Effects of social isolation on sleep during the COVID-19 pandemic.

The current COVID-19 pandemic is a public health emergency that has seriously affected mental health in the general population. Both, studies on previous epidemics and those conducted during the current pandemic have reported a wide range of psychosocial consequences and multiple psychological symptoms as a result of said outbreaks, and among these problems, sleep/wake cycle alterations stand out. Publications addressing this phenomenon have consistently reported that nearly a third of people who experience social isolation develop insomnia, which, in turn, is an important predictor for mental disorders that affect people's functionality, including anxiety disorders, depression and post-traumatic stress disorder. This reflection paper aims to describe the effects that social isolation may have on sleep in the context of the current COVID-19 pandemic.

Examination of physician factors influencing psychiatric assessment of acutely suicidal patients.

Suicide risk assessment is a subjective process and remains a clinical challenge in psychiatry. We aimed to examine physicians' characteristics that influence management of acutely suicidal patients. In a cross-sectional design, we performed an anonymous internet survey of psychiatry residents and attendings from four academic centers. Gender, years of experience, practice setting, prior patient suicide, and personal exposure to suicide were characterized. Participants were presented with three clinical vignettes and asked to rate suicide risk and clinical disposition. The relationship between responses to the vignettes and physician characteristics were examined with generalized linear models. Fifty-four residents and 49 attendings completed the survey. Four (7%) residents and 24 (49%) attendings had patients die by suicide, whereas 32 (59%) and 36 (74%), respectively, knew somebody outside their practice who died by suicide. Among residents, lower rating of acute suicide risk was associated with prior exposure to non-patient suicide. Less hospitalization chosen by attendings was associated with greater perceived difficulty of suicide risk assessment. In the combined resident and attending sample, less proneness to hospitalize was associated with number of previous patients die by suicide and with outpatient practice. Our results suggest that previous exposure to suicide is associated with more risk-averse management.