Experience of the psychiatric and psychotherapy services of an infectious hospital in the context of the COVID-19 pandemic

Прокопович, Г. А.; Владыкина, Т. В.; Sivashova, M. S.; Zueva, O. N.

doi:10.31363/2313-7053-2021-1-67-76

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…According to the literature, self-isolation plays an important role in the formation of suicidal behavior [ 1 , 2 , 3 , 4 , 5 , 7 ], which can be traced in each of the presented cases. The presence of anxiety and sleep disorders accompany patients with COVID-19, and also often precede suicidal actions [ 4 , 5 , 7 , 9 ], which was also reflected in all three patients.…”

Section: Discussionmentioning

confidence: 93%

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Connection of Suicidal Behavior with COVID-19: Clinical Cases

Прокопович¹

2022

Consortium Psychiatricum

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The widespread spread of coronavirus infection has led to significant changes in people's lives. Prolonged isolation, fear of infection, frustration, boredom, all kinds of deficits, inadequate information, money losses and fear of stigmatization, as well as the disease itself - all these factors have had an impact on the emotional and physical well-being of people. The impact of the viral infection itself on the human body, as well as the perception of a new reality, in some cases, led to the formation of reactive, organic or exacerbation of existing chronic mental disorders. Persons with mental health problems are most susceptible to environmental influences and react acutely to rapidly changing circumstances. Often in critical situations, in a state of despair, patients see only one way to solve all problems voluntary retirement. In this article, we present clinical cases that are descriptive in nature and aimed at illustrating depressive experiences and suicidal behavior of patients in a crisis situation. When external circumstances were the reason for suicide attempts: loneliness as a result of restrictive measures, fear of infection or the disease itself, and the reason was a mental disorder that debuted earlier or reemerged as a result of a viral infection. We have presented three clinical cases. All patients suffered from a new coronavirus infection of varying severity and were treated in a psychiatric hospital, where they were transferred from an infectious diseases hospital or hospitalized directly in connection with suicidal actions. In each case, attention was paid to the organizational activities carried out. The described cases may be of interest to specialists not only of a psychiatric profile, but also doctors of other specialties who are part of multifunctional teams to assist patients with COVID-19.

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Section: Discussionmentioning

confidence: 93%

“…Most authors agree that the current situation led to the development of certain mental disorders, among which asthenic, anxiety, and depressive disorders were the most prevalent. Such symptoms are both a consequence of exposure to a viral infection, and a person’s reaction to the disease [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Connection of Suicidal Behavior with COVID-19: Clinical Cases

Прокопович¹

2022

Consortium Psychiatricum

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Features of cognitive functioning in older people with COVID 19

Pashkovskiy

Петрова

Sivashova

et al. 2023

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

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The results of studies on elderly patients with COVID-19 indicate presence of serious comorbidities, including cerebrovascular disease, infection of the central nervous system, and cognitive deficits. Impaired cognitive functioning may be due to neurological damage, combined and potentially reversible effects of depression, anxiety and sleep disturbances.The purpose of the study: to identify characteristics of cognitive impairment of elderly patients hospitalized for COVID-19.Material and methods: the study involved 35 patients: 15 men and 20 women (median age 61.0 years, interquartile range (IQR, 25.0-75.0 percentiles) — 50.0-69.0 years, established clinical diagnosis: “New coronavirus infection COVID-19 (PCR+)”. Inclusion criteria were: 1) confirmation of the diagnosis of COVID-19 by clinical and PCR methods, 2) absence of mental disorders, incl. cognitive impairment prior to COVID-19. The exclusion criterion was age under 40 and over 90 years. The severity of COVID-19 was assessed in accordance with the criteria of the Interim Guidelines of the Ministry of Health of the Russian Federation. Clinical and psychopathological method, psychometric testing using the MMSE scale were used. Monitoring of current physical condition was carried out using The National Early Warning Score (NEWS2) for COVID-19. MMSE testing and monitoring of NEWS2 were carried out twice: upon presentation of cognitive complaints in the first days of hospitalization (1st measurement) and at discharge (2nd time point) Statistical processing was carried out using the STATISTICA 12 package. When comparing features, two-tailed Fisher’s test and Wilcoxon’s test were used. Correlation analysis was carried out using Kendall’s test. The level of statistical significance was p<0.05.Results: Comparative analysis between the first and second measurements revealed an improvement in the cognitive performance of elderly patients with COVID-19 by the end of the hospital stay. A significant predominance of median indicators was revealed: orientation (Med 9.0, IQR 8.0-10.0 vs Med 7.0 IQR 6.0-8.0; p=.0000), immediate memory (Med 3.0 IQR 3.0-3.0 vs Med 2.0 IQR 2.0-3.0; p= .0006), attention and counting (Med 2.0 IQR 2.0-4.0 vs Med 2.0 IQR 1.0-3.0; p=.0000). word reproduction (Med 2.0 IQR 2.0-3.0 vs Med 1.0 IQR 1.0-2.0; p=.0000); speech (Med 6.0 IQR 6.0-8.0 vs Med 5.0 IQR 4.0-5.0; p=.0000). final score (Med 24.0 IQR 23.0-27.0 vs Med 17.0 IQR 15.0-20.0; p=.0000). Correlations between the MMSE scores and anamnestic data were analyzed. Significant negative correlations were found with age, disease severity (only at the 2nd time point), diseases of the nervous, cardiovascular and digestive systems. Statistically significant relationships with gender, disease severity at the first measurement, tumors, diseases of the endocrine, respiratory and genitourinary systems were not obtained.Conclusion. Objective neurocognitive measurements can provide important information for neuropsychiatric sorting and should be included as endpoints in clinical trials.

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A dimensional approach to assessing delirium in COVID-19 in the elderly

Pashkovskiy

Петрова

Sivashova

et al. 2023

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

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The aim of the study was to investigate the structure of delirium in elderly patients with different outcomes of coronavirus infection.Materials and Methods. The study was carried out on the basis of Hospital for War Veterans, St. Petersburg. The study involved 30 patients: 13 male and 17 female (median age (Med) 70.5, interquartile range (IQR) 62-83) with clinical diagnosis: "New coronavirus infection COVID-19 (PCR+), F05.86 other delirium in association with other viral and bacterial neuroinfections. Peculiarities of delirium manifestations were studied using Delirium Rating Scale-Revised-98 (DRS-R-98). Current physical condition was monitored using The National Early Warning Score (NEWS2) for COVID-19.Results: All patients had moderate to severe disorders of the wake-sleep cycle on the DRS-R-98 scale. In addition, perceptual and long-term memory impairments were common. A significant correlation (p<0.05) was found between the severity of the physical condition and disorders of the sleep-wake cycle, lability of affect, formal thought disorders, motor agitation, and disorientation. In addition, there were significant correlations (p<0.05) between delirium symptoms and physical status scores on the NEWS2 scale. In lethal patients, more pronounced disturbances were recorded on sleep-wake indicators (Med.3.0, IQR 2.0-3.0 vs Med.2.0, IQR 2.0-3.0, p=0.0327) and motor agitation (Med.2.0, IQR 1.0-2.5 vs Med.1.0, IQR 0.0-2.0, p=0.441). A logit regression model showed that the variables "respiratory rate," "heart rate," and the final NEWS2 score could be considered predictors of disease outcome.Conclusion. Delirium, one of the most frequent manifestations of acute brain dysfunction, is a serious complication of COID-19 in hospitalized patients and a strong predictor of adverse outcome of coronavirus infection in older patients.

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Experience of the psychiatric and psychotherapy services of an infectious hospital in the context of the COVID-19 pandemic

Cited by 3 publications

References 17 publications

Connection of Suicidal Behavior with COVID-19: Clinical Cases

Connection of Suicidal Behavior with COVID-19: Clinical Cases

Features of cognitive functioning in older people with COVID 19

A dimensional approach to assessing delirium in COVID-19 in the elderly

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