Objective: The current article is aimed at identifying the best practice for counseling around depression in community and outpatient pharmacies, resulting in a draft guideline, proposing key steps and an algorithm for integration of community pharmacists into care for patients with depression. Methods: A literature review was performed followed by a detailed analysis, for the purpose of creation a short draft document used as a basis for creation of a guideline for pharmaceutical care for patients with depression. The technological scheme PRISMA flow diagram was applied. The paper is based on current knowledge, taking into consideration already published articles, guidelines, and recommendations about pharmaceutical care for patients with depression, giving a basis for further studies. Results: This paper includes two main sections: 1) depressiona short description of the main symptoms, risk factors and pharmacotherapy guidelines available in Bulgaria important for the purposes of ensuring qualitative community-based pharmaceutical care; and 2) the pharmacists' role in providing high-quality carethe main aspects of pharmaceutical care for patients with depression with specific examples. Conclusion: The involvement of pharmacists in supporting depressive patients is crucial taking into account the specific characteristics of the pharmacological treatment: delayed onset of clinical results, risks in case of sudden pharmacotherapy abruption without physician consultation, multiple adverse drug reactions and drug-drug, drug-food and drugalcohol interactions, etc. The current article could also be used as an initial document for creating a methodological guideline for providing pharmaceutical care services for patients with depression.

Aim This report aims to illustrate the possibility of an acute onset of psychosis after COVID‐19 infection in a patient without previous history of psychiatric disorders and to highlight the need for early screening and intervention in such cases. Methods Clinical presentation of a case, followed by clinical discussion and literature review of the effect of the new coronavirus SARS‐CoV‐2 and its impact on mental health in terms of neuropsychiatric conditions. Results We present a case of acute and transient psychotic disorder following complete recovery of COVID‐19 bilateral pneumonia. The patient has no prior psychiatric history and presents with acute onset, disorganized behaviour, Cotard's delusion and a potentially high risk of psychotic homicide and suicide. Conclusion Early intervention and treatment with antipsychotic medication are of crucial importance for the effective treatment and complete recovery of these patients.

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Schizophrenia is a serious mental disorder which requires complex treatment and care. Although proof for effective, cost-effective and affordable treatment is available, health economic research is lacking in many low and middle-income countries. The aim of this study was to evaluate the costs and outcomes for individuals with acute exacerbations of schizophrenia before and after inpatient admission and to evaluate the cost-effectiveness of the current treatment in the clinical practice. We used an ambispective comparative observational health economic study design. The participants were individuals with schizophrenia and their primary caregivers. Costs at baseline and follow-up were evaluated from a healthcare perspective. The primary outcomes were psychopathology, social functioning and quality of life for the patients and burden of informal care for the caregivers. Cost-effectiveness planes and cost-effectiveness acceptability curves were generated to illustrate the cost-effectiveness of treating schizophrenia in the real clinical practice, compared to a do-nothing alternative. The main finding is that treatment of individuals with schizophrenia results in improved outcomes for both patients and caregivers, while it is associated with increased healthcare costs from 135.75 Euro (SD ¼ 193.36) per patient before hospital treatment to 189.00 Euro (SD ¼ 126.98) per patient in the follow-up (95% CI: À112.48; À2.31). After application of sensitivity analysis at a particular level of willingness to pay, the treatment remains cost-effective for all 4 outcomes. In conclusion, the treatment of patients with schizophrenia in Bulgaria is cost-effective at acceptable levels of willingness to pay for a unit of improvement on four different outcomes.