , Fatores de Risco , Instituições Acadêmicas , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia
12.
Best Pract Res Clin Anaesthesiol ; 34(3): 553-560, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004166

RESUMO

This comprehensive review aims to explain the potential impact of coronavirus disease 2019 (COVID-19) on mental wellbeing of healthcare professionals (HCPs). Based on up-to-date research and psychological diagnostic manuals of Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 11th revision, we describe associated psychological disorders and experiences that may arise related to COVID-19. Appropriate psychological measures are introduced, along with potential methodological limitations. Lastly, resilience building and preventative measures with interventions that may mitigate the impact on mental health of HCPs are described.


Assuntos
Betacoronavirus , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Pandemias
13.
BMC Psychol ; 8(1): 105, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023667

RESUMO

BACKGROUND: Trauma has a major impact on the mental health and wellbeing of people globally. Friends, family and members of the public are often well positioned to provide initial assistance if someone is experiencing extreme distress following a potentially traumatic event. Expert consensus guidelines for high income, Western countries on how to do this were published in 2008. The aim of the current study was to re-develop these guidelines to ensure they are current and reflect best practice. METHODS: The Delphi consensus method was used to determine which helping statements should be included in the guidelines. Helping statements were derived from a systematic search of literature that considered how a member of the public could help someone experiencing extreme distress following a potentially traumatic event. Two expert panels, comprising 28 mental health professionals with expertise in managing trauma and 26 consumer advocates, rated each statement. Statements were accepted for inclusion in the guidelines if they were endorsed by at least 80% of each panel. RESULTS: Out of 183 statements, 103 were endorsed as appropriate helping actions in providing assistance to someone experiencing extreme distress following a potentially traumatic event. These statements were used to form the re-developed guidelines. CONCLUSION: This study has resulted in a more comprehensive set of guidelines than the original version, with the endorsement of 103 helping actions, compared to 65 previously. The updated guidelines better represent the complexities of experiencing trauma and the considered approach required when providing first aid after a potentially traumatic event. The additional guidance on providing initial assistance, talking about the trauma, offering short-term assistance and seeking appropriate professional help reflects current knowledge. A notable addition is the inclusion of content on how a first aider can assist after a disclosure of abuse. The guidelines are available to the public and will inform future updates of Mental Health First Aid training courses.


Assuntos
Primeiros Socorros , Guias como Assunto , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/terapia , Consenso , Técnica Delfos , Humanos , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários
14.
Trials ; 21(1): 870, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33087178

RESUMO

BACKGROUND: The acknowledgment of the mental health toll of the COVID-19 epidemic in healthcare workers has increased considerably as the disease evolved into a pandemic status. Indeed, high prevalence rates of depression, sleep disorders, and post-traumatic stress disorder (PTSD) have been reported in Chinese healthcare workers during the epidemic peak. Symptoms of psychological distress are expected to be long-lasting and have a systemic impact on healthcare systems, warranting the need for evidence-based psychological treatments aiming at relieving immediate stress and preventing the onset of psychological disorders in this population. In the current COVID-19 context, internet-based interventions have the potential to circumvent the pitfalls of face-to-face formats and provide the flexibility required to facilitate accessibility to healthcare workers. Online cognitive behavioral therapy (CBT) in particular has proved to be effective in treating and preventing a number of stress-related disorders in populations other than healthcare workers. The aim of our randomized controlled trial study protocol is to evaluate the efficacy of the 'My Health too' CBT program-a program we have developed for healthcare workers facing the pandemic-on immediate perceived stress and on the emergence of psychiatric disorders at 3- and 6-month follow-up compared to an active control group (i.e., bibliotherapy). METHODS: Powered for superiority testing, this six-site open trial involves the random assignment of 120 healthcare workers with stress levels > 16 on the Perceived Stress Scale (PSS-10) to either the 7-session online CBT program or bibliotherapy. The primary outcome is the decrease of PSS-10 scores at 8 weeks. Secondary outcomes include depression, insomnia, and PTSD symptoms; self-reported resilience and rumination; and credibility and satisfaction. Assessments are scheduled at pretreatment, mid-treatment (at 4 weeks), end of active treatment (at 8 weeks), and at 3-month and 6-month follow-up. DISCUSSION: This is the first study assessing the efficacy and the acceptability of a brief online CBT program specifically developed for healthcare workers. Given the potential short- and long-term consequences of the COVID-19 pandemic on healthcare workers' mental health, but also on healthcare systems, our findings can significantly impact clinical practice and management of the ongoing, and probably long-lasting, health crisis. TRIAL REGISTRATION: ClinicalTrials.gov NCT04362358 , registered on April 24, 2020.


Assuntos
Betacoronavirus/genética , Terapia Cognitivo-Comportamental/métodos , Infecções por Coronavirus/terapia , Pessoal de Saúde/psicologia , Intervenção Baseada em Internet/estatística & dados numéricos , Pneumonia Viral/terapia , Adulto , Idoso , Biblioterapia/métodos , Estudos de Casos e Controles , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Assistência à Saúde/estatística & dados numéricos , Depressão/epidemiologia , Depressão/prevenção & controle , Feminino , França/epidemiologia , Humanos , Masculino , Saúde Mental/normas , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Prevalência , Estudos Prospectivos , Resiliência Psicológica , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/prevenção & controle , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Resultado do Tratamento
15.
PLoS One ; 15(10): e0240646, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33104711

RESUMO

The COVID-19 pandemic puts health workers at increased risk of adverse mental health outcomes. However, no studies have assessed health workers' experiences using qualitative methods during the COVID-19 outbreak in the United States to identify novel factors that could relate to their mental health. In May 2020, we distributed an online survey to health workers across 25 medical centers throughout the United States. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Primary Care-Post-Traumatic Stress Disorder, and Alcohol Use Disorders Identification Test-Concise and associated cutoff values were used to assess rates of probable major depression, generalized anxiety disorder, post-traumatic stress disorder, and alcohol use disorder, respectively. To provide insight into the factors shaping these and other mental health conditions, we included two open-ended questions asking respondents to recount their most upsetting and hopeful experiences during the COVID-19 pandemic and how it made them feel. Using a hybrid inductive-abductive approach and thematic content analysis, we created a Social Ecological Model to represent themes among health workers' experiences within five ecological levels: individual, interpersonal, organization, community, and public policy. Of the 1,132 participants who completed the survey, 14.0% had probable major depression, 15.8% probable generalized anxiety disorder, 23.1% probable post-traumatic stress disorder, and 42.6% probable alcohol use disorder. Individual level themes included participants' personal health and self-care behaviors. Interpersonal level themes included the health of their social circle, family functioning, and social support. Organization level themes included their hospital's management, resources, patient care, routine, and teams. Themes in the community level included the media, scientific knowledge about COVID-19, morale, behavior, and support of health workers. Lastly, government and health system leadership and shelter-in-place policy were themes within the public policy level. Our findings provide insights into novel factors that have impacted health workers' wellbeing during the COVID-19 pandemic. These factors should be further explored to inform interventions and public policy that mitigate mental health morbidities among health workers during this and future outbreaks.


Assuntos
Alcoolismo/etiologia , Transtornos de Ansiedade/etiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Transtorno Depressivo/etiologia , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Adulto , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Relações Comunidade-Instituição , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Transtorno Depressivo/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Política de Saúde , Humanos , Relações Interpessoais , Masculino , Modelos Teóricos , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Questionário de Saúde do Paciente , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estados Unidos
16.
J Trauma Stress ; 33(5): 864-865, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33007131

RESUMO

A recent study published in the Journal of Traumatic Stress demonstrated that posttraumatic stress disorder (PTSD) rates in Ireland are as high as 17.7% and that this could be related to the COVID-19 pandemic (Karatzias et al., 2020). However, this number is probably skewed, as the fundamental requirement for a PTSD diagnosis-namely, a life-threatening or severely stressful event-was not fulfilled. In this comment, the consideration of COVID-19-related PTSD to represent a diagnosis is questioned based on the definitions of PTSD in the ICD-11 and DSM-5.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Transtornos de Estresse Pós-Traumáticos , Betacoronavirus , Comorbidade , Humanos , Irlanda , Acontecimentos que Mudam a Vida , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
17.
J Trauma Stress ; 33(5): 866-868, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33007141

RESUMO

In a recently published study in this journal that used a population-based sample in the Republic of Ireland (Karatzias et al., 2020), we concluded that 17.7% of the sample met the diagnostic requirements for COVID-19-related posttraumatic stress disorder (PTSD). Subsequently, Van Overmeire (2020) has raised concerns about the validity of our findings, arguing that simply experiencing the COVID-19 pandemic is not sufficient to meet the trauma exposure criterion for a PTSD diagnosis and, consequently, our estimated PTSD prevalence figure was inflated. In this response, we provide (a) an explanation for why the COVID-19 pandemic can be reasonably considered to be a traumatic event, (b) evidence that PTSD in response to the COVID-19 pandemic is a meaningful construct, and (c) an argument for why our estimated prevalence rate is not unreasonably high.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Transtornos de Estresse Pós-Traumáticos , Betacoronavirus , Comorbidade , Humanos , Irlanda/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia
18.
J Trauma Stress ; 33(5): 634-642, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33007149

RESUMO

In response to COVID-19, continued workforce training is essential to ensure that evidence-based treatments are available on the frontline to meet communities' ongoing and emerging mental health needs. However, training during a pandemic imposes many new challenges. This paper describes a multisite training and implementation pilot program, facets of which allowed for continued training despite the onset of the COVID-19 pandemic and subsequent social distancing guidelines. This virtual facilitated learning collaborative in Written Exposure Therapy, an evidence-based treatment for posttraumatic stress disorder, included virtual workshop training, phone-based clinical consultation, implementation-focused video calls for program leadership, and program evaluation. Data are presented about program enrollees and patient impact following the onset of COVID-19-related social distancing restrictions. Challenges, successes, and practical guidance are discussed to inform the field regarding training strategies likely to be durable in an uncertain, dynamic healthcare landscape.


Assuntos
Infecções por Coronavirus/psicologia , Educação a Distância/organização & administração , Terapia Implosiva/educação , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Betacoronavirus , Medicina Baseada em Evidências/métodos , Humanos , Pandemias , Desenvolvimento de Programas/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia , Redação
19.
PLoS One ; 15(10): e0239211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027307

RESUMO

BACKGROUND: The prevalence of psychological complaints is known to be very high in populations of asylum seekers. Despite this, data on the health care system's ability to adequately meet these high-risk populations' mental health needs are scarce. This article investigates how well the German outpatient health care system is able to detect and adequately treat them. METHODS: To this end, we combined data from a cross-sectional survey with billing data from the local social welfare office from the year 2015. Using descriptive statistics, the data of the cross-sectional study are used to quantify the psychological health care needs of asylum seekers while the secondary data analysis indicates the actual access to and extent of psychological treatment. RESULTS: In the cross-sectional study, 54% of patients were screened positive for symptoms of depression, 41% for symptoms of anxiety disorder and 18% for symptoms of Posttraumatic Stress Disorder. In total, 59% were screened positive for at least one of these three disorders. However, when contrasting these screening-based prevalences with the prevalences based on data from the health care system, a mismatch becomes apparent: According to the social welfare office's billing data, only 2.6% of asylum seekers received the diagnosis of depression, 1.4% were diagnosed with anxiety disorder and 2.9% with Posttraumatic Stress Disorder (PTSD). In combination, 4.9% were diagnosed with at least one of these three disorders. Overall, less than one tenth of asylum seekers with symptoms of depression, anxiety or PTSD received the corresponding diagnosis by the health care system. Among those who were diagnosed, about 45% received no treatment at all, while 38% were treated with drugs alone. Only 1% of all patients received psychotherapy. CONCLUSIONS: Psychological complaints are very common among asylum seekers, yet only a small proportion of this population receives the corresponding diagnoses and treatment. While various factors can contribute to these shortcomings, there is an urgent need to systematically address this deficit and introduce measures to improve mental health care for this high-risk population.


Assuntos
Saúde Mental , Refugiados/psicologia , Adolescente , Adulto , Antidepressivos/uso terapêutico , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Estudos Transversais , Depressão/diagnóstico , Depressão/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicoterapia , Seguridade Social , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Inquéritos e Questionários , Adulto Jovem
20.
Ann Pharm Fr ; 78(6): 459-463, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33038309

RESUMO

OBJECTIVES: COVID-19 outbreak can impact mental health including health care workers. The aim of this study was to assess the psychological impact of COVID-19 in French community pharmacists. MATERIAL AND METHODS: We carried out a postal-based survey to assess the psychological impact of COVID-19 in French owner community pharmacists based on three validated self-report questionnaires: Perceived Stress scale, Impact of Event Scale-revised and Maslach Burnout Inventory. RESULTS: The sample consists of 135 community pharmacists. Twenty-three pharmacists reported significant post-traumatic stress symptoms (17%). High burnout symptoms were found in 33 (25%), 46 (34.9%) and 4 (3%) participants. Females scored higher than males for all questionnaires (P=0.01). CONCLUSIONS: This study is the first study which showed the psychological impact of COVID-19 in community pharmacists. Based on validated self-report questionnaires, up to 35% of pharmacists reported psychological disturbances. Interventions to promote psychological well-being of healthcare workers need to be developing.


Assuntos
Betacoronavirus , Esgotamento Profissional/etiologia , Infecções por Coronavirus/psicologia , Estresse Ocupacional/etiologia , Farmacêuticos/psicologia , Pneumonia Viral/psicologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Estresse Psicológico/etiologia , Adulto , Idoso , Esgotamento Profissional/epidemiologia , Serviços Comunitários de Farmácia , Infecções por Coronavirus/epidemiologia , Despersonalização/epidemiologia , Despersonalização/etiologia , Emoções , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Autorrelato , Índice de Gravidade de Doença , Distribuição por Sexo , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários
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