1
|
Dimitropoulos G, Bassi EM, Bright KS, Gondziola J, Bradley J, Fersovitch M, Stamp L, LaMonica HM, Iorfino F, Gaskell T, Tomlinson S, Johnson DW. Implementation of an Electronic Mental Health Platform for Youth and Young Adults in a School Context Across Alberta, Canada: Thematic Analysis of the Perspectives of Stakeholders. JMIR Ment Health 2024; 11:e49099. [PMID: 38231558 PMCID: PMC10831665 DOI: 10.2196/49099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/06/2023] [Accepted: 12/01/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Youth, aged 15 to 24 years, are more likely to experience mental health (MH) or substance use issues than other age groups. This is a critical period for intervention because MH disorders, if left unattended, may become chronic and serious and negatively affect many aspects of a young person's life. Even among those who are treated, poor outcomes will still occur for a percentage of youth. Electronic MH (eMH) tools have been implemented in traditional MH settings to reach youth requiring assistance with MH and substance use issues. However, the utility of eMH tools in school settings has yet to be investigated. OBJECTIVE The objective of this study was to gain an understanding of the perspectives of key school staff stakeholders regarding barriers and facilitators to the implementation of the Innowell eMH platform in secondary schools across the province of Alberta, Canada. METHODS Guided by a qualitative descriptive approach, focus groups were conducted to elicit stakeholder perspectives on the perceived implementation challenges and opportunities of embedding the Innowell eMH platform in secondary school MH services. In total, 8 focus groups were conducted with 52 key school staff stakeholders. RESULTS Themes related to barriers and facilitators to youth and school MH care professional (MHCP) capacity in implementing and using eMH tools were identified. With respect to youth capacity barriers, the following themes were inductively generated: (1) concerns about some students not being suitable for eMH services, (2) minors requiring consent from parents or caregivers to use eMH services as well as confidentiality and privacy concerns, and (3) limited access to technology and internet service among youth. A second theme related to school MHCP barriers to implementation, which included (1) feeling stretched with high caseloads and change fatigue, (2) concerns with risk and liability, and (3) unmasking MH issues in the face of limited resources. In contrast to the barriers to youth and MHCP capacity, many facilitators to implementation were discussed. Youth capacity facilitators included (1) the potential for youth to be empowered using eMH tools, (2) the platform fostering therapeutic relationships with school personnel, and (3) enhancing access to needed services and resources. MHCP capacity facilitators to implementation were (1) system transformation through flexibility and problem-solving, (2) opportunities for collaboration with youth and MHCPs and across different systems, and (3) an opportunity for the continuity of services. CONCLUSIONS Our findings highlight nuanced school MHCP perspectives that demonstrate critical youth and MHCP capacity concerns, with consideration for organizational factors that may impede or enhance the implementation processes for embedding eMH in a school context. The barriers and facilitators to implementation provide future researchers and decision makers with challenges and opportunities that could be addressed in the preimplementation phase.
Collapse
Affiliation(s)
- Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
- Calgary Eating Disorders Program, Alberta Health Services, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Emilie M Bassi
- Faculty of Social Work, University of Calgary, Calgary, AB, Canada
| | - Katherine S Bright
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, AB, Canada
- Heroes in Mind, Advocacy, and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Jason Gondziola
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Jessica Bradley
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Melanie Fersovitch
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Leanne Stamp
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | | | - Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Tanya Gaskell
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - Sara Tomlinson
- Provincial Addiction and Mental Health, Alberta Health Services, Calgary, AB, Canada
| | - David Wyatt Johnson
- Departments of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| |
Collapse
|
2
|
Sánchez-Rico M, Edán-Sánchez A, Olfson M, Alvarado JM, Airagnes G, Rezaei K, Delcuze A, Peyre H, Limosin F, Hoertel N. Antipsychotic use and 28-day mortality in patients hospitalized with COVID-19: A multicenter observational retrospective study. Eur Neuropsychopharmacol 2023; 75:93-104. [PMID: 37713738 PMCID: PMC10272945 DOI: 10.1016/j.euroneuro.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 09/17/2023]
Abstract
Prior research has yielded conflicting results about the potential influence of antipsychotics in patients with COVID-19. In this multicenter retrospective study, we examined the association of antipsychotic use at admission with 28-day all-cause mortality in a sample of 59,021 adult patients hospitalized with COVID-19 from January 2020 to November 2021. In a 1:1 ratio matched analytic sample (N=1,454) accounting for age, sex, hospital, hospitalization period, the Elixhauser Comorbidity Index, other psychotropic medications, medications prescribed according to compassionate use or as part of a clinical trial, current diagnoses of psychiatric disorders, and clinical and biological markers of COVID-19 severity, antipsychotic use was not associated with 28-day mortality [23.5% (N=727) versus 18.6% (N=727); OR=1.16; 95%CI=0.89-1.51; p=0.280]. This association remained non-significant in exploratory analyses across all classes of antipsychotics and individual molecules, except for typical antipsychotics and loxapine, which were significantly linked to increased 28-day mortality, associations likely due to residual indication bias. Contrariwise, antipsychotics prescribed at daily doses higher than 200 mg of chlorpromazine-equivalents might be associated with reduced 28-day mortality when compared to patients not taking antipsychotics in the matched analytic sample [10.4% (N=154) versus 18.6% (N=727); AOR=0.56; 95%CI=0.31-0.96; p=0.040]. These results suggest that antipsychotic use, when prescribed at usual doses, are not be associated with 28-day mortality in patients hospitalized with COVID-19.
Collapse
Affiliation(s)
- Marina Sánchez-Rico
- AP-HP, AP-HP Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et Addictologie, 92130 Issy-les-Moulineaux, France; Department of Psychobiology and Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain.
| | - Alejandro Edán-Sánchez
- AP-HP, AP-HP Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et Addictologie, 92130 Issy-les-Moulineaux, France; Department of Psychobiology and Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Mark Olfson
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Jesús M Alvarado
- Department of Psychobiology and Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, Madrid, Spain
| | - Guillaume Airagnes
- AP-HP, AP-HP Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et Addictologie, 92130 Issy-les-Moulineaux, France; Université Paris Cité, Paris, France
| | - Katayoun Rezaei
- AP-HP, AP-HP Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et Addictologie, 92130 Issy-les-Moulineaux, France
| | - Aude Delcuze
- CLINEA, Clinique Les Orchidées, Service de Psychiatrie, Andilly, France
| | | | - Frédéric Limosin
- AP-HP, AP-HP Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et Addictologie, 92130 Issy-les-Moulineaux, France; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; Université Paris Cité, Paris, France
| | - Nicolas Hoertel
- AP-HP, AP-HP Hôpital Corentin-Celton, DMU Psychiatrie et Addictologie, Service de Psychiatrie et Addictologie, 92130 Issy-les-Moulineaux, France; Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; INSERM UMR_1266, Institut de Psychiatrie et Neuroscience de Paris, F-75014 Paris, France
| |
Collapse
|
3
|
Pignon B, Decio V, Pirard P, Bouaziz O, Corruble E, Geoffroy PA, Kovess-Masfety V, Leboyer M, Lemogne C, Messika J, Perduca V, Schürhoff F, Regnault N, Tebeka S. The risk of hospitalization for psychotic disorders following hospitalization for COVID-19: a French nationwide longitudinal study. Mol Psychiatry 2023; 28:3293-3304. [PMID: 37537285 DOI: 10.1038/s41380-023-02207-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
COVID-19, like other infectious diseases, may be a risk factor for psychotic disorders. We aimed to compare the proportions of hospitalizations for psychotic disorders in the 12 months following discharge from hospital for either COVID-19 or for another reason in the adult general population in France during the first wave of the pandemic. We conducted a retrospective longitudinal nationwide study using the national French administrative healthcare database. Psychotic disorders were first studied as a whole, and then chronic and acute disorders separately. The role of several adjustment factors, including sociodemographics, a history of psychotic disorder, the duration of the initial hospitalization, and the level of care received during that hospitalization, were also analyzed. Between 1 January 2020 and 30 June 2020, a total of 14,622 patients were hospitalized for psychotic disorders in the 12 months following discharge from hospital for either COVID-19 or another reason. Initial hospitalization for COVID-19 (vs. another reason) was associated with a lower rate of subsequent hospitalization for psychotic disorders (0.31% vs. 0.51%, odds ratio (OR) = 0.60, 95% confidence interval (CI) [0.53-0.67]). This was true for both chronic and acute disorders, even after adjusting for the various study variables. Importantly, a history of psychotic disorder was a major determinant of hospitalization for psychotic disorders (adjusted OR = 126.56, 95% CI [121.85-131.46]). Our results suggest that, in comparison to individuals initially hospitalized for another reason, individuals initially hospitalized for COVID-19 present a lower risk of hospitalization for first episodes of psychotic symptoms/disorders or for psychotic relapse in the 12 months following discharge. This finding contradicts the hypothesis that there is a higher risk of psychotic disorders after a severe COVID-19.
Collapse
Affiliation(s)
- Baptiste Pignon
- Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, translational Neuropsychiatry, Fondation FondaMental, F-94010, Creteil, France.
| | - Valentina Decio
- Santé publique France, French National Public Health Agency, Non Communicable Diseases and Trauma Division, F-94415, Saint-Maurice, France
| | - Philippe Pirard
- Santé publique France, French National Public Health Agency, Non Communicable Diseases and Trauma Division, F-94415, Saint-Maurice, France
| | | | - Emmanuelle Corruble
- CESP, MOODS Team, INSERM UMR 1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, F-94275, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, F-75019, Paris, France
| | | | - Marion Leboyer
- Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, translational Neuropsychiatry, Fondation FondaMental, F-94010, Creteil, France
| | - Cédric Lemogne
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004, Paris, France
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, F-75004, Paris, France
| | - Jonathan Messika
- APHP.Nord-Université Paris Cité, Hôpital Bichat-Claude Bernard, Service de Pneumologie B et Transplantation Pulmonaire, Paris, France
- Physiopathology and Epidemiology of Respiratory Diseases, UMR1152 INSERM and Université de Paris, Paris, France
| | | | - Franck Schürhoff
- Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, translational Neuropsychiatry, Fondation FondaMental, F-94010, Creteil, France
| | - Nolwenn Regnault
- Santé publique France, French National Public Health Agency, Non Communicable Diseases and Trauma Division, F-94415, Saint-Maurice, France
| | - Sarah Tebeka
- Santé publique France, French National Public Health Agency, Non Communicable Diseases and Trauma Division, F-94415, Saint-Maurice, France
| |
Collapse
|
4
|
Diaz-Castro L, Suarez-Herrera JC, Gonzalez-Ruiz OO, Orozco-Nunez E, Sanchez-Dominguez MS. Governance in mental healthcare policies during the COVID-19 pandemic in Mexico. Front Public Health 2023; 11:1017483. [PMID: 36960375 PMCID: PMC10029603 DOI: 10.3389/fpubh.2023.1017483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 02/13/2023] [Indexed: 03/08/2023] Open
Abstract
The COVID-19 pandemic has become the greatest burden of disease worldwide and in Mexico, affecting more vulnerable groups in society, such as people with mental disorders (MD). This research aims to analyze the governance processes in the formulation of healthcare policies for people with MD in the face of the COVID-19 pandemic. An analytical qualitative study, based on semi-structured interviews with key informants in the healthcare system was conducted in 2020. The study followed the theoretical-methodological principles of the Governance Analytical Framework (GAF). The software ATLAS.ti-V.9 was used for inductive thematic analysis, classifying themes and their categories. To ensure the proper interpretation of the data, a process of triangulation among the researchers was carried out. The findings revealed that in Mexico, the federal Secretary of Health issued guidelines for mental healthcare, but there is no defined national policy. Decision-making involved multiple actors, with different strategies and scopes, depending on the type of key-actor and their level of influence. Majority of informants described a problem of implementation in which infection control policies in the psychiatric population were the same as in the general populations which decreased the percentage of access to healthcare during the pandemic, without specific measures to address this vulnerable population. The results suggest that there is a lack of specific policies and measures to address the needs of people with mental disorders during the COVID-19 pandemic in Mexico. It also highlights the importance of considering the role of different actors and their level of influence in the decision-making process.
Collapse
Affiliation(s)
- Lina Diaz-Castro
- National Institute of Psychiatry Ramon de la Fuente Muñiz, Directorate of Epidemiological and Psychosocial Research, Mexico City, Mexico
- *Correspondence: Lina Diaz-Castro
| | - Jose Carlos Suarez-Herrera
- KEDGE Business School, Entrepreneurship and Sustainable Development, Department of Strategy, Marseille, France
| | | | - Emanuel Orozco-Nunez
- Medical Sciences, National Institute of Public Health, Health Systems Research Center, Cuernavaca, Mexico
| | | |
Collapse
|
5
|
Une équipe mobile de psychiatrie du sujet âgé au temps de la pandémie : situations cliniques et ressenti des soignantes. NPG NEUROLOGIE - PSYCHIATRIE - GÉRIATRIE 2022. [PMCID: PMC9520318 DOI: 10.1016/j.npg.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Notre équipe mobile de psychiatrie du sujet âgé est restée mobilisée pendant le premier confinement lié à la propagation du SARS-CoV-2. Des adaptations et des modifications des pratiques soignantes ont été nécessaires face aux nouvelles contraintes et à l’absence de différents partenaires sur le terrain. À travers cet article, nous souhaitons partager deux situations cliniques : l’une concerne un duo mère-fille vivant dans un lieu inadapté à la vie à deux, et l’autre, la situation d’une patiente de 93 ans atteinte de troubles cognitifs et ayant contracté le virus. À partir de ces deux situations, l’article aborde le vécu, les émotions et le ressenti des soignantes durant cette période inédite.
Collapse
|
6
|
Lee J, Hong SW, Kim K. Mental Health of Adolescents and Subjective Economic Deterioration Caused by COVID-19 in Korea. J Korean Med Sci 2022; 37:e268. [PMID: 36065652 PMCID: PMC9444571 DOI: 10.3346/jkms.2022.37.e268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/21/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic greatly impacted the health and economy worldwide. Children and adolescents are less affected by COVID-19 but are more vulnerable to secondary damage, such as mental health. We would like to evaluate the subjective economic changes caused by COVID-19 in Korea and adolescents' mental health status. METHODS The data are based on the Korea Youth Risk Behavior Survey, published by the Korea Center for Disease Control and Prevention in South Korea. It is an annual cross-sectional national representative survey of middle and high school students. There were 54,948 subjects, and the survey was conducted from August 3, 2020 to November 13, 2020. We investigated usual stress, loneliness, anxiety, sadness and hopelessness, and suicidal ideation. RESULTS We found that the odds ratio of adolescent mental health increased as the economic deterioration caused by COVID-19 increased. Overall, it was more severe in female students, and the greater the economic change, the worse the anxiety in boys and the worse the sadness and hopelessness in girls. CONCLUSION We hope that it will be possible to prevent and intervene early in adolescents, considering not only the risk of infection from COVID-19 but also mental health, especially mental health related to the economic deterioration caused by COVID-19.
Collapse
Affiliation(s)
- JaeHyuck Lee
- Department of Family Medicine, Keimyung University Daegu Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Seung Wan Hong
- Department of Family Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Keonyeop Kim
- Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
| |
Collapse
|
7
|
Pellegrina U, Deligne H, Quaglino V. Impacts des conditions de vie durant le confinement sur les personnes souffrant de maladies psychiatriques. PSYCHOLOGIE FRANCAISE 2022. [DOI: 10.1016/j.psfr.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
8
|
Bastide J, Barruel D, Masson VDL, Gourevitch R, Pham A. Urgences psychiatriques chez les 15–25 ans durant la première année de la crise sanitaire : une étude épidémiologique descriptive dans le plus grand centre d’urgences psychiatriques français. ANNALES MEDICO-PSYCHOLOGIQUES 2022. [DOI: 10.1016/j.amp.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
9
|
Bera L, Souchon M, Ladsous A, Colin V, Lopez-Castroman J. Emotional and Behavioral Impact of the COVID-19 Epidemic in Adolescents. Curr Psychiatry Rep 2022; 24:37-46. [PMID: 35102536 PMCID: PMC8803571 DOI: 10.1007/s11920-022-01313-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW This review of the literature aims to explore the impact of the COVID-19 pandemic and the lockdown on teenagers' mental health. We distinguish two groups: adolescents who had already been diagnosed with a mental disorder and the general population of adolescents. RECENT FINDINGS An increase in the number of mental health-related difficulties in adolescents has already been reported in previous health crises. Accordingly, the perceived well-being of teenagers declined during the COVID-19 pandemic. Adolescents with mental disorders were significantly more affected by the lockdown than those in the general population. The effect of the COVID-19 crisis on the mental health of adolescents has been heterogeneous. The first pandemic wave was essentially associated with an increase of internalizing symptoms in adolescents, particularly anxiety, depression and eating disorders. The impact on externalizing symptoms was less clear, and seem to concern mostly adolescents with pre-existing behavioral disorders. During the second and later waves of the pandemic, an upsurge of suicidal ideation and attempts among adolescents have been reported in many countries.
Collapse
Affiliation(s)
- Laure Bera
- Département de psychiatrie, CHU Nîmes, Nîmes, France
| | | | | | - Vincent Colin
- Département de psychiatrie, CHU Nîmes, Nîmes, France
| | - Jorge Lopez-Castroman
- Département de psychiatrie, CHU Nîmes, Nîmes, France. .,IGF, CNRS-INSERM, Montpellier, France. .,University of Montpellier, Montpellier, France.
| |
Collapse
|
10
|
Sánchez-Rico M, Limosin F, Vernet R, Beeker N, Neuraz A, Blanco C, Olfson M, Lemogne C, Meneton P, Daniel C, Paris N, Gramfort A, Lemaitre G, De La Muela P, Salamanca E, Bernaux M, Bellamine A, Burgun A, Hoertel N. Hydroxyzine Use and Mortality in Patients Hospitalized for COVID-19: A Multicenter Observational Study. J Clin Med 2021; 10:5891. [PMID: 34945186 PMCID: PMC8707307 DOI: 10.3390/jcm10245891] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 02/07/2023] Open
Abstract
(1) Background: Based on its antiviral activity, anti-inflammatory properties, and functional inhibition effects on the acid sphingomyelinase/ceramide system (FIASMA), we sought to examine the potential usefulness of the H1 antihistamine hydroxyzine in patients hospitalized for COVID-19. (2) Methods: In a multicenter observational study, we included 15,103 adults hospitalized for COVID-19, of which 164 (1.1%) received hydroxyzine within the first 48 h of hospitalization, administered orally at a median daily dose of 25.0 mg (SD = 29.5). We compared mortality rates between patients who received hydroxyzine at hospital admission and those who did not, using a multivariable logistic regression model adjusting for patients' characteristics, medical conditions, and use of other medications. (3) Results: This analysis showed a significant association between hydroxyzine use and reduced mortality (AOR, 0.51; 95%CI, 0.29-0.88, p = 0.016). This association was similar in multiple sensitivity analyses. (4) Conclusions: In this retrospective observational multicenter study, the use of the FIASMA hydroxyzine was associated with reduced mortality in patients hospitalized for COVID-19. Double-blind placebo-controlled randomized clinical trials of hydroxyzine for COVID-19 are needed to confirm these results, as are studies to examine the potential usefulness of this medication for outpatients and as post-exposure prophylaxis for individuals at high risk for severe COVID-19.
Collapse
Affiliation(s)
- Marina Sánchez-Rico
- Département de Psychiatrie, Hôpital Corentin-Celton, AP-HP.Centre-Université de Paris, 92130 Issy-les-Moulineaux, France; (F.L.); (C.L.); (P.D.L.M.); (N.H.)
- Department of Psychobiology & Behavioural Sciences Methods, Faculty of Psychology, Campus de Somosaguas Universidad Complutense de Madrid, 28223 Pozuelo de Alarcon, Spain
| | - Frédéric Limosin
- Département de Psychiatrie, Hôpital Corentin-Celton, AP-HP.Centre-Université de Paris, 92130 Issy-les-Moulineaux, France; (F.L.); (C.L.); (P.D.L.M.); (N.H.)
- Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, UMR_S1266, INSERM, 75014 Paris, France
- UFR de Médecine, Faculté de Santé, Université de Paris, 75006 Paris, France
| | - Raphaël Vernet
- Hôpital Européen Georges Pompidou, Medical Informatics, Biostatistics and Public Health Department, AP-HP.Centre-Université de Paris, 75015 Paris, France;
| | - Nathanaël Beeker
- Unité de Recherche Clinique, Hopital Cochin, Assistance Publique-Hopitaux de Paris, 75004 Paris, France;
| | - Antoine Neuraz
- Cordeliers Research Center, Université de Paris, UMRS 1138, INSERM, 75006 Paris, France; (A.N.); (A.B.)
- Department of Medical Informatics, Necker-Enfants Malades Hospital, AP-HP, Centre-Université de Paris, 75015 Paris, France
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, 6001 Executive Boulevard, Bethesda, MD 20852, USA;
| | - Mark Olfson
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA;
| | - Cédric Lemogne
- Département de Psychiatrie, Hôpital Corentin-Celton, AP-HP.Centre-Université de Paris, 92130 Issy-les-Moulineaux, France; (F.L.); (C.L.); (P.D.L.M.); (N.H.)
- Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, UMR_S1266, INSERM, 75014 Paris, France
- UFR de Médecine, Faculté de Santé, Université de Paris, 75006 Paris, France
| | - Pierre Meneton
- Laboratoire d’Informatique Médicale et d’Ingénierie des Connaissances en e-Santé, UMR 1142, INSERM, Sorbonne Université, Université Paris 13, 93017 Paris, France;
| | - Christel Daniel
- AP-HP, DSI-WIND (Web Innovation Données), 75184 Paris, France; (C.D.); (N.P.)
- Laboratoire d’Informatique Médicale et d’Ingénierie des Connaissances en e-Santé, Sorbonne University, University Paris 13, Sorbonne Paris Cité, INSERM UMRS 1142, 75012 Paris, France
| | - Nicolas Paris
- AP-HP, DSI-WIND (Web Innovation Données), 75184 Paris, France; (C.D.); (N.P.)
- LIMSI, CNRS, Université Paris-Sud, Université Paris-Saclay, 91405 Orsay, France
| | - Alexandre Gramfort
- Institut National de Recherche en Sciences et Technologies du Numérique (INRIA), Université Paris-Saclay, INRIA, CEA, 75012 Palaiseau, France; (A.G.); (G.L.)
| | - Guillaume Lemaitre
- Institut National de Recherche en Sciences et Technologies du Numérique (INRIA), Université Paris-Saclay, INRIA, CEA, 75012 Palaiseau, France; (A.G.); (G.L.)
| | - Pedro De La Muela
- Département de Psychiatrie, Hôpital Corentin-Celton, AP-HP.Centre-Université de Paris, 92130 Issy-les-Moulineaux, France; (F.L.); (C.L.); (P.D.L.M.); (N.H.)
- Department of Psychobiology & Behavioural Sciences Methods, Faculty of Psychology, Campus de Somosaguas Universidad Complutense de Madrid, 28223 Pozuelo de Alarcon, Spain
| | - Elisa Salamanca
- Banque Nationale de Données Maladies Rares (BNDMR), Campus Picpus, Département WIND (Web Innovation Données), AP-HP, 75012 Paris, France;
| | - Mélodie Bernaux
- Direction de la Stratégie et de la Transformation, AP-HP, 75004 Paris, France;
| | - Ali Bellamine
- Unité de Recherche Clinique, Hôpital Cochin, AP-HP, Centre-Université de Paris, 75014 Paris, France;
| | - Anita Burgun
- Cordeliers Research Center, Université de Paris, UMRS 1138, INSERM, 75006 Paris, France; (A.N.); (A.B.)
| | - Nicolas Hoertel
- Département de Psychiatrie, Hôpital Corentin-Celton, AP-HP.Centre-Université de Paris, 92130 Issy-les-Moulineaux, France; (F.L.); (C.L.); (P.D.L.M.); (N.H.)
- Institut de Psychiatrie et Neurosciences de Paris, Université de Paris, UMR_S1266, INSERM, 75014 Paris, France
- UFR de Médecine, Faculté de Santé, Université de Paris, 75006 Paris, France
| | | |
Collapse
|
11
|
[Psychiatric emergencies in teleconsultation: legal and practical aspects]. Soins Psychiatr 2021; 42:35-41. [PMID: 34895693 DOI: 10.1016/j.spsy.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In the context of the Covid-19 pandemic, teleconsultation is an obvious solution in psychiatry to ensure continuity of care and facilitate access. However, the digitisation of ambulatory practices raises a certain number of reservations, in particular concerning the remote management of psychiatric emergencies. These situations, because of the specific aspects they cover, are in fact upsetting texts and recommendations of good practice in terms of teleconsultation. Thus, the questions of eligibility of people suffering from psychiatric disorders, the identification of an immediate self- or hetero-aggressive risk during teleconsultation and the establishment of a measure of psychiatric care without consent at the end of a teleconsultation require specific reflection in order to allow the practitioner to anticipate and manage the situation in the best possible way.
Collapse
|
12
|
Menculini G, Tortorella A, Albert U, Carmassi C, Carrà G, Cirulli F, Dell’Osso B, Luciano M, Nanni MG, Pompili M, Sani G, Volpe U, Fiorillo A, Sampogna G. Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study. Brain Sci 2021; 11:brainsci11111413. [PMID: 34827412 PMCID: PMC8615495 DOI: 10.3390/brainsci11111413] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels. Mental health services have been called to play a key role in facing the impact of the pandemic on the mental health of the general population. In the period March-May 2020, an online survey was implemented as part of the Covid Mental Health Trial (COMET), a multicentric collaborative study carried out in Italy, one of the Western countries most severely hit by the pandemic. The present study aims to investigate the use of mental health resources during the first wave of the pandemic. The final sample consisted of 20,712 participants, mainly females (N = 14,712, 71%) with a mean age of 40.4 ± 14.3 years. Access to mental health services was reported in 7.7% of cases. Among those referred to mental health services, in 93.9% of cases (N = 1503 subjects) a psychological assessment was requested and in 15.7% of cases (N = 252) a psychiatric consultation. People reporting higher levels of perceived loneliness (OR 1.079, 95% CI 1.056-1.101, p < 0.001), practicing smart-working (OR 1.122, 95% CI 0.980-1.285, p = 0.095), using avoidant (OR 1.586, 95% CI 1.458-1.725, p < 0.001) and approach (OR 1.215, 95% CI 1.138-1.299, p < 0.001) coping strategies more frequently accessed mental health services. On the other hand, having higher levels of perceived social support (OR 0.833, 95% CI 0.795-0.873, p < 0.001) was associated with a reduced probability to access mental health services. The COVID-19 pandemic represents a new threat to the mental health and well-being of the general population, therefore specific strategies should be implemented to promote access to mental healthcare during the pandemic and afterwards.
Collapse
Affiliation(s)
- Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy;
- Correspondence: ; Tel.: +39-075-578-3194
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy;
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34128 Trieste, Italy;
- Department of Mental Health, Psychiatric Clinic, Azienda Sanitaria Universitaria Giuliano-Isontina—ASUGI, 34128 Trieste, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milan Bicocca, 20126 Milano, Italy;
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, National Institute of Health, 00161 Rome, Italy;
| | - Bernardo Dell’Osso
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20157 Milan, Italy;
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, 20142 Milan, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy; (M.L.); (A.F.); (G.S.)
| | - Maria Giulia Nanni
- Department of Biomedical and Specialty Surgical Sciences, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy;
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Department of Psychiatry, Fondazione Policlinico Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Umberto Volpe
- Clinical Psychiatry Unit, Department of Clinical Neurosciences, Università Politecnica delle Marche, 60121 Ancona, Italy;
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy; (M.L.); (A.F.); (G.S.)
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Largo Madonna delle Grazie, 80138 Naples, Italy; (M.L.); (A.F.); (G.S.)
| |
Collapse
|
13
|
Leaune E, Vieux M, Marchal M, Combes C, Crandall S, Haesebaert J, Poulet E. Self-reported mental health symptoms, quality of life and coping strategies in French health sciences students during the early stage of the COVID-19 pandemic: An online survey. Encephale 2021; 48:607-614. [PMID: 34625216 PMCID: PMC8461261 DOI: 10.1016/j.encep.2021.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 01/22/2023]
Abstract
Introduction Health sciences students usually report high rates of mental health problems. The COVID-19 pandemic context may have serious psychological impacts in this at-risk population. We aimed to assess the self-reported mental health status, health-related quality of life and coping strategies of health sciences students during the early stage of the pandemic. Method An online 128-item questionnaire sent to 17,673 health sciences students from the Claude Bernard University Lyon 1 in April 2020 assessed: a) sociodemographic characteristics, b) conditions of lockdown, c) depressive (Beck Depression Inventory- Short Form, BDI-SF), anxiety (State-Trait Anxiety Inventory-A, STAI-A) and traumatic symptoms (Impact of Event Scale -Revised, IES-R), d) health-related quality of life (SF12) and e) coping strategies (Brief Coping Orientation to Problems Experienced, Brief COPE). Results The participation rate was 9.9% (n = 1,765). A total of 19.5% of participants reported an IES-R > 33, 11.6% depressive symptoms, 58.1% anxiety symptoms, and 4.4% suicidal ideation. Their mental health-related quality of life was significantly poorer than for physical health. Female gender, COVID-like symptoms, social isolation due to the lockdown, pandemic-related financial restraint and exams-related stress were significantly associated with poorer self-reported mental health conditions. Volunteering in the healthcare system was significantly associated with lower mental health scores. Coping strategies were mostly oriented toward avoidance and positive appraisal. Conclusion French health sciences students exhibited high levels of self-reported mental health problems and a poor mental health-related quality of life during the early stage of the COVID-19 pandemic. Specific risk factors related to the pandemic partly explain the observed prevalence.
Collapse
Affiliation(s)
- E Leaune
- Centre Hospitalier Le Vinatier, 69500 Bron, France; INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response-PSYR2 Team, 69000 Lyon, France; Claude Bernard Lyon 1 University, 69000 Villeurbanne, France.
| | - M Vieux
- Centre Hospitalier Le Vinatier, 69500 Bron, France
| | - M Marchal
- Centre Hospitalier Le Vinatier, 69500 Bron, France; Lumière Lyon 2 University, 69500 Bron, France
| | - C Combes
- Claude Bernard Lyon 1 University, 69000 Villeurbanne, France
| | - S Crandall
- Wake Forrest School of Medicine, Winston-Salem, NC, États-Unis
| | - J Haesebaert
- Claude Bernard Lyon 1 University, 69000 Villeurbanne, France; EA 7425, HESPER Health Services and Performance Research-Claude Bernard Lyon 1 University, Université de Lyon, Lyon, France
| | - E Poulet
- Centre Hospitalier Le Vinatier, 69500 Bron, France; INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response-PSYR2 Team, 69000 Lyon, France; Claude Bernard Lyon 1 University, 69000 Villeurbanne, France; Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, 69000 Lyon, France
| |
Collapse
|
14
|
Maurice V, Didillon A, Purper-Ouakil D, Kerbage H. Adapting a parent training program to the COVID-19 crisis in a mental health care setting in France. Encephale 2021; 48:354-358. [PMID: 34649712 PMCID: PMC8504859 DOI: 10.1016/j.encep.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/28/2021] [Accepted: 06/12/2021] [Indexed: 11/02/2022]
Affiliation(s)
- V Maurice
- Centre hospitalier universitaire de Montpellier, Saint Eloi Hospital, 80, avenue Augustin Fliche, 34195 Montpellier, France.
| | - A Didillon
- Centre hospitalier universitaire de Montpellier, Saint Eloi Hospital, 80, avenue Augustin Fliche, 34195 Montpellier, France
| | - D Purper-Ouakil
- Centre hospitalier universitaire de Montpellier, Saint Eloi Hospital, 80, avenue Augustin Fliche, 34195 Montpellier, France; Inserm U 1018, CESP, psychiatry, development and trajectories, Paris, France
| | - H Kerbage
- Centre hospitalier universitaire de Montpellier, Saint Eloi Hospital, 80, avenue Augustin Fliche, 34195 Montpellier, France
| |
Collapse
|
15
|
Ricadat É, Béliard A, Citrini M, Craus Y, Gabarro C, Mamzer MF, Marques A, Sannié T, Teixeira M, Tocilovac M, Velpry L, Villa F, Virole L, Lefève C. COVID-19 Health Crisis and Chronic Illness: Protocol for a Qualitative Study. JMIR Res Protoc 2021; 10:e28728. [PMID: 34460413 PMCID: PMC8432515 DOI: 10.2196/28728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022] Open
Abstract
Background The acute nature of the COVID-19 pandemic has put a strain on health resources that are usually dedicated to chronic illnesses. Resulting changes in care practices and networks have had major repercussions on the experience of people with chronic disorders. Objective This paper presents the protocol of the Parcours, Associations, Réseau, Chronicité, Organisation, Usagers, Retour d’expérience, Soins (PARCOURS)-COVID study. The aim of this study is to evaluate the effects of reorganization of the health system on the usual care network of patients with chronic illness, which fosters and qualifies the quality and continuum of care provided. The first objective of this study is to document these patients’ experiences through transformations and adaptations of their network, both in the practical dimension (ie, daily life and care) and subjective dimension (ie, psychosocial experience of illness and relationship to the health system). The second objective of the study is to understand and acknowledge these reorganizations during the COVID-19 lockdown and postlockdown periods. The third objective is to produce better adapted recommendations for patients with chronic illness and value their experience for the management of future health crisis. Methods The PARCOURS-COVID study is a qualitative and participatory research involving patient organizations as research partners and members of these organizations as part of the research team. Three group of chronic diseases have been selected regarding the specificities of the care network they mobilize: (1) cystic fibrosis and kidney disease, (2) hemophilia, and (3) mental health disorders. Four consecutive phases will be conducted, including (1) preparatory interviews with medical or associative actors of each pathology field; (2) in-depth individual interviews with patients of each pathology, analyzed using the qualitative method of thematic analysis; (3) results of both these phases will then be triangulated through interviews with members of each patient’s care ecosystem; and finally, (4) focus groups will be organized to discuss the results with research participants (ie, representatives of chronic disease associations; patients; and actors of the medical, psychosocial, and family care network) in a research-action framework. Results The protocol study has undergone a peer review by the French National Research Agency’s scientific committee and has been approved by the research ethical committee of the University of Paris (registration number: IRB 00012020-59, June 28, 2020). The project received funding from August 2020 through April 2021. Expected results will be disseminated in 2021 and 2022. Conclusions Our findings will better inform the stakes of the current health crisis on the management of patients with chronic illness and, more broadly, any future crisis for a population deemed to be at risk. They will also improve health democracy by supporting better transferability of knowledge between the scientific and citizen communities. International Registered Report Identifier (IRRID) DERR1-10.2196/28728
Collapse
Affiliation(s)
- Élise Ricadat
- Institut La Personne en Médecine, Université de Paris, Paris, France.,Institut de la Recherche Saint Louis (IRSL), Université de Paris, Paris, France.,Centre de Recherche Psychanalyse, Médecine et Société (CRPMS), Université de Paris, Paris, France
| | - Aude Béliard
- Institut La Personne en Médecine, Université de Paris, Paris, France.,Centre de Recherche Médecine, Science, Santé, Santé mentale, Société (CERMES 3), Université de Paris, Paris, France
| | - Marie Citrini
- Représentante des Usagers Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Yann Craus
- Institut d'Histoire et de Philosophie des Sciences et des Techniques (IHPST), Université Paris 1 - Panthéon Sorbonne, Paris, France.,Institut des Humanités en Médecine (IHM), Université de Lausanne, Lausanne, Switzerland
| | - Céline Gabarro
- Institut La Personne en Médecine, Université de Paris, Paris, France.,Laboratoire Épidémiologie Clinique et Evaluation Economique appliqué aux populations Vulnérables (ECEVE), Université de Paris, Paris, France
| | - Marie-France Mamzer
- Unité de Recherche Ethics, Research, Translation (ETREs), Centre de Recherche des Cordeliers, Université de Paris, Paris, France.,Unité Fonctionnelle d'Ethique Médicale, Hôpital Necker- Enfants malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Ana Marques
- Etablissement Public de Santé Mentale Ville Evrard, Neuilly-sur-Marne, France
| | | | - Maria Teixeira
- Laboratoire Épidémiologie Clinique et Evaluation Economique appliqué aux populations Vulnérables (ECEVE), Université de Paris, Paris, France
| | - Marko Tocilovac
- Institut La Personne en Médecine, Université de Paris, Paris, France
| | - Livia Velpry
- Institut La Personne en Médecine, Université de Paris, Paris, France.,Centre de Recherche Médecine, Science, Santé, Santé mentale, Société (CERMES 3), Université de Paris, Paris, France.,Université Paris 8, Saint-Denis, France
| | - François Villa
- Institut La Personne en Médecine, Université de Paris, Paris, France.,Centre de Recherche Psychanalyse, Médecine et Société (CRPMS), Université de Paris, Paris, France
| | - Louise Virole
- Institut La Personne en Médecine, Université de Paris, Paris, France
| | - Céline Lefève
- Institut La Personne en Médecine, Université de Paris, Paris, France.,Laboratoire Sciences, Philosophie, Histoire (SPHERE), Université de Paris, Paris, France
| |
Collapse
|
16
|
Hoertel N, Sánchez-Rico M, Vernet R, Beeker N, Jannot AS, Neuraz A, Salamanca E, Paris N, Daniel C, Gramfort A, Lemaitre G, Bernaux M, Bellamine A, Lemogne C, Airagnes G, Burgun A, Limosin F. Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study. Mol Psychiatry 2021; 26:5199-5212. [PMID: 33536545 DOI: 10.1038/s41380-021-01021-4] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/18/2020] [Accepted: 01/07/2021] [Indexed: 11/09/2022]
Abstract
A prior meta-analysis showed that antidepressant use in major depressive disorder was associated with reduced plasma levels of several pro-inflammatory mediators, which have been associated with severe COVID-19. Recent studies also suggest that several antidepressants may inhibit acid sphingomyelinase activity, which may prevent the infection of epithelial cells with SARS-CoV-2, and that the SSRI fluoxetine may exert in-vitro antiviral effects on SARS-CoV-2. We examined the potential usefulness of antidepressant use in patients hospitalized for COVID-19 in an observational multicenter retrospective cohort study conducted at AP-HP Greater Paris University hospitals. Of 7230 adults hospitalized for COVID-19, 345 patients (4.8%) received an antidepressant within 48 h of hospital admission. The primary endpoint was a composite of intubation or death. We compared this endpoint between patients who received antidepressants and those who did not in time-to-event analyses adjusted for patient characteristics, clinical and biological markers of disease severity, and other psychotropic medications. The primary analysis was a multivariable Cox model with inverse probability weighting. This analysis showed a significant association between antidepressant use and reduced risk of intubation or death (HR, 0.56; 95% CI, 0.43-0.73, p < 0.001). This association remained significant in multiple sensitivity analyses. Exploratory analyses suggest that this association was also significant for SSRI and non-SSRI antidepressants, and for fluoxetine, paroxetine, escitalopram, venlafaxine, and mirtazapine (all p < 0.05). These results suggest that antidepressant use could be associated with lower risk of death or intubation in patients hospitalized for COVID-19. Double-blind controlled randomized clinical trials of antidepressant medications for COVID-19 are needed.
Collapse
Affiliation(s)
- Nicolas Hoertel
- AP-HP.Centre-Université de Paris, Hôpital Corentin-Celton, Département Médico-Universitaire de Psychiatrie et Addictologie, 92130, Issy-les-Moulineaux, France. .,INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France. .,Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.
| | - Marina Sánchez-Rico
- AP-HP.Centre-Université de Paris, Hôpital Corentin-Celton, Département Médico-Universitaire de Psychiatrie et Addictologie, 92130, Issy-les-Moulineaux, France.,Department of Psychobiology & Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Campus de Somosaguas, Pozuelo de Alarcon, Spain
| | - Raphaël Vernet
- AP-HP.Centre-Université de Paris, Hôpital Européen Georges Pompidou, Medical Informatics, Biostatistics and Public Health Department, F-75015, Paris, France
| | - Nathanaël Beeker
- AP-HP.Centre-Université de Paris, Unité de Recherche clinique, Hôpital Cochin, Paris, France
| | - Anne-Sophie Jannot
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,AP-HP.Centre-Université de Paris, Hôpital Européen Georges Pompidou, Medical Informatics, Biostatistics and Public Health Department, F-75015, Paris, France.,INSERM, UMR_S1138, Cordeliers Research Center, Université de Paris, Paris, France
| | - Antoine Neuraz
- INSERM, UMR_S1138, Cordeliers Research Center, Université de Paris, Paris, France.,AP-HP.Centre-Université de Paris, Necker-Enfants Malades Hospital, Department of Medical Informatics, 75015, Paris, France
| | - Elisa Salamanca
- Banque Nationale de Données Maladies Rares, Campus Picpus, Département WIND (Web Innovation Données), Paris, France
| | - Nicolas Paris
- AP-HP, DSI-WIND (Web Innovation Données), Paris, France.,LIMSI, CNRS, Université Paris-Sud and Université Paris-Saclay, F-91405, Orsay, France
| | - Christel Daniel
- AP-HP, DSI-WIND (Web Innovation Données), Paris, France.,Sorbonne University, University Paris 13, Sorbonne Paris Cité, INSERM UMR_S1142, F-75012, Paris, France
| | | | | | - Mélodie Bernaux
- Direction de la stratégie et de la transformation, AP-HP, Paris, France
| | - Ali Bellamine
- AP-HP.Centre-Université de Paris, Unité de Recherche clinique, Hôpital Cochin, Paris, France
| | - Cédric Lemogne
- AP-HP.Centre-Université de Paris, Hôpital Corentin-Celton, Département Médico-Universitaire de Psychiatrie et Addictologie, 92130, Issy-les-Moulineaux, France.,INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France.,Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France
| | - Guillaume Airagnes
- AP-HP.Centre-Université de Paris, Hôpital Corentin-Celton, Département Médico-Universitaire de Psychiatrie et Addictologie, 92130, Issy-les-Moulineaux, France.,INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France.,Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France
| | - Anita Burgun
- INSERM, UMR_S1138, Cordeliers Research Center, Université de Paris, Paris, France
| | - Frédéric Limosin
- AP-HP.Centre-Université de Paris, Hôpital Corentin-Celton, Département Médico-Universitaire de Psychiatrie et Addictologie, 92130, Issy-les-Moulineaux, France.,INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France.,Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France
| | | |
Collapse
|
17
|
Davin-Casalena B, Jardin M, Guerrera H, Mabille J, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. The impact of the COVID-19 epidemic on primary care in South-eastern France: implementation of a real-time monitoring system based on regional health insurance system data. Rev Epidemiol Sante Publique 2021; 69:255-264. [PMID: 34454792 PMCID: PMC8818324 DOI: 10.1016/j.respe.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The spring 2020 COVID-19 epidemic severely impacted France's healthcare system. The associated lockdown (17 March- 11 May 2020) and the risk of exposure to SARS-CoV-2 led patients to change their use of healthcare. This article presents the development and implementation of a real-time system to monitor i) private doctors' activity in South-eastern France, and ii) changes in prescription of drugs for people with diabetes, mental health disorders and for certain vaccines from Mars 2020 to October 2020. METHODS Data extracted from the regional healthcare insurance databases for 2019 and 2020 were used to construct indicators of healthcare use. They were calculated on a weekly basis, starting from week 2 2020 and compared for the same period between 2019 and 2020. RESULTS Private doctors' activity decreased during the spring 2020 lockdown (by 23 % for general practitioners and 46 % for specialists), followed by an almost complete return to normal after it ended until week 41. Over the same period, a huge increase in teleconsultations was observed, accounting for 30 % of private doctors' consultations at the height of the crisis. The start of the lockdown was marked by a peak in drug prescriptions, while vaccinations declined sharply (by 39 % for the measles, mumps and rubella (MMR) vaccine in children under 5 years old, and by 54 % for human papillomavirus vaccine in girls aged 10-14 years old). CONCLUSION The ongoing COVID-19 epidemic may lead to health consequences other than those directly attributable to the disease itself. Specifically, lockdowns and foregoing healthcare could be very harmful at the individual and population levels. The latter issue is a concern for French public authorities, which have implemented actions aimed at encouraging patients to immediately seek treatment. However, the COVID-19 crisis has also created opportunities, such as the roll-out of teleconsultation and tele-expertise. The indicators described here as part of the monitoring system can help public decision-makers to become more responsive and to implement tailored actions to better meet the general population's healthcare needs.
Collapse
Affiliation(s)
- B Davin-Casalena
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille.
| | - M Jardin
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - H Guerrera
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - J Mabille
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - H Tréhard
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - D Lapalus
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - C Ménager
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - S Nauleau
- Agence Régionale de Santé (ARS) Provence-Alpes-Côte d'Azur, 132 boulevard de Paris, 13002 Marseille
| | - V Cassaro
- Direction de la Coordination régionale de la Gestion Du Risque (DCGDR), 56 chemin Joseph Aiguier, 13009 Marseille
| | - P Verger
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| | - V Guagliardo
- Observatoire Régional de la Santé (ORS) Provence-Alpes-Côte d'Azur, 27 boulevard Jean Moulin, 13005 Marseille
| |
Collapse
|
18
|
Quel est l’impact du confinement chez les personnes souffrant de troubles psychiatriques lors de la pandémie de COVID-19 ? LA PRESSE MÉDICALE FORMATION 2021. [PMCID: PMC8223026 DOI: 10.1016/j.lpmfor.2021.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Le déploiement sans précédent des mesures de confinement lors de la pandémie de COVID-19 a permis l’émergence d’une littérature précisant ses conséquences pour les personnes atteintes de troubles mentaux. Ces études suggèrent, entre autres, une majoration des symptômes pouvant conduire à l’exacerbation de la dépression, de l’anxiété, des troubles du sommeil et du risque suicidaire. Si les personnes souffrant de troubles anxieux sont particulièrement touchées lors des premières semaines du confinement, les personnes souffrant de troubles bipolaires expérimentent une symptomatologie moins intense mais plus durable. Les personnes souffrant de troubles psychotiques, quant à elles, semblent préservées de l’impact du confinement. Néanmoins les données concernant cette population sont encore peu nombreuses. Par ailleurs, les mesures de confinement sont susceptibles de teinter la présentation clinique de certains troubles mentaux. Une sensibilisation à ces spécificités pourrait alors orienter le regard du clinicien et s’avérer utile à l’adaptation des stratégies préventives, diagnostiques voire thérapeutiques. Parmi les mesures proposées, les plus pertinentes s’articulent autour de la promotion de la santé mentale, du maintien du suivi, et plus largement à la lutte contre l’isolement et la solitude. Les personnes atteintes de troubles mentaux pourraient souffrir d’une persistance à long terme de certains des effets du confinement. D’autres études sont nécessaires afin de caractériser ces effets.
Collapse
|
19
|
Giudici R, Lancioni A, Gay H, Bassi G, Chiara O, Mare C, Latronico N, Pesenti A, Faccincani R, Cabrini L, Fumagalli R, Chieregato A, Briani L, Sammartano F, Sechi G, Zoli A, Pagliosa A, Foti G, Borotto E, Palo A, Valoti O, Botteri M, Carlucci M, Reitano E, Bini R. Impact of the COVID-19 outbreak on severe trauma trends and healthcare system reassessment in Lombardia, Italy: an analysis from the regional trauma registry. World J Emerg Surg 2021; 16:39. [PMID: 34281575 PMCID: PMC8287111 DOI: 10.1186/s13017-021-00383-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022] Open
Abstract
Backgrounds The COVID-19 pandemic drastically strained the health systems worldwide, obligating the reassessment of how healthcare is delivered. In Lombardia, Italy, a Regional Emergency Committee (REC) was established and the regional health system reorganized, with only three hospitals designated as hubs for trauma care. The aim of this study was to evaluate the effects of this reorganization of regional care, comparing the distribution of patients before and during the COVID-19 outbreak and to describe changes in the epidemiology of severe trauma among the two periods. Methods A cohort study was conducted using retrospectively collected data from the Regional Trauma Registry of Lombardia (LTR). We compared the data of trauma patients admitted to three hub hospitals before the COVID-19 outbreak (September 1 to November 19, 2019) with those recorded during the pandemic (February 21 to May 10, 2020) in the same hospitals. Demographic data, level of pre-hospital care (Advanced Life Support-ALS, Basic Life Support-BLS), type of transportation, mechanism of injury (MOI), abbreviated injury score (AIS, 1998 version), injury severity score (ISS), revised trauma score (RTS), and ICU admission and survival outcome of all the patients admitted to the three trauma centers designed as hubs, were reviewed. Screening for COVID-19 was performed with nasopharyngeal swabs, chest ultrasound, and/or computed tomography. Results During the COVID-19 pandemic, trauma patients admitted to the hubs increased (46.4% vs 28.3%, p < 0.001) with an increase in pre-hospital time (71.8 vs 61.3 min, p < 0.01), while observed in hospital mortality was unaffected. TRISS, ISS, AIS, and ICU admission were similar in both periods. During the COVID-19 outbreak, we observed substantial changes in MOI of severe trauma patients admitted to three hubs, with increases of unintentional (31.9% vs 18.5%, p < 0.05) and intentional falls (8.4% vs 1.2%, p < 0.05), whereas the pandemic restrictions reduced road- related injuries (35.6% vs 60%, p < 0.05). Deaths on scene were significantly increased (17.7% vs 6.8%, p < 0.001). Conclusions The COVID-19 outbreak affected the epidemiology of severe trauma patients. An increase in trauma patient admissions to a few designated facilities with high level of care obtained satisfactory results, while COVID-19 patients overwhelmed resources of most other hospitals.
Collapse
Affiliation(s)
- Riccardo Giudici
- Department of Anesthesia and Intensive Care Medicine, ASST Niguarda, Milan, Italy
| | - Armando Lancioni
- Department of Anesthesia and Intensive Care Medicine, University Milano Bicocca, Monza, Italy
| | - Hedwige Gay
- Department of Anesthesia and Intensive Care Medicine, University Milano Bicocca, Monza, Italy
| | - Gabriele Bassi
- Department of Anesthesia and Intensive Care Medicine, ASST Niguarda, Milan, Italy
| | - Osvaldo Chiara
- Emergency Department, General Surgery and Trauma Team, ASST Niguarda, University of Milano, Piazza Ospedale Maggiore 3, 20162, Milano, Italy.
| | - Claudio Mare
- Regional Agency of Emergency and Urgency, Milan, Italy
| | - Nicola Latronico
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
| | - Antonio Pesenti
- Department of Anesthesia, Critical Care and Emergency, Fondazione Policlinico, University of Milan, Milan, Italy
| | | | - Luca Cabrini
- Department of Anesthesia and Intensive Care, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Roberto Fumagalli
- Department of Anesthesia and Intensive Care Medicine, ASST Niguarda, Milan, Italy.,Department of Anesthesia and Intensive Care Medicine, University Milano Bicocca, Milan, Italy
| | - Arturo Chieregato
- Department of Anesthesia and Intensive Care Medicine, Neuro Intensive Care, ASST Niguarda, Milan, Italy
| | - Laura Briani
- Emergency Department, Department of General Surgery and Trauma Team, ASST Niguarda, Milan, Italy
| | - Fabrizio Sammartano
- Emergency Department, Emergency and Trauma Surgery, ASST Santi Carlo e Paolo, Milan, Italy
| | | | - Alberto Zoli
- Regional Agency of Emergency and Urgency, Milan, Italy
| | | | - Giuseppe Foti
- Department of Anesthesia and Intensive Care Medicine, S.Gerardo Hospital, University Milano Bicocca, Monza, Italy
| | - Erika Borotto
- Department of Anesthesia and Intensive Care, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | | | - Marco Botteri
- Regional Agency of Emergency and Urgency, Brescia, Italy
| | - Michele Carlucci
- General and Emergency Surgery and Emergency Department, Ospedale San Raffaele, Milan, Italy
| | - Elisa Reitano
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Roberto Bini
- Emergency Department, Department of General Surgery and Trauma Team, ASST Niguarda, Milan, Italy
| |
Collapse
|
20
|
Rojnic Kuzman M, Vahip S, Fiorillo A, Beezhold J, Pinto da Costa M, Skugarevsky O, Dom G, Pajevic I, Peles AM, Mohr P, Kleinberg A, Chkonia E, Balazs J, Flannery W, Mazaliauskiene R, Chihai J, Samochowiec J, Cozman D, Mihajlovic G, Izakova L, Arango C, Goorwod P. Mental health services during the first wave of the COVID-19 pandemic in Europe: Results from the EPA Ambassadors Survey and implications for clinical practice. Eur Psychiatry 2021; 64:e41. [PMID: 34103102 PMCID: PMC8314055 DOI: 10.1192/j.eurpsy.2021.2215] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations. Methods The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the “EPA Ambassadors”, on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19. Results While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations. Conclusions Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.
Collapse
Affiliation(s)
| | - Simavi Vahip
- Department of Psychiatry, Ege University Medicine Faculty, Affective Disorders Unit, Izmir, Turkey
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Julian Beezhold
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Oleg Skugarevsky
- Psychiatry & Medical Psychology Department, Belarusian Psychiatric Association, Belarusian State Medical University, Minsk, Belarus
| | - Geert Dom
- Belgian Professional Association of Medical Specialists in Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Antwerp, Belgium
| | - Izet Pajevic
- Department of Psychiatry University Clinical Center Tuzla, School of Medicine University of Tuzla, Bosnia and Herzegovina Psychiatric Association of Bosnia-Herzegovina, Tuzla, Bosnia-Herzegovina
| | - Alma Mihaljevic Peles
- Zagreb School of Medicine, Zagreb University Hospital Centre, Zagreb, Croatia.,Croatian Psychiatric Association, Zagreb, Croatia
| | - Pavel Mohr
- Czech Psychiatric Association, National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anne Kleinberg
- Tallinn Children Hospital Children Mental Health, Tallinn, Estonia
| | - Eka Chkonia
- Estonian Psychiatric Association, Centre Tartu University Psychiatry Clinic, TartuEstonia.,Society of Georgian Psychiatrists, Tbilisi State Medical University, Tbilisi, Georgia
| | - Judit Balazs
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Hungarian Psychiatric Association, Bjørknes University College, Oslo, Norway
| | - William Flannery
- Department of Adult Psychiatry, College of Psychiatrists of Ireland, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Ramune Mazaliauskiene
- Lithuanian Psychiatric Association, Lithuanian Health Sciences university, Psychiatric Clinic, Lithuanian Health Sciences university Kaunas hospital, Kaunas, Lithuania
| | - Jana Chihai
- Society of Psychiatrists, Narcologists, Psychotherapists and Clinical Psychologists from Republic of Moldova, Department of Psychiatry, Narcology, Medical Psychology State Medical and Pharmaceutical University "Nicolae Testemitanu" from Republic of Moldova, Kishinev, Moldova
| | - Jerzy Samochowiec
- Polish Psychiatric Association, Department of Psychiatry, Pomeranian Medical University in Szczecin Poland, Szczecin, Poland
| | - Doina Cozman
- Romanian Association of Psychiatry and Psychotherapy, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - Goran Mihajlovic
- Department of Psychiatry, Faculty of Medical Science, University of Kragujevac, Kragujevac, Serbia
| | - Lubomira Izakova
- Slovak Psychiatric Association, Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Philip Goorwod
- INSERM, U1266 (Institute of Psychiatry and Neuroscience of Paris), Université de Paris, Paris, France.,CMME, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France
| |
Collapse
|
21
|
Abstract
OBJECTIVE To examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff. DESIGN Scoping review. DATA SOURCES PubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies. ELIGIBILITY CRITERIA FOR SELECTION OF STUDIES All papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers. RESULTS Of 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons. CONCLUSIONS It is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.
Collapse
Affiliation(s)
- Luke Johnson
- Department of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Kerry Gutridge
- Centre for Women's Mental Health, Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
| | - Julie Parkes
- Department of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Anjana Roy
- Health and Justice Team, Alcohol, Drugs, Tobacco and Justice Division, Public Health England, London, UK
| | - Emma Plugge
- Department of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
- Health and Justice Team, Alcohol, Drugs, Tobacco and Justice Division, Public Health England, London, UK
| |
Collapse
|
22
|
Older Adolescents Who Did or Did Not Experience COVID-19 Symptoms: Associations with Mental Health, Risk Perception and Social Connection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095006. [PMID: 34065093 PMCID: PMC8125970 DOI: 10.3390/ijerph18095006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 12/19/2022]
Abstract
After a decrease in detected cases in the summer, Europe faced the emergence of a second wave of coronavirus disease 19 (COVID-19). Few studies have investigated adolescents, who may constitute a target group with possible lower compliance to public health measures, particularly the social distancing measures. A total sample of 492 participants was included in the study, and the ages of the participants ranged from 18–24 years. According to the hypothesis of our study, the sample was divided into two groups: those who experienced COVID-19 symptoms and those who did not experience COVID-19 symptoms. Demographic characteristics, knowledge, perceptions, and behaviors related to COVID-19 were investigated with ad hoc items; in addition, mood disorders, self-efficacy, and social connectedness were explored. Our results showed significant differences in the variables of risk perception, self-efficacy, and measures of belongingness among older adolescents who did or did not experience COVID-19 symptoms. In this period, adolescents experienced unprecedented disruptions in their daily lives, leading them to isolation and loneliness. Compliance with restrictive measures is considered both a proactive behavior and a social responsibility, especially if supported by prosocial reasons to prevent others from getting sick; therefore, this must be the focus of raising awareness of anti-COVID-19 compliance among adolescents.
Collapse
|
23
|
Htay MNN, Marzo RR, Bahari R, AlRifai A, Kamberi F, El-Abasiri RA, Nyamache JM, Hlaing HA, Hassanein M, Moe S, Abas AL, Su TT. How healthcare workers are coping with mental health challenges during COVID-19 pandemic? - A cross-sectional multi-countries study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 11:100759. [PMID: 33977169 PMCID: PMC8103713 DOI: 10.1016/j.cegh.2021.100759] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 01/02/2023] Open
Abstract
Background The coronavirus pandemic (COVID-19) has a social and psychological impact among healthcare workers worldwide and appropriate coping strategies are essential to avoid the negative mental health effects. This study aimed to investigate the coping strategies among the healthcare workers from different countries and their attitude towards teamwork during the COVID-19 pandemic. Methods A cross-sectional study was conducted by using an online, web-based questionnaire, which was distributed to healthcare workers from 32 countries during April and May 2020. The respondents were recruited by the non-random convenience sampling method. Results A total of 2166 respondents responded to the survey and the majority were working in low- and middle-income countries. Among them, 36% were doctors, 24% were nurses and 40% worked in other healthcare sectors. More than 70% of the respondents answered that “getting family support” and “positive thinking” were coping methods for them during the COVID-19 pandemic. Approximately half of the respondents worshiped according to their belief and conducted prayers (58.4%) and had adequate sleep and food intake (48.2%). The significant associations were observed between attitude score towards interprofessional teamwork and gender (p = 0.009), age (31–45 years) (p < 0.001), marital status (p < 0.001), occupation (p < 0.001), working experience (2–5 years) (p = 0.005), current workplace (clinics) (p = 0.002). Conclusion The local healthcare authorities should promote coping methods and develop an innovative way to encourage practicing among healthcare workers. Digital mental health support interventions or workplace mental health support teams should be accessible to protect mental wellbeing among healthcare workers.
Collapse
Affiliation(s)
- Mila Nu Nu Htay
- Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Roy Rillera Marzo
- Department of Public Health, Faculty of Medicine, Asia Metropolitan University, Johor, Malaysia.,Department of Community Medicine, International Medical School, Management and Science University, Selangor, Malaysia
| | - Rafidah Bahari
- Department of Psychiatry, Faculty of Medicine, University of Cyberjaya, Cyberjaya, Malaysia
| | - Ayesha AlRifai
- Birzeit University & Arab American University in Palestine, Palestine
| | - Fatjona Kamberi
- Research Centre of Public Health, Faculty of Health, University of Vlore "Ismail Qemali", Vlore, Albania
| | - Radwa Abdullah El-Abasiri
- Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt
| | - Jeldah Mokeira Nyamache
- North Star Alliance, Kenya.,North Star Alliance, Uganda.,North Star Alliance, Tanzania.,North Star Alliance, Zimbabwe.,North Star Alliance, Mozambique.,North Star Alliance, South Africa
| | - Htet Aung Hlaing
- Senior Resident Medical Officer (General Practitioner), Pun Hlaing Siloam Hospital, Yangon, Myanmar
| | - Mayada Hassanein
- Maternal and Child Health Unit, Alexandria Fever Hospital, Alexandria, Egypt
| | - Soe Moe
- Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Adinegara Lutfi Abas
- Department of Community Medicine, Melaka-Manipal Medical College, Manipal Academy of Higher Education (MAHE), Melaka, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffery Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| |
Collapse
|
24
|
Surve RM, Sinha P, Baliga SP, M R, Karan N, Jl A, Arumugham S, Thirthalli J. Electroconvulsive therapy services during COVID-19 pandemic. Asian J Psychiatr 2021; 59:102653. [PMID: 33845300 PMCID: PMC8022516 DOI: 10.1016/j.ajp.2021.102653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/05/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has hit the electroconvulsive therapy (ECT) services hard worldwide as it is considered an elective procedure and hence has been given less importance. Other reasons include the risk of transmission of infections, lack of resources, and the scarcity of anesthesiologists due to their diversion to intensive care units to manage COVID-19 patients. However, ECT is an urgent and life-saving measure for patients diagnosed with depression and other severe mental illnesses who have suicidality, catatonia, or require a rapid therapeutic response. COVID-19 pandemic is a significant source of stress for individuals due to its impact on health, employment, and social support resulting in new-onset psychiatric illnesses and the worsening of a pre-existing disorder. Hence, a continuation of the ECT services during the COVID-19 pandemic is of paramount importance. In this narrative review, the authors from India have compiled the literature on the ECT practice during the COVID-19 pandemic related to the screening and testing protocol, necessity of personal protective equipment, modification in ECT Suite, electrical stmulus settings, and anesthesia technique modification. The authors have also shared their experiences with the ECT services provided at their institute during this pandemic. This description will help other institutes to manage the ECT services uninterruptedly and make ECT a safe procedure during the current pandemic.
Collapse
Affiliation(s)
- Rohini M Surve
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Preeti Sinha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
| | - Sachin P Baliga
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Radhakrishnan M
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Nupur Karan
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Anju Jl
- Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Shyamsundar Arumugham
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| |
Collapse
|
25
|
Davin-Casalena B, Jardin M, Guerrera H, J Mabille, Tréhard H, Lapalus D, Ménager C, Nauleau S, Cassaro V, Verger P, Guagliardo V. [The impact of the COVID-19 pandemic on first-line primary care in southeastern France: Feedback on the implementation of a real-time monitoring system based on regional health insurance data]. Rev Epidemiol Sante Publique 2021; 69:105-115. [PMID: 33992499 PMCID: PMC8075812 DOI: 10.1016/j.respe.2021.04.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
Position du problème L’épidémie de COVID-19 du printemps 2020 a fortement affecté le système de soins. Le confinement et les risques d’exposition au coronavirus ont incité les patients à modifier leur recours aux soins. L’objectif était de partager un retour d’expérience sur la mise en place d’un dispositif de surveillance en temps réel de l’activité des médecins libéraux de la région Provence-Alpes-Côte d’Azur, et de l’évolution des remboursements de médicaments prescrits aux assurés du régime général pour le diabète, pour des troubles de la santé mentale et pour certains vaccins. Méthodes Les données ont été extraites à partir des bases régionales de l’Assurance maladie pour les années 2019 et 2020. Elles ont permis de construire des indicateurs en date de soins pour le régime général stricto sensu, calculés de façon hebdomadaire, à partir de la semaine 2. Résultats On constate une chute d’activité des médecins libéraux lors du confinement (−23 % pour les médecins généralistes ; −46 % pour les spécialistes), suivie d’un quasi retour à la normale par la suite. Dans le même temps, les téléconsultations ont connu un véritable essor : elles ont constitué 30 % des actes des médecins libéraux au plus fort de la crise. Le début du confinement a été marqué par un pic d’approvisionnement en médicaments, tandis que la vaccination a fortement diminué (−39 % concernant le vaccin contre la rougeole, les oreillons et la rubéole chez les enfants âgés de moins de 5 ans ; −54 % pour le vaccin contre les papillomavirus humains chez les filles âgées de 10–14 ans). Conclusion L’épidémie de COVID-19 risque d’entraîner d’autres conséquences sanitaires que celles directement imputables à la COVID-19 elle-même. Le renoncement aux soins pourrait causer des retards de soins fortement préjudiciables aux individus et à la collectivité. Ces questions inquiètent les autorités publiques, qui mettent en place des actions visant à inciter les patients à se soigner sans tarder. Mais la crise liée à la COVID-19 a aussi créé des opportunités, telles que le déploiement de la téléconsultation et de la télé-expertise. Bien que partiels, les indicateurs mis en œuvre peuvent permettre aux décideurs publics d’être réactifs et de mettre en place certaines actions afin de répondre aux besoins de santé des populations.
Collapse
Affiliation(s)
- B Davin-Casalena
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France.
| | - M Jardin
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - H Guerrera
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - J Mabille
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - H Tréhard
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - D Lapalus
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - C Ménager
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - S Nauleau
- Agence régionale de santé (ARS) Provence-Alpes-Côte d'Azur, 132, boulevard de Paris, 13002 Marseille, France
| | - V Cassaro
- Direction de la coordination régionale de la gestion du risque (DCGDR), 56, chemin Joseph-Aiguier, 13009 Marseille, France
| | - P Verger
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| | - V Guagliardo
- Observatoire régional de la santé (ORS) Provence-Alpes-Côte d'Azur, 27, boulevard Jean-Moulin, 13005 Marseille, France
| |
Collapse
|
26
|
Sheek-Hussein M, Abu-Zidan FM, Stip E. Disaster management of the psychological impact of the COVID-19 pandemic. Int J Emerg Med 2021; 14:19. [PMID: 33761863 PMCID: PMC7988636 DOI: 10.1186/s12245-021-00342-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/12/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has exposed a suboptimal response to this threatening global disaster, including the response to the psychological impact. Both the economic hardship and the continuous media coverage of alarming news have exacerbated this effect which also includes increased domestic violence. AIM To address this important aspect of disaster management and provide recommendations on how to mitigate these effects. METHODS This is a narrative review written by three experts in community medicine, disaster medicine and psychiatry reflecting the interdisciplinary approach in managing disasters. Selected important papers, personal published papers, PUBMED articles and media news related to the disaster management of the psychological effects of COVID-19 pandemic were collected over the last year, critically appraised and used in writing this manuscript. RESULTS The COVID-19 pandemic causes major emotional distress. Lack of effective treatments and availability of the current vaccines for this virus increases the fear of being infected and infecting others. Negative emotions are common and are related to adjustment but may progress in the long term to anxiety, depression, and post-traumatic stress syndrome. The COVID-19 pandemic has a major impact on mental health. The most common distress reactions include anxiety, insomnia, perception of insecurity, anger, fear of illness, and risky behaviors. Patients having mental disorders are vulnerable during the pandemic because of (1) somatic vulnerability, (2) cognitive and behavioral vulnerability, (3) psychosocial vulnerability, and (4) disruption to psychiatric care. Psychiatric wards, which are commonly separate from main hospitals, should be included in the disaster management plans. Acute care physicians carry the psychological and ethical impact of difficult triage decisions when ending the support of some patients to save others. A combination of fear and guilt may overcome normal human tolerance levels in vulnerable health workers. The moral injuries can be carried for a long time. CONCLUSIONS Addressing the psychological effects is an essential component of disaster management of infectious pandemics. This should be implemented through the whole spectrum of disaster management including preparedness, mitigation, response, and recovery.
Collapse
Affiliation(s)
- Mohamud Sheek-Hussein
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Emmanuel Stip
- Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| |
Collapse
|
27
|
Fond G, Llorca PM, Lançon C, Auquier P, Boyer L. [Mortality in schizophrenia: Towards a new health scandal? COVID-19 and schizophrenia]. ANNALES MEDICO-PSYCHOLOGIQUES 2021; 179:353-362. [PMID: 33753948 PMCID: PMC7969983 DOI: 10.1016/j.amp.2021.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Les patients atteints de schizophrénie représentent une population vulnérable qui a été sous-étudiée dans le cadre de la recherche COVID-19. Nous avons cherché à établir si les résultats et les soins de santé différaient entre les patients atteints de schizophrénie et les patients sans diagnostic de maladie mentale. Nous avons mené une étude basée sur la population de tous les patients présentant des symptômes respiratoires et une infection à COVID-19 identifiés qui ont été hospitalisés en France entre février et juin 2020. Au total, 50 750 patients ont été inclus, dont 823 étaient des patients avec schizophrénie (1,6 %). Ces derniers ont connu une augmentation de la mortalité hospitalière (25,6 % contre 21,7 % pour les autres patients) et une diminution du taux d’admission en unité de soins intensifs-réanimation (23,7 % contre 28,4 %) par rapport aux témoins. Les patients schizophrènes âgés de 65 à 80 ans présentaient un risque de mortalité significativement plus élevé que les témoins du même âge (+7,89 %) alors qu’ils ont été moins admis en USI que les témoins du même âge (−15,44 %). Cette étude montre l’existence de disparités en matière de santé et d’accès aux soins entre les patients schizophrènes et les patients sans diagnostic de maladie mentale. Ces disparités diffèrent en fonction de l’âge et du profil clinique des patients, ce qui suggère l’importance d’une gestion clinique personnalisée du COVID-19 et de stratégies de soins de santé avant, pendant et après l’hospitalisation pour réduire les disparités de santé dans cette population vulnérable. Les patients schizophrènes âgés de 65 à 80 ans étaient plus souvent envoyés par les hôpitaux ou les institutions que les patients sans diagnostic de maladie mentale grave, ce qui peut expliquer les mauvais résultats de santé des patients schizophrènes. Une étude française a rapporté que la plupart des patients psychiatriques hospitalisés avec un diagnostic COVID-19 étaient gardés dans des services psychiatriques spécialisés et non dans des hôpitaux généraux. La division entre médecine physique et psychiatrique entraîne une confusion quant au secteur du service de santé (c’est-à-dire les niveaux de soins primaires, de santé mentale ou de soins aigus) qui devrait assumer la responsabilité de la gestion des patients ayant des besoins de santé complexes. Nous manquons de données nationales sur le taux de patients âgés schizophrènes qui sont institutionnalisés, mais nous pouvons raisonnablement supposer que l’institutionnalisation est un facteur de risque d’infection grave par COVID-19 chez les patients âgés avec schizophrénie. Nos résultats soutiennent une stratégie de détection systématique chez les patients avec schizophrénie institutionnalisés et d’intervention précoce dans cette population. Cela a déjà été fait dans un refuge pour sans-abri à Boston où 36 % des résidents ont été testés positifs. Le taux d’admission en réanimation était plus faible chez les patients schizophrènes que chez les patients sans diagnostic de maladie mentale grave, ce qui illustre parfaitement le débat entre les arguments fondés sur l’utilité et ceux fondés sur l’équité. Les patients schizophrènes présentaient l’un des plus mauvais indicateurs de pronostic justifiant le triage en réanimation. Cependant, ce triage basé uniquement sur le pronostic exacerbe les inégalités existantes en matière de santé, laissant les patients défavorisés dans une situation plus difficile.
Collapse
Affiliation(s)
- Guillaume Fond
- FondaMental Academic Centers of Expertise for Schizophrenia, Créteil, France.,Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean-Moulin, 13005 Marseille, France.,Aix-Marseille University, Assistance publique Hôpitaux universitaires de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, France
| | - Pierre-Michel Llorca
- FondaMental Academic Centers of Expertise for Schizophrenia, Créteil, France.,CMP B, CHU, EA 7280 Faculté de médecine, Université d'Auvergne, BP 69, 63003 Clermont-Ferrand Cedex 1, France
| | - Christophe Lançon
- FondaMental Academic Centers of Expertise for Schizophrenia, Créteil, France.,Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean-Moulin, 13005 Marseille, France.,Aix-Marseille University, Assistance publique Hôpitaux universitaires de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, France
| | - Pascal Auquier
- Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean-Moulin, 13005 Marseille, France.,Aix-Marseille University, Assistance publique Hôpitaux universitaires de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, France
| | - Laurent Boyer
- FondaMental Academic Centers of Expertise for Schizophrenia, Créteil, France.,Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean-Moulin, 13005 Marseille, France.,Aix-Marseille University, Assistance publique Hôpitaux universitaires de Marseille, Hôpital Nord, Service d'Anesthésie et de Réanimation, France
| |
Collapse
|
28
|
Carretier E, Guessoum SB, Radjack R, Mao SF, Minassian S, Blanchet C, Moro MR, Lachal J. [Adjustment of healthcare and telemedicine in times of lockdown and COVID-19 pandemic: Feedback from a "Maison des Adolescents" (Teenager's House)]. ACTA ACUST UNITED AC 2021; 69:132-137. [PMID: 33612908 PMCID: PMC7885696 DOI: 10.1016/j.neurenf.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
La crise sanitaire de la COVID-19 a imposé une réorganisation majeure de l’offre de soins en France. Considérant la nécessité de maintenir des soins pour les adolescents souffrant de troubles physiques ou psychiques, les Maisons des Adolescents ont dû adapter en urgence leurs pratiques afin de maintenir au maximum la continuité des soins pour les adolescents et leurs familles. À travers le cas d’une adolescente qui a présenté une dégradation clinique de son anorexie mentale durant le confinement, nous présentons les réorganisations des soins au sein des différentes unités (consultations–hôpital de jour–unité d’hospitalisation temps plein) d’une Maison des Adolescents parisienne au cours de la pandémie de COVID-19. À partir de la littérature existante, nous discutons les avantages et limites de la télémédecine et les enjeux pratiques pour l’organisation future des soins pour les adolescents. Contrairement à la médecine pédiatrique ou pédopsychiatrique, il n’existe pas de protocole décrivant la mise en place de la télémédecine en médecine et psychiatrie de l’adolescent. Il est urgent d’approfondir les évaluations de l’utilisation de la télémédecine pour les adolescents. Ce type de recherche permettra d’améliorer les connaissances sur l’efficacité, l’acceptabilité et les limites de l’utilisation d’un dispositif de téléconsultation en psychiatrie de l’adolescent, en contexte de crise. Certaines modalités de soins à distance mises en place pendant la crise pourraient ainsi être maintenues dans le temps et s’inscrire en routine dans le domaine de la médecine et psychiatrie de l’adolescent.
Collapse
Affiliation(s)
- E Carretier
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université de Paris, PCPP, 92100 Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - S B Guessoum
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université de Paris, PCPP, 92100 Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - R Radjack
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - S-F Mao
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université de Paris, UFR IHSS, 75013 Paris, France
| | - S Minassian
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
| | - C Blanchet
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université de Paris, PCPP, 92100 Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - M R Moro
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université de Paris, PCPP, 92100 Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - J Lachal
- APHP, Cochin Hospital, Maison de Solenn, 75014 Paris, France
- Université de Paris, PCPP, 92100 Boulogne-Billancourt, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| |
Collapse
|
29
|
Thomas P, Hazif-Thomas C. [Covid-19 infectious disease is also a psychogeriatric disease]. SOINS. GÉRONTOLOGIE 2021; 26:37-39. [PMID: 33894913 DOI: 10.1016/j.sger.2021.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Severe forms of Covid-19 infectious disease often affect the frail elderly. They can induce inaugural psychiatric manifestations or aggravate the underlying psychiatric pathologies. Some of these pathologies persist after the acute episode and require specific management. Doctors and caregivers involved in the care of infected patients are themselves exposed to psychological and even psychiatric difficulties and are looking for collaborative help complementing actions in the somatic care sectors.
Collapse
Affiliation(s)
- Philippe Thomas
- Centre de recherches sémiotiques, EA 3648, université de Limoges, 39 rue Camille-Guérin, 87000 Limoges, France.
| | - Cyril Hazif-Thomas
- Service de psychiatrie du sujet âgé, Soins primaires, santé publique et registre des cancers de Bretagne occidentale, EA 7479, centre hospitalier régional universitaire de Brest, route de Ploudalmezeau, 29820 Bohars, France
| |
Collapse
|
30
|
Stip E, Rizvi TA, Mustafa F, Javaid S, Aburuz S, Ahmed NN, Abdel Aziz K, Arnone D, Subbarayan A, Al Mugaddam F, Khan G. The Large Action of Chlorpromazine: Translational and Transdisciplinary Considerations in the Face of COVID-19. Front Pharmacol 2020; 11:577678. [PMID: 33390948 PMCID: PMC7772402 DOI: 10.3389/fphar.2020.577678] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/14/2020] [Indexed: 12/13/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome (SARS) in humans that is caused by SARS-associated coronavirus type 2 (SARS-CoV-2). In the context of COVID-19, several aspects of the relations between psychiatry and the pandemic due to the coronavirus have been described. Some drugs used as antiviral medication have neuropsychiatric side effects, and conversely some psychotropic drugs have antiviral properties. Chlorpromazine (CPZ, Largactil®) is a well-established antipsychotic medication that has recently been proposed to have antiviral activity against SARS-CoV-2. This review aims to 1) inform health care professionals and scientists about the history of CPZ use in psychiatry and its potential anti- SARS-CoV-2 activities 2) inform psychiatrists about its potential anti-SARS-CoV-2 activities, and 3) propose a research protocol for investigating the use of CPZ in the treatment of COVID-19 during the potential second wave. The history of CPZ's discovery and development is described in addition to the review of literature from published studies within the discipline of virology related to CPZ. The early stages of infection with coronavirus are critical events in the course of the viral cycle. In particular, viral entry is the first step in the interaction between the virus and the cell that can initiate, maintain, and spread the infection. The possible mechanism of action of CPZ is related to virus cell entry via clathrin-mediated endocytosis. Therefore, CPZ could be useful to treat COVID-19 patients provided that its efficacy is evaluated in adequate and well-conducted clinical trials. Interestingly, clinical trials of very good quality are in progress. However, more information is still needed about the appropriate dosage regimen. In short, CPZ repositioning is defined as a new use beyond the field of psychiatry.
Collapse
Affiliation(s)
- Emmanuel Stip
- Department of Psychiatry, University of Montréal, Montréal, QC, Canada
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tahir A. Rizvi
- Department of Medical Microbiology and Immunology, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Farah Mustafa
- Department of Biochemistry, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Syed Javaid
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Salahdein Aburuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nahida Nayaz Ahmed
- Ambulatory Healthcare Services, Al Maqtaa Healthcare Center, Middle Regions Clinics Division, SEHA, Abu Dhabi, United Arab Emirates
| | - Karim Abdel Aziz
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Danilo Arnone
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
- Kings’ College London, Institute of Psychiatry, Psychology, Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, United Kingdom
| | - Aravinthan Subbarayan
- Behavioral Sciences Institute (BSI), Al Ain Hospital, SEHA, Al Ain, United Arab Emirates
| | - Fadwa Al Mugaddam
- Department of Psychiatry, University of Montréal, Montréal, QC, Canada
| | - Gulfaraz Khan
- Department of Medical Microbiology and Immunology, College of Medicine and Health Science, United Arab Emirates University, Al Ain, United Arab Emirates
| |
Collapse
|
31
|
Malzac P, Mathieu M, Einaudi M. Quel accompagnement pour les personnes vulnérables en contexte de confinement ? ÉTHIQUE & SANTÉ 2020; 17:220-225. [PMID: 32837547 PMCID: PMC7429073 DOI: 10.1016/j.etiqe.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Quels sont les enjeux éthiques liés à l’accompagnement des personnes les plus vulnérables dans un contexte de crise sanitaire, obligeant au confinement ? Parce que le concept de vulnérabilité est large et complexe, l’Espace éthique PACA-Corse s’est intéressé plus particulièrement à la prise en charge des enfants porteurs de handicaps, des enfants confiés à l’aide sociale à l’enfance et des personnes atteintes de troubles psychiatriques. Le confinement a engendré une réorganisation de l‘offre de soin et de l’accompagnement médico-social, pouvant révéler ou aggraver certaines situations de vulnérabilités, voire même laisser pour compte certaines personnes. Les plus isolées ou à risque de maltraitance ont pu vivre un double confinement. Comment repérer et répondre aux besoins des personnes déjà en situation de vulnérabilité avant le confinement qui, isolées dans le contexte épidémique, ont vu leurs vulnérabilités s’accroître ? Si de nouvelles façons de travailler ont été mises en place en période de confinement, certaines ont montré leur intérêt, d’autres leurs limites. L’enjeu était de trouver la juste mesure pour aborder la particularité de chaque situation, activer des réseaux de prise en charge de manière effective et solidaire, et ce, malgré la limitation des moyens et le contexte d’urgence. Toute la difficulté était de faire coexister protocoles et valeurs du soin, en agissant de manière réactive et créative. Tout en révélant des vulnérabilités, cette période a obligé à faire preuve à la fois d’humilité face à l’incertitude, ainsi qu’à un devoir de responsabilité pour prendre soin de ceux qui en avaient le plus besoin.
Collapse
|
32
|
Leaune E, Samuel M, Oh H, Poulet E, Brunelin J. Suicidal behaviors and ideation during emerging viral disease outbreaks before the COVID-19 pandemic: A systematic rapid review. Prev Med 2020; 141:106264. [PMID: 33017599 PMCID: PMC7531915 DOI: 10.1016/j.ypmed.2020.106264] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 12/20/2022]
Abstract
The current COVID-19 pandemic is the most severe pandemic of the 21st century, on track to having a rising death toll. Beyond causing respiratory distress, COVID-19 may also cause mortality by way of suicide. The pathways by which emerging viral disease outbreaks (EVDOs) and suicide are related are complex and not entirely understood. We aimed to systematically review the evidence on the association between EVDOs and suicidal behaviors and/or ideation. An electronic search was conducted using five databases: Medline, Embase, Web of Science, PsycINFO and Scopus in April 2020. A rapid systematic review was carried out, which involved separately and independently extracting quantitative data of selected articles. The electronic search yielded 2480 articles, of which 9 met the inclusion criteria. Most of the data were collected in Hong Kong (n = 3) and the USA (n = 3). Four studies reported a slight but significant increase in deaths by suicide during EVDOs. The increase in deaths by suicide was mainly reported during the peak epidemic and in older adults. Psychosocial factors such as the fear of being infected by the virus or social isolation related to quarantine measures were the most prominent factors associated with deaths by suicide during EVDOs. Overall, we found scarce and weak evidence for an increased risk of deaths by suicide during EVDOs. Our results inform the need to orient public health policies toward suicide prevention strategies targeting the psychosocial effects of EVDOs. High-quality research on suicide risk and prevention are warranted during the current pandemic.
Collapse
Affiliation(s)
- Edouard Leaune
- Centre Hospitalier Le Vinatier, Bron, France; INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France.
| | - Maeva Samuel
- Centre Hospitalier Le Vinatier, Bron, France; University Lyon 1, Villeurbanne F-69000, France
| | - Hans Oh
- University of Southern California, Los Angeles, CA, USA
| | - Emmanuel Poulet
- Centre Hospitalier Le Vinatier, Bron, France; INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon F-69000, France; University Lyon 1, Villeurbanne F-69000, France; Department of Emergency Psychiatry, University Hospital Edouard Herriot, Hospices civils de Lyon, Lyon, France
| | - Jérôme Brunelin
- Centre Hospitalier Le Vinatier, Bron, France; INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, Psychiatric Disorders: from Resistance to Response - PSYR2 Team, Lyon F-69000, France
| |
Collapse
|
33
|
Wadoo O, Latoo J, Reagu SM, Amro RAA, Masoodi NA, Alabdulla M. Mental health during COVID-19 in Qatar. Gen Psychiatr 2020; 33:e100313. [PMID: 33195990 PMCID: PMC7594533 DOI: 10.1136/gpsych-2020-100313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/30/2020] [Accepted: 08/27/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ovais Wadoo
- Department of Psychiatry, Mental Health Services, Doha, Qatar
| | - Javed Latoo
- Department of Psychiatry, Mental Health Services, Doha, Qatar
| | | | | | | | - Majid Alabdulla
- Department of Psychiatry, Mental Health Services, Doha, Qatar
- Department of Psychiatry, Qatar University College of Medicine, Doha, Ad Dawhah, Qatar
| |
Collapse
|
34
|
Pignon B, Gourevitch R, Tebeka S, Dubertret C, Cardot H, Dauriac-Le Masson V, Trebalag AK, Barruel D, Yon L, Hemery F, Loric M, Rabu C, Pelissolo A, Leboyer M, Schürhoff F, Pham-Scottez A. Dramatic reduction of psychiatric emergency consultations during lockdown linked to COVID-19 in Paris and suburbs. Psychiatry Clin Neurosci 2020; 74:557-559. [PMID: 32609417 PMCID: PMC7361336 DOI: 10.1111/pcn.13104] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Baptiste Pignon
- AP-HP, Department of Psychiatry and Addictology, Mondor University Hospital, DMU IMPACT, Créteil, France.,Translational Neuro-Psychiatry Laboratory, INSERM U955, Créteil, France.,FondaMental Foundation, Créteil, France.,Paris-Est Créteil University (UPEC), Medical School, Créteil, France
| | - Raphaël Gourevitch
- CPOA, Sainte-Anne Hospital, Paris Psychiatry & Neurosciences University Hospital, Paris, France
| | - Sarah Tebeka
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France.,INSERM U1266, Paris, France.,Paris University, Paris, France
| | - Caroline Dubertret
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France.,INSERM U1266, Paris, France.,Paris University, Paris, France
| | - Hélène Cardot
- Department of Psychiatry, AP-HP, Louis Mourier Hospital, Colombes, France
| | - Valérie Dauriac-Le Masson
- Department of Medical Information, Paris Psychiatry & Neurosciences University Hospital, Paris, France
| | - Anne-Kristelle Trebalag
- CPOA, Sainte-Anne Hospital, Paris Psychiatry & Neurosciences University Hospital, Paris, France
| | - David Barruel
- Department of Medical Information, Paris Psychiatry & Neurosciences University Hospital, Paris, France
| | - Liova Yon
- CPOA, Sainte-Anne Hospital, Paris Psychiatry & Neurosciences University Hospital, Paris, France
| | - François Hemery
- AP-HP, Department of Medical Information, Mondor University Hospital, Créteil, France
| | - Marie Loric
- AP-HP, Department of Psychiatry and Addictology, Mondor University Hospital, DMU IMPACT, Créteil, France
| | - Corentin Rabu
- AP-HP, Department of Psychiatry and Addictology, Mondor University Hospital, DMU IMPACT, Créteil, France
| | - Antoine Pelissolo
- AP-HP, Department of Psychiatry and Addictology, Mondor University Hospital, DMU IMPACT, Créteil, France.,Translational Neuro-Psychiatry Laboratory, INSERM U955, Créteil, France.,FondaMental Foundation, Créteil, France.,Paris-Est Créteil University (UPEC), Medical School, Créteil, France
| | - Marion Leboyer
- AP-HP, Department of Psychiatry and Addictology, Mondor University Hospital, DMU IMPACT, Créteil, France.,Translational Neuro-Psychiatry Laboratory, INSERM U955, Créteil, France.,FondaMental Foundation, Créteil, France.,Paris-Est Créteil University (UPEC), Medical School, Créteil, France
| | - Franck Schürhoff
- AP-HP, Department of Psychiatry and Addictology, Mondor University Hospital, DMU IMPACT, Créteil, France.,Translational Neuro-Psychiatry Laboratory, INSERM U955, Créteil, France.,FondaMental Foundation, Créteil, France.,Paris-Est Créteil University (UPEC), Medical School, Créteil, France
| | - Alexandra Pham-Scottez
- CPOA, Sainte-Anne Hospital, Paris Psychiatry & Neurosciences University Hospital, Paris, France
| |
Collapse
|
35
|
Nollace L, Cravero C, Abbou A, Mazda-Walter B, Bleibtreu A, Pereirra N, Sainte-Marie M, Cohen D, Giannitelli M. Autism and COVID-19: A Case Series in a Neurodevelopmental Unit. J Clin Med 2020; 9:E2937. [PMID: 32932951 PMCID: PMC7564973 DOI: 10.3390/jcm9092937] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND COVID-19 has become pandemic and can impact individuals with autism as well. Here, we report a case series admitted to a neurobehavioral unit dedicated to challenging behaviors in patients with autism. METHODS We describe 16 patients (mean age 20.8 years; range 12-43 years; 76% male) with autism hospitalized between March 2020 and mid-April 2020 for challenging behaviors, for which COVID-19 disease has been suspected and who needed both psychiatric and medical care. A close cooperation with the Infectious and Tropical Diseases Department was organized to limit viral spread and training sessions (e.g., hygiene, clinical COVID-19 monitoring, virus testing) were given to staff members. RESULTS Most patients had severe autism and severe/moderate intellectual disability. Eleven patients were already in the unit when it was hit by the pandemic, and five were admitted from the community. Based on a virus search via reverse transcriptase polymerase chain reaction (RT-PCR) or serology at the 2-month follow-up, we had 11 confirmed COVID-19 cases. The main COVID-19 symptoms included benign upper respiratory infection signs (N = 9, 81.8%), diarrhea (N = 7, 63.6%), fatigue (N = 7, 63.6%), and respiratory signs (N = 5, 45.5%), including one patient who needed oxygen therapy. Three patients remained asymptomatic and COVID-19-free (including two under immunosuppressive treatments). Among the symptomatic patients, five showed atypical behaviors that we understood as idiosyncratic manifestations (e.g., irrepressible licking behavior). On day 14, only one patient with respiratory dysfunction still had a positive RT-PCR SARS-CoV-2 test. CONCLUSIONS Organizing a COVID+ unit for patients with autism is realistic and requires close collaboration with infectologists. We believe that this initiative should be promoted to limit both the spread of the virus and the ostracism of patients with autism and challenging behaviors.
Collapse
Affiliation(s)
- Leslie Nollace
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
| | - Cora Cravero
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
- Interdepartmental Mobile Unit for Complex Situations in Autism (UMI 75-92), Elan Retrouvé Foundation, 75009 Paris, France
| | - Alice Abbou
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
| | - Brice Mazda-Walter
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
| | - Alexandre Bleibtreu
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, APHP. Sorbonne Université, 75013 Paris, France;
| | - Nathalie Pereirra
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
| | - Myriam Sainte-Marie
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
| | - David Cohen
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
- Institut des Systèmes Intelligents et Robotiques (ISIR), CNRS UMR 7222, Sorbonne Université, 75005 Paris, France
| | - Marianna Giannitelli
- Department of Child and Adolescent Psychiatry, Reference Centre for Rare Psychiatric Diseases, APHP. Sorbonne Université, 75013 Paris, France; (L.N.); (C.C.); (A.A.); (B.M.-W.); (N.P.); (M.S.-M.); (M.G.)
| |
Collapse
|
36
|
Antoine B, Nicolas D, Laurent D. Reshaping Community Mental Health Services during the COVID-19 Epidemic - Report from the 59G21 Service in Lille, France. Health Serv Insights 2020; 13:1178632920954876. [PMID: 32973373 PMCID: PMC7495522 DOI: 10.1177/1178632920954876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic led to a rapid transformation of the health care system to cope with the risk of contamination and of developing a severe form of the infection. Although it is an international crisis, strategies have been decided nationally. In France, priority was given to hospital reorganization, especially intensive care units. Reorganization of primary health and mental health services took place with late and inadequate national guidelines or coordination. For mental health services, lack of visibility on the crisis impact on mental health, and difficulties in defining their place in the overall health strategy appeared as the main challenges to overcome. These rapid transformations impacted the whole organization of community mental health care. Any strategies developed must ensure that every person enjoys the highest attainable standard of physical and mental health. Using a systemic approach, it has been necessary to identify both status and risk factors of communities, and to implement appropriate and efficient health promotion and crisis resolution actions. These theoretical issues and their practical impact are discussed using the field strategy developed during the first 28 days of confinement by the 59G21 service in Lille, France.
Collapse
Affiliation(s)
- Baleige Antoine
- Mental health service of the municipalities of Mons-en-Barœul, Hellemmes, Lezennes, Ronchin, Faches-Thumesnil, Lesquin (59G21); EPSM Lille-Métropole, WHO Collaborating Centre; Ronchin, France
| | - Daumerie Nicolas
- Mental health service of the municipalities of Mons-en-Barœul, Hellemmes, Lezennes, Ronchin, Faches-Thumesnil, Lesquin (59G21); EPSM Lille-Métropole, WHO Collaborating Centre; Ronchin, France
| | - Defromont Laurent
- Mental health service of the municipalities of Mons-en-Barœul, Hellemmes, Lezennes, Ronchin, Faches-Thumesnil, Lesquin (59G21); EPSM Lille-Métropole, WHO Collaborating Centre; Ronchin, France
| |
Collapse
|
37
|
Guessoum SB, Lachal J, Radjack R, Carretier E, Minassian S, Benoit L, Moro MR. Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown. Psychiatry Res 2020; 291:113264. [PMID: 32622172 PMCID: PMC7323662 DOI: 10.1016/j.psychres.2020.113264] [Citation(s) in RCA: 497] [Impact Index Per Article: 124.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/26/2020] [Accepted: 06/28/2020] [Indexed: 01/19/2023]
Abstract
The aim of this paper was to review the literature on adolescent psychiatric disorders related to the COVID-19 pandemic and lockdown. Stressful life events, extended home confinement, brutal grief, intrafamilial violence, overuse of the Internet and social media are factors that could influence the mental health of adolescents during this period. The COVID-19 pandemic could result in increased psychiatric disorders such as Post-Traumatic Stress, Depressive, and Anxiety Disorders, as well as grief-related symptoms. Adolescents with psychiatric disorders are at risk of a break or change in their care and management; they may experience increased symptoms. The COVID-19 pandemic and lockdown may have a negative impact on the mental health of adolescents, although there is still no data on the long term impact of this crisis. Adolescents' individual, familial, and social vulnerability, as well as individual and familial coping abilities, are factors related to adolescent mental health in times of crisis. Adolescents are often vulnerable and require careful consideration by caregivers and healthcare system adaptations to allow for mental health support despite the lockdown. Research on adolescent psychiatric disorders in times of pandemics is necessary, as such a global situation could be prolonged or repeated.
Collapse
Affiliation(s)
- Sélim Benjamin Guessoum
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France; University of Paris, PCPP, F-92100 Boulogne-Billancourt, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France.
| | - Jonathan Lachal
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France; University of Paris, PCPP, F-92100 Boulogne-Billancourt, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
| | - Rahmeth Radjack
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
| | - Emilie Carretier
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France; University of Paris, PCPP, F-92100 Boulogne-Billancourt, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
| | - Sevan Minassian
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France
| | - Laelia Benoit
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France; University of Paris, PCPP, F-92100 Boulogne-Billancourt, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
| | - Marie Rose Moro
- Greater Paris University Hospital, University Hospital Cochin, Maison des Adolescents - Youth Department, F-75014 Paris, France; University of Paris, PCPP, F-92100 Boulogne-Billancourt, France; University Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, F-94807, Villejuif, France
| |
Collapse
|
38
|
Al Joboory S, Monello F, Bouchard JP. [PSYCOVID-19, psychological support device in the fields of mental health, somatic and medico-social]. ANNALES MEDICO-PSYCHOLOGIQUES 2020; 178:747-753. [PMID: 32836306 PMCID: PMC7315978 DOI: 10.1016/j.amp.2020.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In December 2019 the World Health Organization (WHO) recorded the first cases of an infectious disease that appeared in China in November of the same year. Generated by the new coronavirus SARS-CoV2, it is quickly named COVID-19 for COronaVirus Infectious Disease 2019. The spread of this unknown disease will soon have worldwide consequences: the contagiousness of the virus is extremely high and potentially lethal. In France, the population initially reacted with disbelief until the disease reached Europe and the first cases appeared on French territory, at the end of January. A few weeks later, on 16 March 2020, President Macron declared the country "at war" against COVID-19. The next day the population was placed in lockdown. At the present time, the country's activity is at a standstill. Schools, businesses and shops are closed. The French citizens are astounded. They suddenly have to face fear: fear of falling ill or that a close relative may fall ill, fear of being locked up and experiencing restrictions of liberties, fear of economic precariousness. And, above all, fear of uncertainty. In order to prevent the mental consequences of this crisis, psychological support units have been created with urgency at national scale. These units are intended to support the healthcare professionals as well as the patients and more broadly, the general population. The unit responsible for the department of Gironde has been set up quickly, over the weekend of March 21, 2020. The COVIDPSY33 listening unit has thus been created in Bordeaux by the Charles Perrens Hospital with support from the Agence Régionale de Santé Nouvelle-Aquitaine (ARS). Simultaneously, the PSYCOVID-19 unit was created. This additional unit works in collaboration with the COVIDPSY33 platform and offers psychological assistance to the general population and caregivers in the sectors of Bordeaux Rive Droite, Bordeaux Gare, Rives de Garonne, Rives d'Arcins and Sud Gironde. It thus covers an area equivalent to approximately half of Gironde, the largest department in metropolitan France. In the present interview, Samantha Al Joboory and Florence Monello, psychiatrist and psychologist coordinating PSYCOD-19, present this psychological support unit.
Collapse
Affiliation(s)
- Samantha Al Joboory
- Centre d'Accueil SPÉcialisé dans le Repérage et le Traitement des Traumatismes psychiques (Caspertt), centre hospitalier de Cadillac, 31 rue des Cavaillès, 33310 Lormont, France
- Institut psycho-judiciaire et de psychopathologie (IPJP), institute of forensic psychology and psychopathology, centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France
- Centre de recherche inserm/U1219, université de Bordeaux, ISPED, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France
- Maison d'Ella, 381, boulevard du Président-Wilson, 33200 Bordeaux, France
| | - Florence Monello
- Centre hospitalier de Cadillac, 89, rue Cazeaux-Cazalet, 33410 Cadillac, France
| | - Jean-Pierre Bouchard
- Institut psycho-judiciaire et de psychopathologie (IPJP), institute of forensic psychology and psychopathology, centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France
- Unité pour malades difficiles (UMD), pôle de psychiatrie médico-légale (PPML), centre hospitalier de Cadillac, 10, avenue Joseph-Caussil, 33410 Cadillac, France
| |
Collapse
|
39
|
Roncero C, García-Ullán L, de la Iglesia-Larrad JI, Martín C, Andrés P, Ojeda A, González-Parra D, Pérez J, Fombellida C, Álvarez-Navares A, Benito JA, Dutil V, Lorenzo C, Montejo ÁL. The response of the mental health network of the Salamanca area to the COVID-19 pandemic: The role of the telemedicine. Psychiatry Res 2020; 291:113252. [PMID: 32623263 PMCID: PMC7329660 DOI: 10.1016/j.psychres.2020.113252] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/21/2020] [Accepted: 06/21/2020] [Indexed: 01/07/2023]
Abstract
The COVID-19 pandemic reached world-wide causing a great impact on healthcare services. The aim of this work is to describe the response of the Mental Health Network of the Salamanca´ Area (Spain) to this crisis and the reorganization of its resources within the first 8 weeks after the state of alarm was declared. The Psychiatry Service applied a contingency plan which included the reorganization of the human resources, the closure of some of the units and the implementation of telemedicine programs along with two specific programs, namely a mental health assistance program in the context of the infection by coronavirus, and another program for homeless people. 9.038 phone interviews were carried out in the outpatients and community mental health programs. The activity in subacute and acute wards, as well as that of the day hospital programs was decreased to 50%. Based on that this real-world response provided we concluded that the usage of telemedicine is promising in patients with any kind of disorder. Its implementation in daily practice will be considered in the future. Research must continue on COVID-19's impact on patients with mental disorders and Psychiatry's necessary adaptations and new approaches to them.
Collapse
Affiliation(s)
- Carlos Roncero
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain; Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain; School of Medicine, University of Salamanca, Salamanca, Spain.
| | - Llanyra García-Ullán
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Medicine, University of Salamanca, Salamanca, Spain
| | - Javier I. de la Iglesia-Larrad
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Carmen Martín
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Pilar Andrés
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Ana Ojeda
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - David González-Parra
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Javier Pérez
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Clara Fombellida
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - Ana Álvarez-Navares
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - José Antonio Benito
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Medicine, University of Salamanca, Salamanca, Spain
| | - Virginia Dutil
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain
| | - Carolina Lorenzo
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Medicine, University of Salamanca, Salamanca, Spain
| | - Ángel Luis Montejo
- Psychiatry Service, University of Salamanca Healthcare Complex (USHC), Salamanca, Spain,Institute of Biomedicine of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain,School of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
| |
Collapse
|
40
|
Marehin MS, Mboumba Hinnouo A, Obiang PA. [Organisation of psychiatric care in Gabon during the COVID-19 epidemic]. ANNALES MEDICO-PSYCHOLOGIQUES 2020; 179:137-140. [PMID: 32863389 PMCID: PMC7442892 DOI: 10.1016/j.amp.2020.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/14/2020] [Indexed: 01/16/2023]
Abstract
Objectifs L’épidémie du COVID-19 est survenue au Gabon à une période où l’hôpital psychiatrique vit une crise sans précédent du fait d’une baisse des moyens matériels et humains. À partir de l’expérience clinique des soignants, nous présentons les difficultés que rencontrent ces acteurs du soin pour maintenir l’alliance thérapeutique. Méthode L’article expose une synthèse de travaux sur le confinement, le COVID-19 et les troubles psychiques. Résultats Globalement, on observe une baisse des consultations en ambulatoire. En zone rurale, la crise sanitaire a occasionné une suppression des suivis au domicile des patients ainsi qu’une difficulté d’accès aux médicaments psychotropes onéreux, favorisant l’inobservance du traitement avec comme conséquence des décompensations psychiatriques.
Collapse
|
41
|
Salamin V, Rossier V, Joye D, Nolde C, Pierrehumbert T, Gothuey I, Guenot F. [Adaptations of an outpatient Dialectical Behavioral Therapy during the COVID-19 pandemic and consequences of the confinement on patients with borderline personality disorder]. ANNALES MEDICO-PSYCHOLOGIQUES 2020; 179:131-136. [PMID: 32843771 PMCID: PMC7439824 DOI: 10.1016/j.amp.2020.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/14/2020] [Indexed: 11/15/2022]
Abstract
Objectif La pandémie due à la COVID-19 a impacté l’accessibilité à la psychothérapie pour des patients particulièrement vulnérables pendant la période de confinement. Nous présentons les adaptations d’un programme de thérapie comportementale dialectique et les conséquences du confinement sur le vécu de patients souffrant d’un trouble de personnalité borderline. Méthode Nous avons, pour sept patients, comparé deux périodes de huit semaines, avant et pendant le confinement. Nous avons analysé leurs cartes journalières (n = 426) et le recensement hebdomadaire de la fréquence de leurs comportements problèmes (n = 69). Résultats L’analyse des cartes journalières indique que la période de confinement prédit une diminution significative des sentiments de peur, de honte ou culpabilité et de tension mais une augmentation de la détresse. Le suivi hebdomadaire montre une diminution significative des comportements hyperphagiques. Discussion Malgré le petit nombre de patients inclus, cette étude se base sur des échantillonnages d’expérience au quotidien et des mesures hebdomadaires. Ces deux types de mesures répétées indiquent certaines améliorations pendant le confinement, attestant des capacités d’adaptation de ces patients, soutenus par un cadre thérapeutique intensif qui a été maintenu.
Collapse
Affiliation(s)
- Virginie Salamin
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| | - Vanessa Rossier
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| | - Daisy Joye
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| | - Chrystelle Nolde
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| | - Timothée Pierrehumbert
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| | - Isabelle Gothuey
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| | - Florence Guenot
- Réseau fribourgeois de santé mentale, Centre psychosocial, 56, avenue Général-Guisan, 1700 Fribourg, Suisse
| |
Collapse
|
42
|
Psychiatrists and COVID-19: what is our role during this unprecedented time? Ir J Psychol Med 2020; 38:307-312. [PMID: 32811576 PMCID: PMC7533475 DOI: 10.1017/ipm.2020.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The declaration of a COVID-19 (Severe Acute Respiratory Syndrome - CoronaVirus2) pandemic by the World Health Organization in March 2020 has vastly changed the landscape in which mental health services function. Consideration is required to adapt services during this unusual time, ensuring continued provision of care for current patients, availability of care for patients with new-onset mental health difficulties and delivery of evidence-based support for healthcare professionals working with affected patients. Lessons can be learned from research carried out during the severe acute respiratory syndrome, Middle East respiratory syndrome and Ebola epidemics to ensure the delivery of efficient and effective mental health services both now and into the future.
Collapse
|
43
|
Aragona M, Barbato A, Cavani A, Costanzo G, Mirisola C. Negative impacts of COVID-19 lockdown on mental health service access and follow-up adherence for immigrants and individuals in socio-economic difficulties. Public Health 2020; 186:52-56. [PMID: 32771661 PMCID: PMC7409736 DOI: 10.1016/j.puhe.2020.06.055] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 12/21/2022]
Abstract
Objectives Lockdown measures in response to the coronavirus disease 2019 (COVID-19) pandemic can have serious mental health effects on the population, especially in vulnerable groups, such as those living in poor socio-economic conditions, those who are homeless, migrant workers and asylum seekers/refugees. In addition, these vulnerable groups frequently have greater difficulty accessing health services and in treatment adherence. The aim of this study is to estimate the impact of the COVID-19–related lockdown on service utilisation and follow-up adherence in an Italian mental health outpatient service for migrants and individuals in socio-economic difficulties. Study design The design of this study is a retrospective cross-sectional study. Methods All patients who visited the mental health outpatient service in the months of February and March in the years 2017–2020 were included in the study. To compare service utilisation before and after the lockdown, the number of patients who visited the mental health outpatient service for psychiatric interview were recorded. Follow-up adherence was calculated as the percentage of patients who visited in February and subsequently attended a follow-up visit in March of the same year. Results The number of patients who visited the outpatient service between February 2017 and February 2020 was continuously increasing. In March 2020, fewer patients visited the service for psychiatric interview, in line with the introduction of lockdown measures. In addition, the number of the patients who visited in February 2020 and returned for their follow-up visits in March 2020 declined from approximately 30% over the same months in 2017–2019 to 17.53% in March 2020. Conclusions The lockdown-related reduction in numbers of patients accessing the mental health service makes it difficult to help vulnerable populations during a period of time in which their mental health needs are expected to increase. Moreover, the reduction seen in follow-up compliance increases the risk of treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations. Lockdown can have serious mental health effects on vulnerable groups. These population subgroups also have greater difficulties in accessing health services and maintaining treatment adherence. Access to mental health services and follow-up compliance dramatically dropped as a consequence of lockdown. Vulnerable groups are at risk of unmet mental health needs, treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations.
Collapse
Affiliation(s)
- M Aragona
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy.
| | - A Barbato
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - A Cavani
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - G Costanzo
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - C Mirisola
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| |
Collapse
|
44
|
Chiappini S, Guirguis A, John A, Corkery JM, Schifano F. COVID-19: The Hidden Impact on Mental Health and Drug Addiction. Front Psychiatry 2020; 11:767. [PMID: 32848937 PMCID: PMC7403495 DOI: 10.3389/fpsyt.2020.00767] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Stefania Chiappini
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| |
Collapse
|
45
|
Mental health of orthopaedic trauma patients during the 2020 COVID-19 pandemic. INTERNATIONAL ORTHOPAEDICS 2020; 44:1921-1925. [PMID: 32676778 PMCID: PMC7365601 DOI: 10.1007/s00264-020-04711-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/06/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE The outbreak of the SARS-CoV-2 virus has been associated with reports of increased anxiety, depression and fear among the general population. People with underlying psychiatric disorders are more susceptible to stress than the general population. The purpose of this study was to determine the prevalence of concomitant psychiatric conditions in the orthopaedic trauma population during the COVID-19 pandemic. METHODS This retrospective cohort study evaluated orthopaedic trauma patients who received care at our institution between February through April of 2019 and February through April of 2020. Patient sex, age, mechanism of injury, associated injuries, fracture location, tobacco use, employment status, mental health diagnosis and presence of interpersonal violence were documented. Mental health diagnoses were defined based on International Classification of Diseases-10 classification. RESULTS The study included 553 orthopaedic patients evaluated at our institution during the defined time period. Patients in the 2020 cohort had a higher prevalence of mental health diagnoses (26% vs. 43%, p < 0.0001) compared with the 2019 group. The odds ratio for mental health disorder in the 2020 patients was 2.21 (95% CI 1.54, 3.18) compared with the 2019 cohort. The 2020 cohort had a higher percentage of patients who reported interpersonal violence (20% vs. 11%, p = 0.005). CONCLUSION Our study showed a higher prevalence of psychiatric disease among orthopaedic trauma patients during the COVID-19 pandemic when compared with those seen during the same time of the year in 2019. Stress induced by the coronavirus pandemic can place patients with mental illness at a higher risk for perilous behaviours and subsequent fractures.
Collapse
|
46
|
Sauvaget A, Dumont R, Bukowski N, Bonnot O, Auffret R, Poulet E, Szekely D, Quiles C, Yrondi A, Plaze M, de Carvalho W, Amad A, Bulteau S. [Recommendations for a gradual and controlled resumption of electroconvulsive therapy in France during the period of lifting of the containment and of the COVID-19 pandemic linked to SARS-CoV-2]. L'ENCEPHALE 2020; 46:S119-S122. [PMID: 32507557 PMCID: PMC7271849 DOI: 10.1016/j.encep.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/17/2020] [Indexed: 11/18/2022]
Abstract
La pandémie du COVID-19 a des conséquences majeures sur l’organisation des soins. En France et dans le monde, les centres pratiquant l’électroconvulsivothérapie (ECT) ont vu leur activité diminuer, voire s’arrêter, pour de diverses raisons. Dans ce contexte, le maintien ou la reprise de cette activité thérapeutique essentielle pour de nombreux patients souffrant de troubles psychiatriques nécessite des adaptations matérielles, humaines et logistiques qu’il convient d’encadrer. L’objectif de ce travail collectif et national est de proposer des recommandations simples et applicables immédiatement par tout établissement de santé, public ou privé, pratiquant les ECT. Elles sont issues d’un retour d’expériences pluriprofessionnelles et interétablissements. Déclinées en trois étapes, ces recommandations sont accompagnées d’une fiche pratique qui décrit, de façon précise, les conditions nécessaires et préalables à toute reprise d’activité ECT.
Collapse
Affiliation(s)
- A Sauvaget
- French Society for Biological Psychiatry and Neuropsychopharmacology, STEP Section (Stimulation transcrânienne en psychiatrie), Saint-Germain-en-Laye, France; Nantes Université, CHU Nantes, Movement, Interactions, Performance (MIP), EA 4334, University of Nantes, Nantes, France.
| | - R Dumont
- CHU de Nantes, Department of Anesthesiology and Critical Care Medicine, Hôtel-Dieu-PTMC, Nantes, France
| | - N Bukowski
- CHU Nantes, Department of Addictology and Psychiatry, Nantes, France
| | - O Bonnot
- Child and Adolescent Psychiatry Department, CHU and University of Nantes, Nantes, France
| | - R Auffret
- CHU Nantes, Department of Addictology and Psychiatry, Nantes, France
| | - E Poulet
- French Society for Biological Psychiatry and Neuropsychopharmacology, STEP Section (Stimulation transcrânienne en psychiatrie), Saint-Germain-en-Laye, France; Centre hospitalier Le Vinatier, Bron, France; Université de Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, 69000 Lyon, France; University Lyon 1, 69000 Villeurbanne, France; Department of Emergency Psychiatry, hospices civils de Lyon, University Hospital Edouard-Herriot, Lyon, France
| | - D Szekely
- French Society for Biological Psychiatry and Neuropsychopharmacology, STEP Section (Stimulation transcrânienne en psychiatrie), Saint-Germain-en-Laye, France; Department of psychiatry, centre hospitalier Princesse-Grace, 98000 Monaco, France
| | - C Quiles
- Centre hospitalier Charles-Perrens, 33000 Bordeaux, France
| | - A Yrondi
- French Society for Biological Psychiatry and Neuropsychopharmacology, STEP Section (Stimulation transcrânienne en psychiatrie), Saint-Germain-en-Laye, France; Service de psychiatrie et de psychologie médicale, centre expert dépression résistante fondamental, CHU de Toulouse, Toulouse, France; Inserm, UPS, ToNIC Toulouse NeuroImaging Center, hôpital Purpan, université de Toulouse, Toulouse, France
| | - M Plaze
- French Society for Biological Psychiatry and Neuropsychopharmacology, STEP Section (Stimulation transcrânienne en psychiatrie), Saint-Germain-en-Laye, France; Université de Paris, 75005 Paris, France; Service hospitalo-universitaire, GHU de Paris psychiatrie & neurosciences, 75014 Paris, France
| | - W de Carvalho
- Pôle ECT - groupe SINOUÉ, clinique BELLEVUE, 92190 Meudon, France
| | - A Amad
- Inserm, U1172 - LilNCog - Lille Neuroscience & Cognition, CHU de Lille, université de Lille, 59000 Lille, France
| | - S Bulteau
- French Society for Biological Psychiatry and Neuropsychopharmacology, STEP Section (Stimulation transcrânienne en psychiatrie), Saint-Germain-en-Laye, France; CHU Nantes, Department of Addictology and Psychiatry, Nantes, France; Inserm-U1246 SPHERE University of Nantes and University of Tours, Nantes, France
| |
Collapse
|
47
|
Fovet T, Lancelevée C, Eck M, Scouflaire T, Bécache E, Dandelot D, Giravalli P, Guillard A, Horrach P, Lacambre M, Lefebvre T, Moncany AH, Touitou D, David M, Thomas P. [Mental health care in French correctional facilities during the Covid-19 pandemic]. L'ENCEPHALE 2020; 46:S60-S65. [PMID: 32475693 PMCID: PMC7205690 DOI: 10.1016/j.encep.2020.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The impact of the Covid-19 pandemic on the 11 million people currently incarcerated worldwide is the subject of many concerns. Prisons and jails are filled with people suffering from many preexisting medical conditions increasing the risk of complications. Detainees' access to medical services is already limited and overcrowding poses a threat of massive contagion. Beyond the health impact of the crisis, the tightening of prison conditions worries. On March 16, 2020, in France, the lockdown measures have been accompanied by specific provisions for prisons: all facilities have suspended visitations, group activities and external interventions. Over 10,000 prisoners have been released to reduce the prison population and the risk of virus propagation. These adjustments had major consequences on the healthcare system in French prisons. The objectives of this article are to describe the reorganization of the three levels of psychiatric care for inmates in France in the context of Covid-19 pandemic and to have a look at the impact of lockdown measures and early releases on mental health of prisoners. METHODS This work is based on a survey conducted in April 2020 in France among psychiatric healthcare providers working in 42 ambulatory units for inmates and in the 9 full-time inpatient psychiatric wards exclusively for inmates called "UHSAs" (which stands for "unités hospitalières spécialement aménagées", and can be translated as "specially equipped hospital units"). A review of the international literature on mental healthcare system for inmates during the Covid-19 epidemic has also been performed. RESULTS The Covid-19 epidemic has been rather contained during the period of confinement in French prisons but the impact of confinement measures on the prison population is significant. The three levels of psychiatric care for inmates have implemented specific measures to ensure continuity of care, to support detainees during Coronavirus lockdown and to prevent an infection's spread. Among the most important are: limitation of medical consultations to serious and urgent cases, creation of "Covid units", cancellation of voluntary psychiatric hospitalizations, reinforcement of preventive hygiene measures and reshuffling of medical staff. Prolonged confinement has consequences on mental health of detainees. Currently, mental health workers are facing multiple clinical situations such as forced drug and substance withdrawal (linked to difficulties in supplying psychoactive substances), symptoms of anxiety (due to concerns for their own and their relatives' well-being) and decompensation among patients with severe psychiatric conditions. Early releases from prison may also raise some issues. People recently released from prison are identified as at high risk of death by suicide and drug overdose. The lack of time to provide the necessary link between health services within prisons and health structures outside could have serious consequences, emphasizing the well-known "revolving prison doors" effect. DISCUSSION The current lockdown measures applied in French jails and prisons point out the disparities between psychiatric care for inmates and psychiatric care for general population. Giving the high vulnerability of prison population, public health authorities should pay more attention to health care in prisons.
Collapse
Affiliation(s)
- T Fovet
- CHU de Lille, Pôle de psychiatrie, 59000 Lille, France; Université Lille, Inserm, U1172 - Lille Neuroscience & Cognition - Équipe Plasticity & Subjectivity, 59000 Lille, France.
| | - C Lancelevée
- Fédération de recherches en psychiatrie et santé mentale des Hauts-de-France (F2RSM Psy), Saint-André-Lez-Lille, France
| | - M Eck
- CHU de Lille, Pôle de psychiatrie, 59000 Lille, France
| | - T Scouflaire
- CHU de Lille, Pôle de psychiatrie, 59000 Lille, France
| | - E Bécache
- UHSA Simone-Veil, Pôle de Santé Mentale des Détenus et de Psychiatrie Légale, centre hospitalier le Vinatier, Bron, France
| | - D Dandelot
- UHSA, pôle psychiatrie médicolégale, centre hospitalier Cadillac, Cadillac, France
| | - P Giravalli
- Pôle 11 : psychiatrie médecine addictologie en détention, médecine légale, UMR ADES AMU, AP-HM, Marseille, France
| | - A Guillard
- Pôle de psychiatrie en milieu pénitentiaire, EPSM Georges-Daumezon, Loiret, France
| | - P Horrach
- Département santé mentale-justice, pôle SMPR, CPN Nancy Laxou, centre hospitalier Lorquin, Lorquin, France
| | | | - T Lefebvre
- UHSA de Rennes, pôle de psychiatrie en milieu pénitentiaire, Centre hospitalier Guillaume Regnier, Rennes, France
| | - A-H Moncany
- Pôle de psychiatrie et conduites addictives en milieu pénitentiaire, centre hospitalier Marchant, Toulouse, France
| | - D Touitou
- UHSA Paul-Verlaine, groupe hospitalier Paul-Guiraud, 94800 Villejuif, France
| | - M David
- Association des secteurs de psychiatrie en milieu pénitentiaire et de la fédération française de psychiatrie et co-référent de l'atelier « psychiatrie en milieu pénitentiaire » du Comité de pilotage de la psychiatrie, France
| | - P Thomas
- CHU de Lille, Pôle de psychiatrie, 59000 Lille, France; Université Lille, Inserm, U1172 - Lille Neuroscience & Cognition - Équipe Plasticity & Subjectivity, 59000 Lille, France
| |
Collapse
|
48
|
Javelot H, Llorca PM, Meyer G, Fossati P, Haffen E. [Challenges for psychotropics in the context of the SARS-Cov-2 pandemic]. L'ENCEPHALE 2020; 46:S116-S118. [PMID: 32360037 PMCID: PMC7177137 DOI: 10.1016/j.encep.2020.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 01/08/2023]
Abstract
French recommendations have been proposed for psychotropics use and possible adaptations during the SARS-CoV-2 epidemic. Between uncertainties linked to the lack of data and speculations about possible benefits of psychotropics against the coronavirus, we propose here elements allowing to base the pharmacotherapeutic decisions potentially useful in Covid+ patients with psychiatric disorders.
Collapse
Affiliation(s)
- H Javelot
- Établissement Public de Santé Alsace Nord, Brumath, France; Laboratoire de Toxicologie et Pharmacologie Neuro Cardiovasculaire, Université de Strasbourg, Strasbourg, France.
| | - P-M Llorca
- CHU Clermont-Ferrand, EA 7280, Université Clermont Auvergne, France
| | - G Meyer
- Service Pharmacie, Établissement Public de Santé Alsace Nord, Brumath, France; Service Pharmacie, CHU de Strasbourg, Strasbourg, France
| | - P Fossati
- Service de psychiatrie adultes, APHP, Sorbonne université, Groupe Hospitalier Pitié Salpêtrière, ICM, Inserm U1127, Paris, France
| | - E Haffen
- Service de psychiatrie, CIC-1431 Inserm, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, Besançon, France
| |
Collapse
|
49
|
[Responsiveness and sustainability of psychiatric care in France during COVID-19 epidemic]. Encephale 2020; 46:S81-S84. [PMID: 32471705 PMCID: PMC7250556 DOI: 10.1016/j.encep.2020.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The sudden changes of healthcare system due to COVID-19 particularly affect the organization of psychiatry. The objective of this review is to examine the adaptations of psychiatric care in France during this pandemic. METHOD This narrative review is based on the observation of changes made in French psychiatric hospitals and on an analysis of the literature. RESULTS Regarding psychiatric hospitalization, the COVID-19 epidemic required rapid measures that profoundly modified the conditions of patients' reception, forcing the medical staffs to adapt their methods of care. The authors noted the creation of at least 89 wards specifically dedicated to patients with COVID-19 needing psychiatric hospitalization, allowing dual care of general medicine and psychiatry. Regarding ambulatory care, maintaining patients with long-term follow-up was a priority. Patients recalling and teleconsultation have been precious resources but cannot entirely replace face-to-face consultations. DISCUSSION COVID-19 epidemic created unprecedented situation of large-scale upheavals in the healthcare system and in society. Despite the absence of previous recommendations on the subject, French psychiatry has shown great adaptability. Some changes could inspire post-COVID-19 care.
Collapse
|
50
|
Javelot H, Weiner L. [Panic and pandemic: Review of the literature on the links between panic disorder and the SARS-CoV-2 epidemic]. Encephale 2020; 46:S93-S98. [PMID: 32507556 PMCID: PMC7241353 DOI: 10.1016/j.encep.2020.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/17/2020] [Indexed: 12/15/2022]
Abstract
L’état de panique associé à la pandémie liée au SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) incite à s’interroger sur les troubles anxieux que cette situation pourrait générer ou aggraver. Si la littérature a déjà fourni des projections généralistes en la matière, les données concrètes concernent à ce stage davantage le trouble de stress post-traumatique et le trouble obsessionnel compulsif, tandis que quelques évaluations s’intéressent au cadre nosographie du trouble anxieux généralisé. Le trouble panique ne se voit que peu ou pas cité et l’évocation de la « panique », au sens social, la supplante largement. Bien que d’une légitimité clinique encore débattue, le trouble panique qualifié de « respiratoire » pourrait se voir augmenter en nombre et/ou être intensifié chez les patients qui en présentent déjà. D’éventuelles situations co-morbides entre un tel trouble et la COVID-19 (coronavirus disease 2019) doivent inciter à certaines précautions en matière de prescriptions médicamenteuses, notamment en lien avec les traitements ou situations, sources d’hypokaliémie : (i) le salbutamol, source potentielle de surconsommation, notamment chez les patients anxieux ; (ii) l’infection par le SARS-CoV-2 et plus encore en cas de diarrhées et/ou vomissements. L’hypokaliémie est associée à un risque accru de torsade de pointe, il convient donc également d’être prudent en matière de prescription de psychotropes à risque : comme avec le citalopram et l’escitalopram, des antidépresseurs indiqués dans le trouble panique ou encore l’hydroxyzine, à visée anxiolytique. Ces données sont de nature à resituer l’importance de la prise en considération du trouble panique dans le cadre de la pandémie en cours.
Collapse
Affiliation(s)
- H Javelot
- Établissement Public de Santé Alsace Nord (EPSAN), Brumath, France; Laboratoire de toxicologie et pharmacologie neurocardiovasculaire, université de Strasbourg, Strasbourg, France.
| | - L Weiner
- Clinique de psychiatrie, CHU de Strasbourg, Strasbourg, France; Laboratoire de psychologie des cognitions, université de Strasbourg, Strasbourg, France
| |
Collapse
|