Showing papers in "Psychiatria Danubina in 2020"

COVID-19 Pandemia and Public and Global Mental Health from the Perspective of Global Health Securit.

Abstract: The Coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China and has spread all over the world and has caused huge threats to health and lives. It has affected different frontiers of lives and induced many psychiatric individual and collective problems such as panic, anxiety, depression, post-traumatic stress disorders, suspiciousness, infodemia, cacophony, xenophobia, racisms, etc. The COVID-19 outbreak has induced public and global mental health crisis as well as a huge psycho-social experiment. Psychiatry and other mental health sciences can play very useful role in supporting the well-being of COVID-19 patients and their families, healthcare personnel and the society. For successful fighting with present and future pandemics we have to learn more about psychiatric and psychological aspects of COVID-19 from the perspectives of public and global mental health.

Impact of Human Disasters and COVID-19 Pandemic on Mental Health: Potential of Digital Psychiatry.

Abstract: Deep emotional traumas in societies overwhelmed by large-scale human disasters, like, global pandemic diseases, natural disasters, man-made tragedies, war conflicts, social crises, etc., can cause massive stress-related disorders. Motivated by the ongoing global coronavirus pandemic, the article provides an overview of scientific evidence regarding adverse impact of diverse human disasters on mental health in afflicted groups and societies. Following this broader context, psychosocial impact of COVID-19 as a specific global human disaster is presented, with an emphasis on disturbing mental health aspects of the ongoing pandemic. Limited resources of mental health services in a number of countries around the world are illustrated, which will be further stretched by the forthcoming increase in demand for mental health services due to the global COVID-19 pandemic. Mental health challenges are particularly important for the Republic of Croatia in the current situation, due to disturbing stress of the 2020 Zagreb earthquake and the high pre-pandemic prevalence of chronic Homeland-War-related posttraumatic stress disorders. Comprehensive approach based on digital psychiatry is proposed to address the lack of access to psychiatric services, which includes artificial intelligence, telepsychiatry and an array of new technologies, like internet-based computer-aided mental health tools and services. These tools and means should be utilized as an important part of the whole package of measures to mitigate negative mental health effects of the global coronavirus pandemic. Our scientific and engineering experiences in the design and development of digital tools and means in mitigation of stress-related disorders and assessment of stress resilience are presented. Croatian initiative on enhancement of interdisciplinary research of psychiatrists, psychologists and computer scientists on the national and EU level is important in addressing pressing mental health concerns related to the ongoing pandemic and similar human disasters.

COVID-19 Pandemic and Impending Global Mental Health Implications.

Abstract: The increase in organisms transference and infectious pandemics across the globe have been accelerated by an increase in travel, international exchange and global changes in earth's climate. COVID-19, a virus caused by the novel coronavirus that was initially identified on December 2019, in Wuhan city of China is currently affecting 146 territories, states and countries raising distress, panic and increasing anxiety in individuals exposed to the (actual or supposed) peril of the virus across the globe. Fundamentally, these concerns ascend with all infections, including those of flu and other agents, and the same worldwide safeguards are compulsory and suggested for protection and the prevention of further diffusion. However, media has underlined COVID-19 as rather an exclusive threat, which has added to panic and stress in masses which can lead to several mental health issues like anxiety, obsessive compulsive disorder and post-traumatic stress disorder which should be contained immediately in its initial phases.

The Importance of Psychodynamic Approach during COVID-19 Pandemic.

Abstract: The coronavirus (COVID-19) outbreak was labeled a global pandemic by the WHO in March of 2020. Understanding how crisis influence an individual's reactions to stressful events (and vice versa) is important in order to create meaningful and effective interventions. Our literature search have revealed lack of the papers related to psychodynamic approach to recent crisis. Psychodynamic places a large emphasis on defense mechanisms and unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings and thoughts are outside of our awareness, they still influence our behavior in many ways. Optimal application of psychodynamic approach offers the frame for acceptance of psychological stress in a more positive way and benefits psychological growth. We believe that including psychodynamic approach in the national public and mental health emergency system will empower Croatia and the world during (and after) COVID-19 pandemic crisis.

Resilience in Health and Illness.

Abstract: Resilience is a relatively new concept that lacks clarity although it is increasingly used in everyday conversation and across various disciplines. The term was first introduced into psychology and psychiatry from technical sciences and afterwards thorough medicine and healthcare. It represents a complex set of various protective and salutogenic factors and process important for understanding health and illness, and treatment and healing processes. It is defined as a protective factor that makes an individual more resilient to adverse events that lead to positive developmental outcomes. Resilience is a positive adaptation after stressful situations and it represents mechanisms of coping and rising above difficult experiences, i.e., the capacity of a person to successfully adapt to change, resist the negative impact of stressors and avoid occurrence of significant dysfunctions. It represents the ability to return to the previous, so-called "normal" or healthy condition after trauma, accident, tragedy, or illness. In other words, resilience refers to the ability to cope with difficult, stressful and traumatic situations while maintaining or restoring normal functioning. The higher the resilience, the lower the vulnerability and risk of illness. Resilient individuals tend to be optimistic, have a tendency to see everything as a useful experience, focus on personal strengths and qualities, use constructive criticism, develop close relationships with others, have developed social skills, and are emotionally conscious. Good resilience aggravates and prevents the onset of disease, provides good heath, facilitates and accelerates healing, and provides productive life and a sense of well-being despite chronic illness. Resilience experts believe that anyone can strengthen their resilience and thus contribute to the advancement of health and, if ill, ease the illness, accelerate and facilitate healing.

The Impact of Coronavirus (SARS-CoV2) Epidemic on Individuals Mental Health: The Protective Measures of Pakistan in Managing and Sustaining Transmissible Disease.

Abstract: Background This study performed a focalized examination of the global impact of the coronavirus epidemic. This current review is one of the few kinds of research, which has sought to check the effect of the coronavirus on mental health issues and the need for psychological well-being in the standard population and patients in response to the global wake of the epidemic and its effects in Pakistan. Subjects and methods This study has utilized the data on coronavirus patients from the Ministry of Health, National Institute of Health Pakistan. The age of the confirmed coronavirus patients ranged from 12 to over 80 years, including international and local transmitters. Results Recorded data delivered by the National Institute of Health, Pakistan has quantified that the outbreak of coronavirus (SARS-CoV-2) entered Pakistan through international travelers. They carried the virus after they visited different countries, such as Saudi Arabia, Iran, Iraq, the USA, China, and European countries. By April 30, 2020, there were 16,473 confirmed cases of coronavirus. Total deaths are 361, with a mortality rate of 2.20%, and ultimately recovered cases reported 4,105 with a percentage of 24.90%. As of October 24, 2020, there were 327,063 confirmed cases of the COVID-19 in Pakistan, which posed vast social, economic, health, and environmental problems in the society. The epidemic has affected individuals across the country and confirmed patients in the country increased rapidly. Conclusion The government officials had initially estimated over 50,000 corona patents by April 30, which would be a great challenge; however, the situation remained under control because of suppression and smart-lockdown strategies by the Government. This study's findings reported that superior health facilities are required to treat the patients. This research review incorporated data generated by NIH, and respondents are from all the regions of Pakistan, subsequently restricting its generalizability to experimental results.

Differences in Distress and Coping with the COVID-19 Stressor in Nurses and Physicians.

Abstract: Background Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, health workers have shown an incredible commitment to their patients, sometimes in apocalyptic conditions. We explored ways to deal with the coronavirus stressor and psychological outcomes among physicians and nurses. Subjects and methods 124 healthcare workers in General Hospital Nasice (Croatia) were invited to participate in a study by performing within the period of March 26 to April 6 2020 questionnaire collected information on socio-demographic characteristics and living conditions that may be risk factors for covid-19 concern, Short form health survey-36, Depression Anxiety Stress Scales (DASS-21) and Ways of Coping Questionnaire (WOC; consisting of 8 subscales: Confrontive Coping, Distancing, Self-Controlling, Seeking Social Support, Accepting Responsibility, Escape-Avoidance, Planful Problem Solving, Positive Reappraisal). Results 11% healthworkers reports moderate to very-severe depression, 17% moderate to extremely-severe anxiety and 10% for moderate to extremely-severe stress. 67% of medical staff are worried. No statistically significant differences in the scales of depression, anxiety, and stress were found between nurses and physicians, but differences were found on Escape-Avoidance and Positive Reappraisal subscales. Nurses use significantly more avoiding coping style and positive reappraisal than doctors. Seeking social support is more pronounced in those over 40 years old, while those under 40 use more avoidable stress management techniques. Conclusions Monitoring and ensuring the mental health of coronavirus care staff is crucial for global health. The education of medical staff in the field of stress management is a conditio sine qua non of the issue of an adequate relationship with the COVID-19 pandemic.

COVID-19 Pandemic: A Serious Threat for Public Mental Health Globally.

Abstract: Deep emotion traumas in societies around the globe are overcome by extreme human catastrophes such as natural disasters, social crises, war conflicts and infectious virus induced pandemic diseases, etc., can lead to enormous stress-related disorders. The current ongoing pandemic known as COVID-19 caused by novel Corona virus first appeared in Wuhan, city of China and then rapidly spread in the whole world. It has affected various frontiers of lives and caused numerous psychiatric problems like nervousness, post-traumatic stress disorder (PTSD), fear and uncertainty, panic attacks, depression, obsessive compulsory disorder, xenophobia and racism, etc. Globally COVID-19 has persuaded public mental health crisis. Furthermore, inadequate resources of public mental health services in several countries are discussed in this review, which will be further straighten by the upcoming increase in demand for mental health services due to the COVID-19 pandemic. All mental health sciences including Psychiatry can play a very important role in the comfort of COVID-19 infected individuals and their relatives, healthcare providers and society. We need to learn more about psychological and psychiatric features of COVID-19 from the perceptions of public and global mental health in order to cope up the present deteriorating situation caused by the SARS-CoV-2 pandemic.

Psychological Resilience and Depression during the Covid-19 Pandemic in Turkey.

Abstract: Background Turkey is one of the countries affected during the period of COVID-19 outbreak. The purpose of the current study is to investigate psychological resilience and depression in individuals during the period of COVID-19 outbreak in Turkey in relation to different variables. The study also aims to explore the relationship between psychological resilience and depression. Subjects and methods The current study was conducted on a total of 518 people over the social media through the Google e-forms. In the study, the "Short Psychological Resilience Scale" and the "Beck Depression Scale" were used to collect data. In the analysis of the collected data, t-test, One Way Anova, Mann-Whitney U Test, Kruskal Wallis-H Test, Pearson Correlation Coefficient were used. Results In the current study, psychological resilience and depression were investigated in relation to different variables. Psychological resilience was found to be higher male participants, educators,university graduates and groups with not mental health problems. Depression was found to be higher females, university students, high school and lower graduates,with mental health problems. When the relationship between psychological resilience and depression was investigated, it was found that there is a medium and negative correlation between them. Moreover, the cut-off point for the depression score was set to be 17 and the rate of the people having 17 points or higher scores was found to be 16.6%. Conclusion In light of the findings of the current study, it can be suggested to offer more mental health care services to those having higher levels of depression. Studies can be conducted to improve online psychological support services. A medium and negative correlation was found between psychological resilience and depression in the current study, which shows that more importance should be attached to activities to improve psychological resilience.

Public Mental Health in Post-COVID-19 Era.

Abstract: Transmission of the 2019 novel coronavirus (COVID-19) has now rapidly spread around the world, which has alarming implications for individuals and communities, in particular for public mental health. Significant progress has been made in the prevention and control of the COVID-19 pandemic in China, but the psychological crisis caused by the epidemic is still not over and may continue to exist. The public mental health in the post-COVID-19 era should not be ignored. This article provides early warning for the public's mental health in the post-COVID-19 era by listing the characteristics and duration of the public mental health crisis following the SARS outbreak. In addition, based on the current situation, specific methods and measures are proposed in order to provide effective reference for the prevention and control of psychological crisis caused by the COVID-19 epidemic.

Mental Health Outcomes of Adults with Comorbidity and Chronic Diseases during the COVID-19 Pandemic: A Matched Case-Control Study.

Abstract: Social and clinical determinants of 30 compulsory admissions (CAs) to a psychiatric ward during a six-month period were compared to 134 voluntary admissions (VAs), and outcomes of hospitalisation were assessed in relation to its types. Psychosocial and clinical characteristics at admission and discharge were measured using 5 scales. Unemployment, hospitalisations >7 days and continuing hospitalisation in Community Mental Health Centres were positively associated with CA. At admission, CAs showed lower functioning, while outcome at discharge was similar. Social determinants had a main role in determining CAs. Clinical and psychosocial outcomes might have been improved by a mental health system community-based.

The Role of Fatigue of Compassion, Burnout and Hopelessness in Healthcare: Experience in the Time of COVID-19 Outbreak.

Abstract: Background: In the times of serious health alarm, as it is happening in the COVID-19 pandemic, burden of healthcare is likely to explode. The current pandemic is having a profound effect on all aspects of society, including mental health and physical health. In a previous study we showed interaction between compassion fatigue, burnout and workload. Methods: In our study, we have evaluated stress levels in 102 healthcare workers recruited in different rehabilitation depart ments (psychiatric and multidisciplinary). In particular, we evaluated the fatigue of compassion, vicarious trauma, burnout and hope (hopelessness) in the first two months of lookdown due to the COVID-19. Results: The results obtained after the administration of the following evaluation scales: sCFs, CBI, Pro QOL, HBS, showed an overall increase in the scores in all professional figures. Significant compassion fatigue and burnout percentage is present in several groups. The highest levels of hopelessness in some professional figures, while higher educational levels can protect workers from the risk of developing high levels of work stress. Conclusions: The data obtained with this study are similar to those of our previous study, although they may indicate that during the period of the coronavirus pandemic the scores of the several scales used are higher. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

COVID-19 Pandemia: Neuropsychiatric Comorbidity and Consequences.

Abstract: Infection with the new corona virus (SARS-CoV-2) was first registered in December 2019 in China, and then later spread rapidly to the rest of the world. On December 31, 2019, the World Health Organization (WHO) informed the public for the first time about causes of pneumonnia of unknown origin, in the city of Wuhan (Hubei Province, China), in people who were epidemiologically linked to a seafood and wet animal whole sale local market in Wuhan. Coronavrus disease, called COVID-19 (Corona virus disease 2019), after China quickly spread to most countries in the wold, and the WHO on March 11, 2020 declared a pandmic with this virus. SARS-CoV-2, has a high level of sequential similarities to the SARS-CoV-1 and uses the same receptors when it enters the human body (angiotensin-converting enzyme 2/ACE2). COVID-19 is respiratry infection that is primarily transmitted via respiratry droplets. Typical symptoms of COVID-19 infection can be very moderate (infected can be even asymptomatic) to very severe, with severe respiratory symptoms (bilateral severe pneumonia), septic schock, and fatal outcome. Numeous unknows regarding the biological, epidemilogical adn clinical characteristics of COVID-19, still exist, and make it impossible to predict with certainty the further course of the current pandemic. COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2, in a number of patients also penetrates the CNS, and apparently could be responsible for fatal outcome in some cases. The entrry of the virus into the brain can lead to neurological and psychiatric manifestationss, which are not uncommon, including headache, paresthesia, myalgia, impaired consciousnessm, confusion or delirum and cerebrovascular diseases. SARS-CoV-2 positive individuals should be evaluated in a timely manner for neurological and psychiatic symptoms because tretament of infection-related neurological and psychiatric complications is an important factor in better prognosis of severe COVID-19 patients.From the current point of view, it seems that in COVID-19 survivors, in the coming years and decades, the inflammatory systemic process and/or the inflammatory process of the brain could trigger long-term mechanisms that generally lead to an increase of neurological and neurodegenerative disorders. Psychosocial consequences as well as consequences for mental health are also significant, both for the general population and especially for health workers of all profiles. COVID-19 pandemia is associtaed with negative psychosocial consequences, including depressive symptoms, anxiety, anger and stress, sleep disorders, simpotms of posttrauamtic stres disorder, social isolation, loneliness and stigmatization.

Fear and Depression among Residents of Bosnia and Herzegovina during COVID-19 Outbreak - Internet Survey.

Abstract: Background: Occurrence of symptoms of fear and depression among general population during the outbreak of COVID-19 seems to present an emerging problem worldwide. The aim of this study was to examine levels of fear and depressive symptoms in association with COVID-19 outbreak and to assess other contributing factors in the population of Bosnia and Herzegovina. Subjects and methods: Link to an anonymous questionnaire, mainly based on The Fear of CO VID-19 Scale (Ahorsu et al. 2020) and two-item and nine-item Patient Health Questionnaires (PHQs) (Maurer et al. 2018) (background information, fear assessment and information regarding depression) was distributed online to general population of Bosnia and Herzegovina. Results: Out of 1201 respondents, 217 (18.0%) reported experiencing fear and 341 (28.4%) reported having symptoms of de pression during COVID-19 outbreak. The mean age of the subjects was 30.57+/-11.26. Being older (OR=1.044;95% CI 1.031-1.057;p<0.001) and having moderate to severe depressive symptoms (OR=1.093;95% CI 1.067-1.120;p<0.001) were independent significant predictors for developing fear;living in rural environment (OR=0.551;95% Cl 0.325-0.935;p=0.0027) significantly decreased the risk of developing fear;being female (OR=1.750;95% CI 1.242-2.466;p=0.001), unemployed (OR=1.557;95% CI 1.040-2.330;p=0.032) or student (OR=1.943;95% CI 1.450-2.604;p<0.001) were independent significant predictors for develo ping moderate to severe depressive symptoms in association with COVID-19. Mann Whitney U-test showed that being older was statistically associated with fear (p<0.001) and being younger was statistically associated with depressive symptoms (p<0.001). Conclusions: In conclusion, based on our findings, fear and depressive symptoms in general population of Bosnia and Herzego vina during the outbreak of COVID-19 were present in 18.06% (fear) and 28.39% (depression) of subjects and it was statistically associated with age, gender, occupation, living environment and may present a secondary uprising problem connected to outbreak of COVID-19. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Psychiatry in Time of COVID-19 Pandemic.

Abstract: COVID-19 or Coronavirus pandemic has generated a very serious and grave global concern regarding the health of every person in the whole world. Besides, due to the rapid diffusion of the viral infection, there are already alarms on how to deal with the psychiatric aspects of COVID-19 pandemic in persons with an established diagnosis of psychiatric disorders, staff, and those in self-isolation. What is the influence of COVID-19 on mental health? The current study will review the psychiatric implications of COVID-19 pandemic on the general population, the bearing of social isolation, the prevention behaviours, and clinical cases of people who required psychiatric admission to hospital due to the emotional impact of COVID-19 social circumstances.

Attachment Theory and Psychological Responses to the COVID-19 Pandemic: A Narrative Review.

Abstract: The novel coronavirus disease (COVID-19) pandemic has had a significant impact on the psychological health of individuals and societies. A theoretical framework is required in order to understand this impact and strategies to mitigate it. In this paper, individual and community responses to COVID-19 are discussed from the point of view of attachment theory, a psychological theory which examines the formation and disruption of attachment bonds across the life-span from an evolutionary perspective. The contributions of this perspective to individual psychological disorders such as anxiety, depression and post-traumatic stress, as well as to social responses such as interpersonal violence and stigmatization, are discussed in the light of findings from attachment research. Proposals for incorporating the knowledge derived from attachment theory into therapeutic strategies, as well as in developing community resilience in the face of COVID-19, are discussed based on the available evidence. It is hoped that this information will be of value to clinicians and researchers, as well as to those involved in planning health services and social policy.

Peer Education Intervention on Adolescents' Anxiety, Depression, and Sleep Disorder during the COVID-19 Pandemic.

Abstract: BACKGROUND: Adolescents' anxiety and depression during the coronavirus disease 2019 (COVID-19) pandemic outbreak cannot be ignored. In public health crisis events, adolescents are prone to negative psychological problems, such as anxiety and depression. Hence, this research focuses on the use of reasonable and efficient methods to intervene in adolescents' psychological problems during the COVID-19 pandemic. SUBJECTS AND METHODS: From February to April 2020, we conducted an anonymous online survey on a total of 1,200 adolescents in the provinces of Hunan and Guangxi in China. Moreover, we randomly divided a total of 150 middle school students with anxiety scores greater than 50 and volunteered to participate in the intervention experiment into control and intervention groups, with 75 members in each group. On the basis of the proposed routine treatment, we conducted 8 weeks of model 328-based peer education intervention in the intervention group. RESULTS: After the intervention, the self-rating anxiety scale scores (SAS) of the intervention group are better than those of the control group (P<0.001). Moreover, the self-rating depression scale (SDS) scores of both groups are reduced, but the effect is more significant on the intervention group (P<0.001) than on the control group. Finally, the total Pittsburgh sleep quality index (PSQI) scores of both groups are reduced, but the effect is more significant on the intervention group than on the control group (P=0.001 and <0.001, respectively). CONCLUSIONS: Model 328-based peer education intervention can significantly reduce the level of anxiety and depression in adolescents and improve their sleep quality.

Psychiatry for Better World: COVID-19 and Blame Games People Play from Public and Global Metal Health Perspective.

Abstract: Blame games tend to follow crisis, be they at local, national or international level related to political, financial or health issues. COVID-19 crisis from the very beginning has been followed by divisive and disruptive psychosocial and political blame games. Active or passive blaming is an inherent feature of human beings in order to shift responsibilities onto others, single out a culprit, find a scapegoat and pinpoint a target. Finger pointing, blame games and scapegoating are associated with creation of binaries that identify agency as good or bad, right or wrong, moral or immoral. The scapegoat is expectedly always bad, wrong and immoral, commonly black evil. The detrimental effects of the COVID-19 blame games are seen in a lack of cohesion and coherence in the anti-COVID-19 solving strategies. Fighting the COVID-19 crisis all countries and nations need to join efforts on defeating it and to shift from a destructive blaming and zero-sum type of thinking to a much more creative, systemic and humanistic type. Effective response to COVID-19 is related to sowing the seeds for humanistic self and empathic civilization, rather than blaming, scapegoating and xenophobia.

COVID-19 Pandemic: Psycho-social Consequences During the Social Distancing Period Among Najran City Population.

Abstract: BACKGROUND: COVID-19 is a global pandemic that endanger the health and enforced social distancing for the whole world. Social distancing may generate stress, anxiety, and depression. Understanding the psychosocial consequences of COVID19 during social distancing may help decision-makers to take suitable decisions that help in increasing awareness. Evaluate the psychosocial consequences of COVID-19 pandemic during the social distancing period and explore the relationship between social media use and psychological stress during COVID-19 outbreak among Najran city population. Research design is descriptive correlational research design. SUBJECTS AND METHODS: A snowball sampling technique, was used to recruit participants live in Najran city during the COVID-19 pandemic (1508 participant). RESULTS: A statistically significant differences (P<0.05) are observed between Saudi and non-Saudi participants in all social aspects assessed except for time spent on social media. In addition, a high mean of depression, stress, and anxiety subscale scores are observed in non-Saudi compared to the Saudi participants with statistically significant differences (p=0.000). As well as high DASS-21 total scores in non-Saudi compared to the Saudi participants. Also, there are positive statistically significant correlations (≤0.05) between participants' time spent in social media and their depression, stress, anxiety, and total DASS scores during the COVID-19 outbreak. CONCLUSION: The findings of the present study indicate that COVID-19 pandemic generates stress, anxiety and depression among Najran population especially, non-Saudi. This poor psychological condition is exaggerated with prolonged social media use. COVID-19 also has negative impact on social wellbeing and use of social media cannot replace direct contact with friends. The current study results may be utilized to formulate interventions that enhance psychosocial health and resilience during the COVID-19 outbreak.

Anxiety and Post-Traumatic Stress Disorder Symptoms in Pregnant Women during the COVID-19 Pandemic's Delay Phase.

Abstract: Background The Coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China and has spread all over the world and affected global mental health. Pregnant women may be particularly vulnerable and experience high levels of distress during an infectious disease outbreak. The aim of this study was to determine anxiety and post-traumatic stress disorder (PTSD) symptoms in pregnant women during the COVID-19 pandemic. Subjects and methods This cross-sectional study surveyed a total of 283 pregnant women within the period of May 11 to May 28,2020. During their regular antenatal visit, pregnant women were invited to participate in the study. The self-created personal information form was used to assess the main characteristics of the participants. Anxiety and PTSD symptoms of the pregnant women were measured by the Spielberger State-Trait Anxiety Inventory (STAI) and Impact of Events Scale-Revised (IES-R), respectively. Results The mean age of the pregnant women was 29.20±5.55 years. Regarding gestational age, 72 (25.4%), 86 (30.4) and 125 (44.2) were in the first, second and third trimesters, respectively. The mean gestational age was 23.82±11.05 weeks. The mean STAI-S and STAI-T scores were 39.52±10.56 within the cut-off value (39-40) of the instrument and 42.74±8.33, respectively. Furthermore, the mean total IES-R score was 36.60±15.65 within the cut-off value (24) of the instrument. Multiple regression analysis revealed that pregnancy complication (p=0.01) and employment status of husband (p=0.04) were the best predictors of state anxiety. Additionally, the presence of COVID-19-related symptoms (p=0.01) and educational level (p=0.01) were found to predict PTSD symptoms. Conclusions Pregnant women would be likely to experience high levels of anxiety and PTSD symptoms during the COVID-19 pandemic's delay phase. The results should sensitize the medical team to increased anxiety and PTDS symptoms of the pregnant women in order to prevent negative outcomes for women and their fetuses.

COVID-19 Infodemic and Public Trust from the Perspective of Public and Global Mental Health.

Abstract: Crisis usually involves participants who trust and distrust each other, commonly in the same time. COVID-19 infodemic induced confidence crisis and distrust in authorities, science communities, governments and institutions can lead to harmful health behaviors and ill mental health and become a serious threat to public and global mental health as another kind of virus. Distrust mentality, conspiracy thinking and blame games may have detrimental effects not just on the individual level, but on the level of the whole groups, communities and global world. Public distrust and mistrust are related to the crisis in the domain of social and political relations, not only on the same country level, but also between different countries at regional or global level. Dynamics between public trust and mental health is a complex and bidirectional, ill mental health is causing and enhancing the inclination to confidence crisis, distrust, conspiracy theories and blame games and vice versa confidence crisis, distrust, conspiracy thinking and blame games are leading to ill mental health. It is important to have a holistic transdisciplinary integrative understanding of these dynamics and science-based treatment and prevention.

Stress and Anxiety among Healthcare Workers Associated with COVID-19 Pandemic in Russia.

Abstract: Background Mental health of medical workers treating patients with COVID-19 is an issue of increasing concern worldwide. The available data on stress and anxiety symptoms among healthcare workers during the COVID-19 are relatively limited and have not been evaluated in Russia yet. Subjects and methods The cross-sectional anonymous survey included 1,090 healthcare workers. Stress and anxiety symptoms were assessed using Stress and Anxiety to Viral Epidemics - 9 (SAVE-9) and Generalized Anxiety Disorder - 7 (GAD-7) scales. Logistic regression, Kaiser-Meyer-Olkin two component factor model, Cronbach's alpha and ROC-analysis were performed to determine the influence of different variables, internal structure and consistency, sensitivity and specificity of SAVE-9 compared with GAD-7. Results The median scores on the GAD-7 and SAVE-9 were 5 and 14, respectively. 535 (49.1%) respondents had moderate and 239 (21.9%) had severe anxiety according to SAVE-9. 134 participants (12.3%) had severe anxiety, 144 (13.2%) had moderate according to GAD-7. The component model revealed two-factor structure of SAVE-9: "anxiety and somatic concern" and "social stress". Female gender (OR - 0.98, p=0.04) and younger age (OR - 0.65, p=0.04) were associated with higher level of anxiety according to regression model. The total score of SAVE-9 with a high degree of confidence predicted the GAD-7 value in comparative ROC analysis. Conclusions Healthcare workers in Russia reported high rates of stress and anxiety. The Russian version of the SAVE-9 displayed a good ratio of sensitivity to specificity compared with GAD-7 and can be recommended as a screening instrument for detection of stress and anxiety in healthcare workers.

New Insights into Schizophrenia: a Look at the Eye and Related Structures

Abstract: Background Schizophrenia is a multifactorial neurodevelopmental disorder associated with cognitive dysfunction and changes in primary sensory processing. This article aims to explore the current insights into the relationship between schizophrenia and different visual disturbances. Methods To provide a literature review of visual impairments in schizophrenia, we performed a PubMed/MEDLINE and Scopus search to identify all articles in English on the topic up to the end of 2018. Results Multiple retinal functional and structural abnormalities are found in patients with schizophrenia. Wider retinal venules suggest chronically insufficient brain supply of oxygen and this could contribute to the occurrence of psychotic symptoms. Optical coherence tomography studies showed that retinal nerve fiber layer, macular thickness, and macular volume were significantly lowered in the chronic phase of schizophrenia. Results from electroretinogram recordings have demonstrated different declinations such as abnormalities of a - wave activity in the photoreceptors or b - wave activity in the bipolar and Muller cells. Abnormalities in eye movements, such as a notable decrease in saccades and smooth pursuit eye movements, are one of the most reliable and reproducible impairments associated with schizophrenia. Disrupted visual processing of the magnocellular pathway may result in a decrease of contrast sensitivity, sensory processing, orientation discrimination, visual integration, trajectory and spatial localization, backward masking and motion tracking. Visual perceptual abnormalities occur in more than 60% of schizophrenic patients and these are visual hallucinations, perceptual distortion of colors, shapes and light intensity, decrease in contour integration and surround suppression. Other, frequently present eye disorders include impaired visual acuity, strabismus and nystagmus. Conclusion Visual impairments are one of the most important features of schizophrenia, which could help in defining the disease state and assigning appropriate treatment.

Why Do People High in COVID-19 Worry Have More Mental Health Disorders? The Roles of Resilience and Meaning in Life.

Abstract: Background Multiple sclerosis (MS) as chronic neurodegenerative disease significantly impact patients' quality of life (QoL). QoL instruments can be generic (EQ-5D, SF-36) and disease-specific like MSQoL-54. Use of disease-specific instruments is preferred since it captures broader symptoms related to MS than generic instruments. Mental health is impacted by MS and different psychiatric conditions significantly impact QoL. We have conducted prospective non-interventional study among MS patients. Aim was to measure and compare MS patients QoL by generic and disease-specific instrument at baseline and after one year and to identify potential correlation between these two types of measurements and to assess mental health scores among MS patients in Bosnia and Herzegovina (BH rho=0.873 p=0.0001 for physical health and rho=0.711 p=0.0001 for mental health. At the end of the study no significant correlations have been found (p>0.05). High negative correlation found between EDSS and scores measured by EQ-5D and MSQoL-54; at baseline (rho=-0.744 p=0.0001) and at the end of the study (rho=-0.832 p=0.0001). Similar MS impact and loss of QoL found in B&H and other countries. Conclusions Both instruments can be used in measuring QoL but disease-specific are preferred since they capture broader symptoms impacting MS patient QoL. Using QoL instruments could drive clinician decision and patient-centric care as well as reimbursement and policy decision by recording treatment outcomes.

Therapeutic Mechanisms of Ketamine.

Abstract: Major depressive disorder is the greatest burden of developed countries in the context of morbidity caused by mental disorders. Until recent, ketamine has been mostly used for anesthesia, analgesia, sedation and treatment of chronic pain syndromes. However, unique pharmacodynamic properties of ketamine have increased interests in it's use for treatment of depression. It is assumed that ketamine reverses synaptic chronic stress pathology within one day of administration by postsynaptic glutamate activation, providing synaptic connectivity restoration that last for days or weeks. Potential glutamatergic agents, in context of treatment of major depressive disorder are not entirely novel phenomenon. Considering the aforementioned, current neurobiological view of depression as a solely monoaminergic phenomenon should be reassessed in order to prompt discovery of putative antidepressant drugs of novel generation. Acute side effects, such as increased salivation, increase in heart rate, systemic arterial pressure and intracranial pressure necessitate careful monitoring during intravenous administration of ketamine, even in subanesthetic doses. However, major burden of ketamine administration lies in it's ability to produce psychotomimetic side effects and emergence delirium. Esketamine nasal spray has now been widely approved and is considered safe in terms of acute side effects, tolerability and consistent therapeutic benefit.

Child Neglect - Causes and Consequences.

Abstract: Introduction Child neglect is one of the most prevalent forms of child abuse. Neglect can be defined as a lack of sufficient attention, responsibility and protection that matches the age and needs of the child. There is no theory that fully explains why neglect of children happens. Three different causal models of neglect are given: parental deficit model, ecological deficit model and ecological-transaction model. Exposure to neglect in childhood may have a negative impact on the development of the child and cause short-term and long-term health, emotional, cognitive, academic and social difficulties. The aim of this paper was to provide a comprehensive theoretical overview of neglect of children causes and consequences. Methods In this paper, we used review articles and meta-analyzes about child neglect causes and consequences published on Medline. Results Child neglect has a relatively high prevalence rate compared to other types of child abuse. Several studies suggest that the impact of neglect on the health and development of the child is just as negative as the impact of other types of abuse. Children who experience neglect in early childhood are more likely to have health, cognitive, emotional and social consequences in later life. A significant number of studies suggest the existence of a link between child neglect and risk factors related to parents, the child and the environment. Conclusions Child neglect is determined by multiple risk areas and is considered as the result of a complex interaction of risk factors present in children and in their care environment. Neglect may have long-term consequences for all aspects of the health and functioning of the child.

A New Rating Scale (SAVE-9) to Demonstrate the Stress and Anxiety in the Healthcare Workers During the COVID-19 Viral Epidemic.

Abstract: The COVID-19 epidemic has been a major global public health problem during past months in Italy and in several other Countries and on the date of publication of this article, is still a serious public health problem. The health staff, engaged in the care of the sick and in the prevention of the spread of the infection have been subjected to a further increase in psychological difficulties and work-related stress, related to the workload for the continuous influx of sick and intense and close working shifts for the viral emergency. The SAVE-9 (Stress and Anxiety to Viral Epidemics - 9 items) scale has been developed as a tool for assessing work anxiety and stress in response to the viral epidemic of health professionals working to prevent the spread of the virus and to treat infected people.

Self-care of Frontline Health Care Workers: During COVID-19 Pandemic.

Abstract: The world is amidst the COVID-19 pandemic that has used social distancing as a tool for containing the virus from spreading exponentially among other individuals. Previous literature suggests that human contact and attachment is a key for well-being which is why punishments like solitary confinement in detention centers like jail has always been debated as being torturous (Wolfendal 2020). With this notion, anxiety and stress may become more prevalent in individuals who experience self-isolation or are under a forced lockdown. For health-care workers like doctors and psychologists, who advocate for physical health, mental health and wellbeing; the challenges might increase during the pandemic phase as they are expected to go through the crises just like others while simultaneously contributing in rendering services related to dealing with physical and psychological health issues present in patients and clients with their continued practice from either on-site or online platforms. Although all health care professional's training inoculates the ill effects of compassion fatigue by other's overwhelming situations and discussions but they might still be prone to vicarious burnout, trauma and stress. Hence, they may become exposed to being at risk of experiencing anxiety more than the general population. This review discusses facets of the importance of self-care as mental health first aid tool for health care professionals including doctors and psychologists using research and supportive techniques to help them process stress and anxiety during and after the global pandemic.

Efficacy and Safety of Cariprazine in Acute Management of Psychiatric Disorders: a Meta-Analysis of Randomized Controlled Trials.

Abstract: BACKGROUND Cariprazine is a new atypical antipsychotic drug approved for the treatment of schizophrenia and bipolar disorders. METHODS we searched the published randomized controlled-trials (RCT) to review cariprazine efficacy and tolerability using the databases (PubMed, EUDRACT, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials) for cariprazine role in managing the following psychiatric conditions (schizophrenia, bipolar mania, bipolar depression and major depressive disorder). A meta-analysis was conducted using the identified 13 clinical trials to assess efficacy using with the outcomes: positive and negative syndrome scale (PANSS), clinical global impressions - severity of Illness (CGI-S), young mania rating scales (YMRS), Montgomery Asberg depression rating scale (MADRS) and Hamilton rating scale for depression (HAM-D). The risk of discontinuation due to adverse effects and common side effects were examined. RESULTS The mean difference in change from baseline for PANSS was -6.23 (95% Confidence Interval (CI) -7.18, -5.28) favoring cariprazine treatment (p<0.00001). Similarly, mean difference for CGI-S was -0.36 (95% CI -0.41, -0.30), YMRS -5.64 (95% CI -6.86, -4.43), MADRS -1.43 (95% CI -1.88, -0.99) and HAM-D -1.52 (95% CI -2.28, -0.76). The risk ratio (RR) of discontinuing due to adverse events was 1.18 (95% CI 1.01, 1.38) meaning risk increased by 18% in cariprazine group with RR for EPS related side effects 2.82 (95% CI 2.47, 3.22) reflecting an increased risk of experiencing EPS related side effects by 182%. Cariprazine was also associated with an increased incidence of side effects such as akathisia, nausea and insomnia. CONCLUSION Cariprazine demonstrates significant improvements in symptom intensity control in patients suffering from psychiatric conditions including schizophrenia, bipolar disorders and depression and is considered well-tolerated with similar rates of trials discontinuation; however, cariprazine was associated with a higher risk of EPS side effects. These findings will guide psychiatrists and pharmacists in their clinical role for supporting psychiatric patients care.

Burned out and Avoided: Stigmatizing Processes among Psychiarists.

Abstract: Background Within a few months during COVID-19 pandemic, more than a thousand studies on this topic have been published in scientific journals. Hence, the aim of the present study was to review and analyze the publishing trends on mental health literature including top cited documents, productive countries, institutions, journals, authorship and collaboration, the most frequent keywords and funding bodies. Method A bibliometric analysis was performed, and data were retrieved from Scopus. The relevant data was harvested and 277 relevant records were imported on July 15, 2020. The data analysis was performed using various bibliometric software. Results These documents were published by 195 journals and received 738 citations. USA ranked first with 50 articles and China is the most influential country with the highest Citation Impact. International journal of Environmental research and Public Health is the top journal for mental health studies with highest number of papers and citation impact. The trend of multi-author publications has outnumbered single-author pattern. Conclusion Overall research shows that most of the papers published related to mental health care and COVID-19 were in the field of medicine and psychology. This research is first bibliometric study in the field of mental health care related to COVID-19.