Development of a psychological first-aid model in inpatients with COVID-19 in Wuhan, China

Psychological Status of the Participants in Alzheimer's Prevention Initiative Autosomal Dominant Alzheimer's Disease Colombia

BACKGROUND

The SARS-CoV2 global pandemic impacted participants in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) clinical trial, who faced three stressors: 1) fear of developing dementia; 2) concerns about missing treatment; and 3) risk of SARS-CoV2 infection.

OBJECTIVE

To describe the frequency of psychological disorders among the participants of the API ADAD Colombia clinical study, treated by a holistic mental health team during the COVID-19 pandemic. The extent of use of mental health team services was explored considering different risk factors, and users and non-users of these services were compared.

METHODS

Participants had free and optional access to psychology and psychiatry services, outside of the study protocol. Descriptive statistics was used to analyze the frequency of the mental health difficulties. A multivariable logistic regression model has been used to assess associations with using this program.

RESULTS

66 participants were treated by the Mental Health Team from March 1, 2020, to December 31, 2020. Before and after the start of the pandemic, the most common psychological problems were anxiety (36.4% before, 63.6% after) and depression (34.8% before, 37.9% after). 70% of users assisted by psychology and 81.6% of those assisted by psychiatry felt that the services were useful for them. Female sex, depression, and anxiety before the pandemic were positively associated with being assisted by either psychology or psychiatry, while the association with hyperlipidemia was negative.

CONCLUSIONS

A holistic mental health program, carried out in the context of a study, could mitigate psychopathology during pandemics such as COVID-19.

The mental health of China and Pakistan, mental health laws and COVID-19 mental health policies: a comparative review

Mental health is one of the major causes of disability worldwide, and mental health problems such as depression and anxiety are ranked among the top 25 leading causes of disease burden in the world. This burden is considerable over the lifetime of both men and women and in various settings and ages. This study aims to compare the mental health status of people in China and Pakistan and to highlight the mental health laws and policies during COVID-19 and afterwards. According to the literature on mental health, before the COVID-19 pandemic, mental health problems increased gradually, but during and after the COVID-19 pandemic, an abrupt surge occurred in mental health problems. To overcome mental health disorders, most (but not all) countries have mental health laws, but some countries ignore mental health disorders. China is one such country that has mental health laws and policies and, during the COVID-19 pandemic, China made beneficial and robust policies and laws, thereby succeeding in defeating the COVID-19 pandemic. The mortality rate and financial loss were also lower than in other countries. While Pakistan has mental health laws and general health policies, the law is only limited to paperwork and books. When it came to COVID-19, Pakistan did not make any specific laws to overcome the virus. Mental health problems are greater in Pakistan than in China, and China's mental health laws and policies are more robust and more widely implemented than those in Pakistan. We conclude that there are fewer mental health issues in China than in Pakistan both before and since the COVID-19 pandemic. China has strong mental health laws and these are robustly implemented, while the mental health law in Pakistan is not applied in practice.

Development study of psychological first aid application self-efficacy scale

PURPOSE

The aim of this study is to develop a measurement tool that can be utilized to determine in the psychological first aid application of self-efficacy.

DESIGN AND METHOD

The development of scale consisted of the following stages: literature reviews, examination of the conceptual structure, creation of scale items, expert advice, and individual and focus group interviews.

FINDINGS

A measurement tool was obtained by factor analysis, consisting of one factor and 35 items. The obtained scales were statistically significant, thereby providing a sensitive measurement (p < 0.05).

PRACTICE IMPLICATIONS

This measurement tool would assist in determining the self-efficacy of psychological first aid administered by aid providers working in disaster situations, thereby increasing the quality of their intervention.

Implementing Psychological First Aid for Healthcare Workers During the COVID-19 Pandemic: A Feasibility Study of the ICARE Model

Maintaining the resilience of healthcare workers (HCWs) during the protracted COVID-19 pandemic is critical as chronic stress is associated with burnout, inability to provide high-quality care, and decreased attentiveness to infection prevention protocols. Between May and July 2020, we implemented the ICARE model of psychological first aid (PFA) in a novel online (i.e., telehealth) format to address the psychological support needs of HCWs during the COVID-19 pandemic. We found that HCWs needed psychological support related to obtaining clear information about pandemic policies and guidelines, navigating new rules and responsibilities, and processing overwhelming and conflicting emotions. The HCWs in our program repeatedly expressed appreciation for the support we provided. Future directions include establishing online discussion forums, increasing opportunities for individual support, and training HCWs to provide peer support using PFA. This program has far-reaching potential benefit to HCWs and to society at large in the context of a pandemic.

Medical students in the face of SARS-CoV-2 pandemic: an estimated risk of infection and the need for social support

OBJECTIVES

A pandemic triggers certain attitudes and behaviors, resulting in the need for adequate social support. The aim of the study was to determine the factors influencing the estimated risk of SARS-CoV-2 infection and to assess the need for social support in a group of medical students.

MATERIAL AND METHODS

The survey was conducted among 981 people, including 814 women and 167 men. For this purpose, a self-assessment survey with 22 multiple-choice questions was used. The online survey was conducted on March 20-April 2, 2020, which can be considered as the first stage of the pandemic in Poland.

RESULTS

The tested model for the subjective SARS-CoV-2 infection risk assessment explained 32.6% of the dependent variable variance (F(7.945) = 66.61, p < 0.001). The model for adherence to the recommendations for reducing the risk of SARS-CoV-2 transmission explained 9.5% of the variability (F(8.943) = 12.39, p < 0.001), and the model for an increased need for social support due to the SARS-CoV-2 epidemic explained 27.4% of the variability (χ2(8) = 12.17, p = 0.144).

CONCLUSIONS

Factors important for estimating the risk of SARS-CoV-2 infection and the need for social support in the group of medical students were determined. The subjective assessment of the stress level, infection symptoms experienced and the field of study proved to be crucial. Int J Occup Med Environ Health. 2022;35(4):473-84.

INCloud: integrated neuroimaging cloud for data collection, management, analysis and clinical translations

Background

Neuroimaging techniques provide rich and accurate measures of brain structure and function, and have become one of the most popular methods in mental health and neuroscience research. Rapidly growing neuroimaging research generates massive amounts of data, bringing new challenges in data collection, large-scale data management, efficient computing requirements and data mining and analyses.

Aims

To tackle the challenges and promote the application of neuroimaging technology in clinical practice, we developed an integrated neuroimaging cloud (INCloud). INCloud provides a full-stack solution for the entire process of large-scale neuroimaging data collection, management, analysis and clinical applications.

Methods

INCloud consists of data acquisition systems, a data warehouse, automatic multimodal image quality check and processing systems, a brain feature library, a high-performance computing cluster and computer-aided diagnosis systems (CADS) for mental disorders. A unique design of INCloud is the brain feature library that converts the unit of data management from image to image features such as hippocampal volume. Connecting the CADS to the scientific database, INCloud allows the accumulation of scientific data to continuously improve the accuracy of objective diagnosis of mental disorders.

Results

Users can manage and analyze neuroimaging data on INCloud, without the need to download them to the local device. INCloud users can query, manage, analyze and share image features based on customized criteria. Several examples of 'mega-analyses' based on the brain feature library are shown.

Conclusions

Compared with traditional neuroimaging acquisition and analysis workflow, INCloud features safe and convenient data management and sharing, reduced technical requirements for researchers, high-efficiency computing and data mining, and straightforward translations to clinical service. The design and implementation of the system are also applicable to imaging research platforms in other fields.

Neurology Telemusic Program at the Time of the COVID-19 Pandemic: Turning Hospital Time Into Aesthetic Time During Crisis

Strict precautions during the COVID-19 pandemic left patients isolated during already stressful hospital stays. Research indicates that listening to music recruits regions in the brain involved with social interaction and reduces feelings of loneliness. We formed a team of clinicians and clinical musicians to bring music to the bedside, as “psychological first aid.” Our goal was to reduce feelings of anxiety and isolation in patients admitted to the Northwestern Memorial Hospital's neurosciences unit. Participants were offered 30–40-min live music sessions over FaceTime by a violist in consultation with a music therapist and a certified music practitioner. Music used for the interventions was personalized. Participants were evaluated with the Music Assessment Tool where they indicated their musical preferences and music to which they objected. Following the intervention, participants answered a questionnaire assessing how music impacted their emotional state based on a 1–10 Likert scale. Scores were then averaged across all patients and were calculated as percentages. Eighty-seven sessions were completed during a 3-month period. Despite different degrees of disability, most patients engaged aesthetically with the music. The likelihood to recommend (LTR) for the program was 98%; participants tended to highly agree that the intervention improved their emotional state (92%); that it provided a pleasurable experience (92.4%); and that it reduced their stress and anxiety (89.5%). This pilot project showed that the telemusic intervention was feasible for our neurosciences patients during the COVID-19 pandemic. Our results are consistent with previous in-person hospital-based music interventions and highlight the importance of such programs when in-person interventions are not possible. This pilot project serves as a prelude to further investigate mechanisms by which music interventions can support admitted neurology patients.

Efficacy of video-based psychotherapy in reducing psychological distress of COVID-19 patients treated in isolation ward

BACKGROUND Hospitalized patients with COVID-19 experience isolation during treatment, which may cause psychological distress. Thus, alternative ways to deliver psychological support are needed when face-to-face therapy is not possible. This study aimed to investigate the efficacy of video-based psychotherapy in reducing distress in COVID-19 patients treated in an isolation ward. METHODS This quasi-experimental trial without a control group included 42 COVID-19 patients aged 20–59 years. Participants were recruited conveniently in the COVID-19 isolation ward in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. They watched three brief psychotherapy videos including relaxation, managing thoughts and emotions, and mindfulness for approximately 30 min. The videos were created by the Department of Psychiatry, Faculty of Medicine, Universitas Indonesia. Subjective units of distress scale (SUDS) was measured before and after watching all videos. Data were analyzed using the Wilcoxon-signed rank test. RESULTS All 42 subjects finished watching the videos. 31 subjects experienced a significant median decrease in SUDS score after the intervention. The effect size of the psychotherapy videos for the SUDS score was 0.485 (95% CI 0.302 to 0.634). CONCLUSIONS Watching psychotherapy videos is effective in reducing the SUDS score for COVID-19 patients in an isolation ward. Our brief video-based psychotherapy intervention has reduced psychological distress in hospitalized COVID-19 patients with limited access to face-to-face consultations due to the risk of disease transmission.

Uses of digital technologies in the time of Covid-19: opportunities and challenges for professionals in psychiatry and mental health care

BACKGROUND

The Covid-19 pandemic has required psychiatric and mental health professionals to change their practices to reduce the risk of transmission of SARS-CoV-2, in particular by favoring remote monitoring and assessment via digital technologies.

OBJECTIVE

As part of a research project that was co-funded by the French National Research Agency (ARN) and the Centre-Val de Loire Region, we carried out a systematic literature review to investigate how such uses of digital technologies have been developing.

METHODS

The present systematic review was conducted following the PRISMA guidelines. The search was carried out in MEDLINE (PubMed) and Cairn databases, as well as in a platform specializing in mental health, Ascodocpsy. The search yielded 558 results for the year 2020. After applying inclusion and exclusion criteria, first on titles and abstracts, and then on full texts, 61 articles were included.

RESULTS

The analysis of the literature revealed a heterogeneous integration of digital technologies, not only depending on countries, contexts, and local regulations, but also depending on the modalities of care. Notwithstanding these variations, the use of videoconferencing has developed significantly, affecting working conditions and therapeutic relationships. For many psychiatric and mental health professionals, the pandemic has been an opportunity to build up an experience of remote care, and thus better identify the possibilities and limits of these digital technologies.

CONCLUSIONS

The new uses of such technologies essentially consist in a transition from the classic consultation model towards teleconsultation and makes less use of the specific potential of artificial intelligence. As professionals were not prepared for these uses, they were confronted with practical difficulties and ethical questions, such as the place of digital technology in care, confidentiality and protection of personal data, and equity in access to care. The health crisis questions how the organization of health care integrates the possibilities offered by digital technology, in particular so as to promote the autonomy and empowerment of mental health service users.

CLINICALTRIAL

The Early Impacts of the COVID-19 Pandemic on Mental Health Facilities and Psychiatric Professionals

(1) Background: While in many countries, the psychiatric and mental health sectors had been in crisis for years, the onset of a novel coronavirus pandemic impacted their structures, organizations, and professionals worldwide. (2) Methods: To document the early impacts of the COVID-19 health crisis on psychiatry and mental health sectors, a systematic review of the international literature published in 2020 was conducted in PubMed (MEDLINE), Cairn.info, and SantéPsy (Ascodocpsy) databases. (3) Results: After applying inclusion and exclusion criteria, 72 articles from scientific journals were selected, including papers documenting the early impact of the COVID-19 pandemic on the organization of psychiatric care delivery, work processes in psychiatry and mental health units, and personal experiences of mental health professionals. This review identified the contributions aimed at preventing the onset of mental disorders in the early stages of the health crisis. It lists the organizational changes that have been implemented in the first place to ensure continuity of psychiatric care while reducing the risk of SARS-CoV-2 transmission. It questions the evolution of the rights and duties of mental health professionals in the first months of the pandemic. (4) Discussion and conclusions: Although this literature review exclusively documented the early impacts of the COVID-19 health crisis, it is of significant interest, as it pictures the unprecedent situation in which psychiatry and mental health care professionals found themselves in the first stages of the pandemic. This work is a preliminary step of a study to be conducted with mental health professionals on an international scale—the Psy-GIPO2C project—based on more than 15 group interviews, 30 individual interviews, and 2000 questionnaires. The final aim of this study is to formulate concrete recommendations for decision-makers to improve work in psychiatry and mental health.

Interventions to Optimise Mental Health Outcomes During the COVID-19 Pandemic: A Scoping Review

Adverse mental health has been a major consequence of the COVID-19 pandemic. This review examines interventions to enhance mental health outcomes and well-being of populations during COVID-19. Four electronic databases (MEDLINE, PsycINFO, Embase, and CINAHL) were searched following Arskey and O’Malley’s six-staged scoping review process. Twenty studies were included in the review. Various study populations were included to ensure greater generalisability of results. Interventions informing treatment of mental health concerns during COVID-19 were included and classified into (a) prevention of poor mental health, (b) therapeutic interventions, and (c) other interventions. Preventative strategies (n = 16) included public health education, modified social media use, technology-based interventions, physical activity, policy adaptations, and therapeutic interventions. Treatment strategies (n = 7) included adapting existing treatment and the creation new treatment programmes and platforms. While current evidence is promising, future research should focus on novel effective interventions to address mental health issues during the pandemic.

Remote W.A.R.A. Compared With Face-to-Face W.A.R.A.: A Pilot Study

BACKGROUND

Since the outbreak of the COVID-19 pandemic and its social restriction measures, online therapy is a life-saving possibility for patients with acute stress. Wiring Affect with ReAttach (W.A.R.A.) is a brief psychological intervention aiming to decrease negative affect, that can be offered online.

METHODS

We assessed the effect of remote W.A.R.A. on negative affect in 37 patients. Consequently, we compared the effect of remote W.A.R.A. versus face-to-face W.A.R.A on negative affect in a cross-sectional design.

RESULTS

W.A.R.A. remote therapy provoked a significant reduction of negative affect with a large effect size (d = 3.08, p < 0.001). However, the reduction on negative affect was smaller than with W.A.R.A. face-to-face. We found a substantial difference between W.A.R.A. remote therapy and W.A.R.A. face-to-face in decrease of negative affect (d = 1.36, p < 0.001).

LIMITATIONS

The major limitation of the pilot-study is the sample size of 37 patients. Besides, we designed a numeric rating scale for evaluating negative affect. We investigated the impact on negative affect by assessing "unpleasant feelings." This conceptualization of negative affect might still be a point of discussion.

CONCLUSION

The study's findings indicated that W.A.R.A. remote therapy significantly reduced negative affect, but to a lesser extent than W.A.R.A. face-to-face. Nevertheless, W.A.R.A. remote therapy might offer a fast relief, especially when personal contact is difficult.