Traumatic brain injury (TBI) is a leading cause of morbidity and mortality, giving rise to a variety of neuropsychiatric syndromes associated with great functional impairments, chronic disability and poor quality of life. Depending on diagnostic criteria, 20-90% of victims of TBI develop at least one neuropsychiatric manifestation in the first month, and about 40% present at least three symptoms during three months, with higher incidence in females. Survivors of TBI are at increased risk for development of severe, long-term psychiatric disorders. The aetiology of these disturbances remains unclear.

To review current knowledge on the neuropsychiatric consequences associated with TBI.

Non-systematic review of literature through search on PubMed/MEDLINE database for publications up to 2020, following the terms “traumatic brain injury” and “neuropsychiatry”.

Although the experience of neuropsychiatric symptoms may be temporary and may resolve in the acute period, many patients with TBI can experience psychopathology that is persistent or that develops in the post-acute period, regardless of injury severity. These symptoms can involve personality changes, psychosis, major depression, generalized anxiety disorder, post-traumatic stress disorder, maladaptive social behaviours, poor disability adjustment, reduced coping skills and cognitive impairment. Evidence remains insufficient to conclude the role of TBI-related neuropathological consequences in the development of post-TBI neuropsychiatric disorder. Non-organic factors are also implicated in its generation and maintenance.

Neuropsychiatric sequelae are common following TBI. Several of these syndromes are amenable to treatment. Further investigations are required to better understand the mechanistic aetiology of these conditions and the effectiveness of therapeutic modalities.

Coronary-artery bypass graft (CABG) surgery is known to improve cardiac function and decrease mortality, albeit, this method of treatment is associated with a high risk of postoperative delirium. The pathophysiology of delirium after cardiac surgery is largely unknown.

To investigate whether oxidative stress reflected by decreased preoperative and postoperative plasma antioxidant capacity (AC) is independently associated with delirium after cardiac surgery. Furthermore, to assess whether the association between AC and the level of soluble receptor for advanced glycation end-products (sRAGE) exists.

The patients were examined 1 day preoperatively with the Mini International Neuropsychiatric Interview and MMSE test to screen for depression, anxiety disorders, and for cognitive impairment, respectively. Blood samples for AC and sRAGE levels were collected both preopertively and postoperatively. The CAM ICU and MDAS were used within the first 5 days postoperatively to screen for a diagnosis of delirium.

Postoperative delirium developed in 34% (61 of 177) of participants. Multivariate stepwise logistic regression analysis revealed that patients with low baseline AC are at significantly increased risk of developing delirium. Moreover, preoperative AC levels were inversly correlated with postoperative sRAGE concentrations (Spearman’s Rank Correlation -0.198; p<0.05). The most optimal cutoff values of the preoperative and postoperative AC that predict the development of delirium were 1.720 mM and 1.893 mM, respectively.

Decreased plasma AC levels are associated with delirium after cardiac surgery and inversly correlated with post-surgery sRAGE concentration. This may be an important pathophysiological consideration in the increased risk of postoperative delirium seen in cardiac surgery patients.

Delirium is a frequent and serious complication of cardiac surgery. However, the knowledge regarding pathogenesis of postoperative delirium is limited.

To investigate whether increased levels of monocyte chemoattractant protein-1 (MCP-1) and hyper-sensitive C-Reactive Protein (hsCRP) are associated with postoperative delirium in cardiac surgery patients.

Patients were examined and screened for major depressive disorder (MDD) and cognitive impairment one day preoperatively, using the Mini International Neuropsychiatric Interview and The Mini-Mental State Examination Test. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. Following surgical interventions, the Confusion Assessment Method for the Intensive Care Unit and the Memorial Delirium Assessment Scale with the cut-off score 10 were used to diagnose delirium.

Postoperative delirium screening was found positive in 34% (61 of 177) of patients. Both, pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p=0.001; p=0.0004; p < 0.001, respectively. However, according to a multivariate stepwise logistic regression analysis only MCP-1 concentration raised before surgery was independently associated with postoperative delirium, and related to advancing age of participants (Spearman’s Rank Correlation 0.192; p=0.0103). According to ROC analysis, the most optimal cut-off for MCP-1 concentration in predicting the development of delirium was 371.81 ng/ml with sensitivity of 77.0% and specificity of 58.6%.

The present study suggests that raised preoperative MCP-1 concentration is independently associated with delirium after cardiac surgery. Preoperative monitoring of pro-inflammatory markers combined with regular surveillance may be helpful in the prediction and early detection of postoperative delirium in this patient group.

The strcuture of personal disorders in hypertensive disease aptients remains relevant topic.

The study population included 57 hypertensive disease patients; mean age 49,1+9,6 years old (42 females and 15 males). The control group included 62 healthy individuals (49 females and 13 males); mean age 48,1+8,6 years old.

Emotional condition of subjects was assessed using the Depression Scale of Zung, the Spielberger trait Anger scale and Anxiety, the Toronto Alexithymia Scale and SCL – 90-R Questionnaire.

The study results showed that as compared to the healthy individuals, the hypertensive disease patients showed significantly higher scores of reactive anxiety (46,0+9,0 and 39,0+8,2; р<0,01), personal anxiety (50,3+9,2 and 41,03+7,9; р<0,01), depression (42,7+7,2 and 36,59+5,95;р<0,01), alexithymia (69,4+8,8 and 59,0+9,2; р<0,01), state anger (11,8+3,6 and 10,6+1,8; р<0,01), reactive anger (9,2+2,6 and 8,1+2,4; р<0,05), personal anger (21,4+5,3 and 18,1+4,6; р<0,01), trait anger (8,3+3,0 and 7,3+2,3; р<0,05), self-aggression (16,2+4,9 and 13,4+3,8; р<0,01), aggression towards others (15,9+3,9 and 14,7+3,4; р<0,05), somatization (1,27+0,6 and 0,5+0,4; р<0,01), hostility (1,2+0,7 and 0,5+0,4; р<0,01), obsessive-compulsive traits (1,2+0,7 и 0,6+0,4; р<0,01), psychoticism (0,7+0,6 and 0,27+0,30; р<0,01) and paranoid traits (1,22+0,6 and 0,5+0,4; р<0,01), phobic anxiety (0,6+0,5 and 0,2+0,2; р<0,01) and interpersonal sensitivity (1,2+0,7 and 0,7+0,5; р<0,01).

Close interrelations between manifestations of anxiety and depression spectrum disorders and anger may be explained by internal conflict between aggressive impulses and the need for adaptive behavior in such individuals, resulting in consistent vicious vortex.

The paper will describe the experience as consultation-liaison psychiatrist during the Covid 19 Pandemic in a private hospital in Madrid, what we have learned and its implications given the considerable and increasing interest in European Consultation-Liaison research.

Following the request of one of the internal medicine department doctors the service was initially provided for patients admitted with the infection but very quickly included relatives and also the hospital staff.

Patients were offered a telephone consultation that in most cases took place on a daily basis. Referrals where made by a doctor, some of them were locums due to the increasing demands of the service since patients from public hospitals were also admitted. Relatives were also referred by doctors and the frequency was more varied, depending on their needs. Members of the multidisciplinary team referred themselves..

Patients and their families felt that the telephone consultation was useful to them. The work with some members of the staff is ongoing and will continue given the toxic levels of stress that they had to face and the changes taking place at the institution at the time.

The COVID-19 pandemic and the short and long term consequences that will follow will increase our understanding the breadth and depth of Consultation-Liaison Psychiatry and the broad perspective required for a comprehensive evaluation and treatment of patients. My experience as psychoanalytic psychotherapist and organizational consultant proved most helpful.

The problem of specificity of psychological adaptation mechanisms at the patients with Type 2 Diabetes Mellitus (T2DM) is extremely actual. The aim is to investigate gender psychological characteristics associated with T2DM

In the comparative study 62 patients (28 male, 34 female; mean age 56,8±2,3 and 55,4±2,7 yrs.) with T2DM (HbA1c 7,3±1,3%) and visceral obesity (Grade 2) were included.

Research methods: the Depression Scale of Zung, the Spielberger trait scale anxiety, Toronto Alexithymia Scale and MMPI test

T2DM-female-patients in comparison with T2DM-male showed significantly higher personal anxiety scores (51,2+7,6 and 44,1+10,6 respectively; р<0,05), depression scores (44,2+7,6 and 36,7+8,4 respectively; р<0,05), while alexithymia scores were higher at T2DM-males (68,2+9,6 and 71,7+6,4 respectively; p<0,05). In MMPI test (after correction by K-scale) 46,8% of patients demonstrated profiles with elevated scale 1 score (above 70 Т-scores, but below 80 Т-scores) regardless of gender differences. However, the T-scores for T2DM-male patients were on the average by 1,07 higher than for T2DM-female (58,4 vs 54,4 respectively, р˃0,05), that indicated more higher concern related to own physical health condition. The female T2DM-patients significantly more often demonstrated profiles with scale 6 peak (exceeding 65 Т-scores): 79,4% vs. 21,4%, which indicated the more higher accentuation of personality traits (concealed hostility; protest; rigidity, desire to blame the others for one’s failure, et cetera)

The patient’s gender has to be taken into consideration at development of clinical, diagnostic and prevention activities of patients with T2DM and visceral obesity.

Сognitive deficit significantly affects the quality of life of patients. Aims of research was detection of cognitive impairments of varying degrees in epilepsy, and as well as studying the results of complex treatment in conditions of University clinic, physical and psychological rehabilitation, cognitive training and VNS included.

We studied the features of clinical and psychopathological manifestations of cognitive impairments in patients suffering from epilepsy.

The study was attended by 100 patients (35 men and 65 women) who were inpatient care. The following psychodiagnostic techniques were used: the Toronto Cognitive Assessment TorCA, the test of 10 words of Luria, the MOCA test, the Münsterberg test, the quality of life scale, the Hamilton scale of depression and anxiety.

MCI was observed in 88 % patients, dementia in 12 % (50 % - mild dementia, in 24 % - moderate dementia and in 16% - severe dementia). We used non-pharmacological rehabilitation methods for correction of cognitive impairment in epileptic patients with MCI and mild dementia during 3 mounth.. Improving of cognitive function was observed in 48 % patients, stable level of cognitive function - in 36 %, progressing of cognitive imparment - in 16 % patiens with epilepsy.

The results of the conducted research indicate the need for further study of the features of cognitive disorders in pharmacologically treatment resistant epilepsy and implementation of training aimed at improving cognitive function and preventing the progression of cognitive impairment in complex treatment of those patients.

Hepatitis C virus (HCV) infection is known to be associated with neuropsychiatric manifestations as part of the disease. Previous neuroimaging studies showed brain connectivity dysfunction among HCV-infected patients

To assess, by MR in resting state, the potential structural and connectivity changes before (BL) and after HCV eradication (FU12) with direct-acting antivirals (DAA), along with clinical parameters.

Twenty-one HCV-patients, aged≤55 years, without psychiatric history, nor advanced liver disease, and eligible for DAA, and 25 healthy controls were included. Evaluations were performed at BL and FU12. Brain volume and local gyrification index (LGI) were assessed in MR-T1, and functional connectivity by seed-based analysis (left insula). Depression (MADRS/PHQ9) and neurotoxicity symptomatology (NRS) were assessed. We compared patients between BL/FU12, and controls by means of paired/independent T-test analysis.

Substained virologycal response was obtained in all patients (100%). Depressive and neurotoxicity symptomatology improved after cure (p<0.01). HCV-patients showed a reduced volume in a right latero-occipital area compared to controls (CWP<0.005) in both BL and FU12. This difference was smaller between FU12 and controls. LGI was higher in FU12-HCV compared to BL-HCV. fMRI connectivity showed a high association between insula and occipital/parietal territories in patients than controls, being higher among BL-HCV and controls. Differences were limited to occipital areas among FU12-HCV and controls.

Neuropsychiatric symptomatology improved after cure. Left insula is altered among HCV-patients in structured and connectivity (mainly occipital areas). After cure differences with controls were reduced, suggesting a partial restoration of brain connectivity.

Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder, that typically manifests in adulthood, clinically characterized by progressive motor, cognitive and psychiatric/behavioural symptoms. Psychiatric symptoms are common in HD. The presentation of these symptoms is highly variable, and their course does not correlate with motor or cognitive disease progression. Psychiatric symptoms often precede motor onset by many years.

The authors intend to review the literature the most frequent psychiatric disorders in patients with HD.

Non-systematic review of the literature.

Psychiatric symptoms have been a core feature of HD. Pre-symptomatic HD patients exhibit a greater prevalence of psychiatric symptoms, particularly affective disorders. This symptoms are presenting symptoms of HD in up to half of all people. In symptomatic HD patients, it is estimated that up to 73–98% of patients will have a major psychiatric disorder or psychiatric symptoms. Psychiatric manifestations in HD include depression, irritability, apathy, anxiety, mania, perseverations, obsessions and psychosis. Cognitive changes include progressive deficits in attention, learning, executive and sensory functions, resulting in dementia. Depression, diagnosed in half of patients with HD, is the most common and earliest symptoms prior to the motor onset. There are likely multiple causes of the psychiatric symptoms, with underlying factors including a combination of neurobiological, cognitive, psychological, social and environmental factors.

Patients with HD have high psychiatric comorbidity, that causes significant functional impairment and affect quality of life. Thus, they require a multidisciplinary approach in the recognition and treatment of psychiatric symptoms.

During the COVID-19 pandemic people experience higher levels of negative emotions, as well as face many negative and intense emotions felt by others. Thus, it is important to look for risk and protective factors that allow and help individuals to regulate these negative emotions and adapt to the hardships of the COVID-19 pandemic.

The main aims of the study were to (i) test how empathic dimensions (perspective taking, empathic concern and personal distress) and emotion regulation abilities were related to intensity of depressive symptoms during the COVID-19 lockdown in Poland, as well as to (ii) check if emotion regulation difficulties and personal distress predicted slower decrease in depressive symptoms over the two months in which the number of COVID-19 cases declined in Poland.

A total of 792 participants took part in the three-wave panel study. The sample was representative of the Polish population in terms of gender, age, and place of residence. Participants completed the following online questionnaires: The Patient Health Questionnaire-9, The Difficulties in Emotion Regulation Scale Short Form, and Brief version of the Empathic Sensitivity.

Significant positive correlations were found between depressive symptoms and both personal distress and emotion regulation difficulties during the lockdown. Moreover, emotion regulation difficulties were the only significant predictor of slower decrease in depressive symptoms over time during the COVID-19 pandemic.

It seems that interventions focused on improvement of emotion regulation abilities could be particularly beneficial in reducing depressive symptoms during the pandemic and preventing potential negative long-term outcomes.

The diagnosis of hypochondria has disappeared in the new classification of mental illness. About 25% of patients who were diagnosed with hypochondria now fall into the category illness anxiety disorder. This disorder constitutes a new diagnostic category in DSM5 and is included within the somatic symptom and related disorders.

We propose to carry out a bibliographic review off the new diagnostic category of illness anxiety disorder.

We present the clinical case of a 27-year-old man in the context of the Covid19 pandemic.

The illness anxiety disorder is characterized by being concerned about having or acquiring a serious illness. Somatic symptoms are not present, but if they are, they are of mild intensity. The level of concern is excessive or disproportionate if there is any disease or if there is a high risk of developing it. There is a high level of health anxiety and the individual is easily alarmed by personal health status. It is a disorder that tends to be chronic and recurrent. The exact comorbidity is still unknown. However, it is important to keep in mind that hypochondria concurs with anxiety disorders and depressive disorders. Treatment is based on the cognitive restructuring of bodily symptoms. In addition, exposure therapy and acceptance and commitment therapy are also effective. Regarding pharmacological treatment, SSRIs are useful in relation with comorbidity.

Illness anxiety disorder is characterized by significant attention to somatic concerns in medical places, making it very useful for primary care professionals.

Several restrictive measures have been implemented to reduced COVID- 19 impact with unknown consequences on people daily life.

The primary objective is to asses the psychosocial impact and employment status changes since lockdown COVID-19 measures in Chile.

Cross-sectional study was implemented using an anonymous and self-administered online questionnaire. Adult people were invited to participate through social networks between May to June 2020. The questionnaire included sociodemographic information, coping strategies, changes in income and working conditions and psychological distress (K10 Scale).

3102 participants over 18 years answered the questionnaire. 69.9% reported psychological distress mainly women (82.2%), members of the public health system (59%), dependent workers (39.8%), people who suffered income reduction (36.8%)., and those who changed their employment status (26.4%). Participants who presented income reduction were 1.83 times more likely to present psychological distress than those without changes (p <0.001)

Pandemic crisis had impacted population health, especially in some specifics groups that could be targeted for future interventions.

Since its early stages, the Covid-19 outbreak has posed immense challenges for effective, scalable and rapid interventions. Telehealth approaches have been considered as key part of an effective pandemic response.

The aim of this systematic review was to evaluate the role of digital solutions in fighting the mental health needs during COVID-19 outbreak.

This review was conducted through searching four databases including PubMed, Scopus, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of mental health care during COVID-19 outbreak, published from December 31, 2019 to October 31, 2020, written in English language and published in peer-reviewed journals. Narrative synthesis was undertaken to summarize the findings according a SWOT (strengths, weaknesses, opportunities, threats) analysis.

62 studies met the inclusion out of the 278 search results. Data converged on: strengths in minimizing the risk of Covid-19 transmission, reduction of travel time and costs, comparable effectiveness to in-person care; weaknesses i.e. decreased ability to detect non-verbal cues, lower therapeutic alliance, possible technical connection problems; opportunities in improving the healthcare system and expanding its accessibility for patients also for the future; threats such as privacy and legal issues, and risk to overlook vulnerable populations (e.g. elderly, marginalized ethnic minorities).

In the midst of a global mental health emergency, telehealth may represent a “virtually perfect” solution. However, further implementations facing issues of quality, justice and healthcare equity are required to ensure that all patients receive the care they need.

Sleep-related complaints are among the most common during pandemic, along with anxiety and depression (Huang, Zhao 2020, Rajkumar 2020). Their prevalence is associated with anxiety about the pandemic (Roy et al., 2020), online information search (Moghanibashi-Mansourieh, 2020, Wang et al., 2020).

The aim was to reveal relationship between the type anxiety and coping during pandemic and sleep-related complaints after 3-4 weeks of lockdown.

203 adults aged 18 to 59 years filled situational version COPE (Carver et al., 1989) and scales measuring anxiety of infection and pandemic consequences (Tkhostov, Rasskazova, 2020) in the mid-April 2020 after 2-3 weeks of lockdown in Russia. After 3-4 weeks, they filled in a modified insomnia severity index (Morin, 1991) appraising how much worse their sleep and daytime functioning during this period (Cronbach’s alpha .62-.73).

Prevalence of sleep and day functioning related complaints during lockdown varied 19.3%-30.5%. Complaints were associated with anxiety only if it reaches dysfunctional level (interfering with daily activities, r = .17-.34, p <.05) and coping strategy of mental disengagement (r = .15-.19, p <.05). Sleep complaints were related to substance use to cope with lockdown problems while complaints on daytime functioning correlated were more common among young respondents (r = -0.22, p <0.01).

Complaints about poor sleep during a pandemic are not related to the general severity of pandemic anxiety, but to the dysfunctional level of anxiety and attempts to avoid it. Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00740.

Research is supported by the Russian Foundation for Basic Research, project No. 20-013-00740.

COVID-19, was declared a pandemic by World Health Organisation on March 11, 2020. Older people with dementia or those with multimorbidity are more vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the development of COVID-19. Given absence of a vaccine or treatment, prevention is the fundamental aspect of COVID-19 control. This requires early identification of contagious people with COVID-19 and isolation keeping them apart from non infected group of people. Early identification of infection in elderly with dementia or functional psychiatric condition is often difficult, due to difficulty in obtaining history or evaluating medical symptoms.

1) To establish the current standards of interventions provided at the unit to control COVID-19, with current recommendation by Government guidance. 2) To address difficulties in early identification of people of COVID-19 in Old Age Psychiatry wards. 3) To introduce sustainable interventions aimed at controlling COVID-19 risk, targeted to this group.

Trust guidance for COVID-19 testing on the ward and guidance of isolation were reviewed. Literature review of currently available scientific evidence for testing for controlling COVID-19 was conducted.

We have created a bi-weekly mass testing guidance for Old Age Psychiatry inpatient wards with clear guidane of when to start isolation and when to stop isolation.

There is no specific interventions to target older adult within our service currently and it was felt that it is necessary to develop a sustainable mass testing programme for this group of people for control of COVID-19.

For young people, just as in the general population, COVID-19 caused many changes in their lives. The literature review has shown an increased risk for mental illness symptoms as a consequence of the pandemic.

With this study, we aimed to evaluate the impact of COVID-19 pandemic in university students’ anxiety and depression symptoms.

This study is part of a larger longitudinal research on university students’ mental health with the Portuguese version of The Patient Health Questionnaire (PHQ-9) and the Portuguese version of the Generalised Anxiety Disorder (GAD-7) data with evaluations on January, May and October 2019 and June 2020, as well as socio-demographic information.

341 university students (257 females and 84 males) were included in this study, with a mean age of 19.91 (SD=1.58). In June 2020, the mean for perceived well-being loss was 60.47% (SD=26.56) and 59.54% (SD=28.95) for mental health loss. In the PHQ-9, the proportion of students with scores equal or above 15 ranged between 22.6% and 25.5% in 2019, however, in June 2020, the proportion was significantly higher (37.0%). The proportion of GAD-7 scores above the cut-off 10 ranged between 46.0% and 47.8% in 2019, and, in 2020, 64.5% of the students scored 10 or above. Compared with preceding trends, PHQ-9 scores were 3.11 (CI=2.40-3.83) higher than expected, and GAD-7 scores were 3.56 (CI=2.75-5.37) higher.

COVID-19 had a negative impact on depressive and anxiety symptoms in university students, in line with the literature and confirming the vulnerability of young people in such uncertain times.

The COVID-19 pandemic represents a stressful event for humanity. The spread of this disease mainly affects health professionals and interests them closely.

Identify the impact of the COVID-19 pandemic on the mental health of healthcare personnels and associated factors exposing them to increased psychological fragility.

The current article is a narrative review of the existing literature. A search on electronic database like PubMed was undertaken using the search terms “coronavirus mental health healthcare workers”. 20 articles were included in this review.

Studies revealed that health care workers have prensented considerable psychiatric symptoms such as anxiety, depression, PTSD, stress, insomnia, somatization, mental and physical exhaustion, addiction and obssessive compulsive symptoms. The prevalence of these symptoms varies from study to another with almost a more notable prevalence of anxiety and depressive symptoms. The following factors that predispose to developing mental distress were noted: being a frontline health worker, having direct contact with infected patients, working in a city with a high infection rate, female sex, isolation, being a suspected case, stigmatization, change of organization, lack of materials, lack of information, lack of communication, lack of support, fear of contamination or of contaminating loved ones, having an organic pathology.

This notable impact of the pandemic on the mental health of healthcare workers alerts us as colleagues and civil society to the ultimate need for an urgent adequate and up-to-date intervention to alleviate this distress.

The Group of Studies and Research on Psychology and Cognition (GEPESPSI) in Brazil has developed important academic and clinical actions on mental health in contexts of difficult psychological handling.

GEPESPSI organized a symposium to discuss the psychological effects of isolation due to the strict measures of social distancing.

11 psychologists and one speech language pathologist discussed possible contributions to face social distancing in their specific fields of expertise in a virtual symposium of two days. The themes were: university teaching; support to the development of social and emotional competencies among children; the threat of the death of dreams in a phenomenological perspective; resilience and self-esteem; the repercussions of the lack of the school space for socialization; psychological tools for facing isolation; the challenges and perspectives of women who are victims of violence; online therapy for children; the health of workers; suicidal behavior; formulation of educational policies for remote learning and family mental health.

1094 people were enrolled with an average of 400 people participating in each period. 91,1% of which were graduate students of a university. 55,7% were students of Psychology, 12,8% of Pedagogy, 6% of Physical Therapy among other courses. 39,8% of them were from the city of Santos, the others were from different regions of the country.

The feedback given by the participants was positive and involved gains such as sharing experience and knowledge but mainly creating connections to exchange psychological tools as a way of facing the difficulties of social distancing among researchers and graduate students.

Survivors of critical illness stay frequently experience long-term mental health morbidity, suggesting that many critically ill patients with COVID-19 may also show a high prevalence of psychiatric conditions.

To describe depression in COVID-19 survivors 4-months post-hospital discharge and to examine its association with health-related quality of life (HRQoL).

This pilot study involved COVID-19 adult patients admitted in Intensive Care Medicine Service (ICMS) of a University Hospital. Exclusion criteria were: ICMS length of stay (LoS)≤24h, terminal illness, major sensory loss and inability to communicate at the time of assessment. All participants were evaluated at ICMS scheduled telephone follow-up appointment, with Patient Health Questionnaire (PHQ-9) (depression) and EQ-5D-5L (HRQoL). Critical-illness severity was assessed with APACHE-II and SAPS-II.

Twenty patients were included with a median age of 62(range: 24-77) y.o., the majority male (75%) and married (70%). Median (range) APACHE-II and SAPS-II was 17 (5-34) and 32.5 (7-77), respectively, and LoS was 18 (4-58) days. Overall, 25% patients presented depression symptoms and most reported problems on EQ-5D-5L domains of pain/discomfort (65%), anxiety/depression (55%) and mobility (50%). Depression scores were higher in patients with problems in EQ-5D-5L domains of usual activities (median 4 vs 1.5; p=0.046), pain/discomfort (median 0 vs 4; p=0.004) and anxiety/depression (median 4 vs 0;p<0.001).

These preliminary findings show that depression is frequent in COVID-19 survivors and it is associated with worse HRQoL. This pilot study highlights the importance of psychological assessment and treatment of COVID-19 survivors, in order to minimize its negative impact on HRQoL, optimizing their recovery.

Since the declaration of the COVID-19 pandemic, several studies have demonstrated its considerable psychological impact. The isolation and social distancing, the increased fear of being infected or infecting others and the insecurity generated by the economic impact, could contribute to an increase in the incidence of mental health issues, such as psychotic disorders.

The aim is to discuss four clinical cases in order to provide further evidence on this matter.

We report on three females and one male with no personal psychiatric history who were admitted to a tertiary hospital during the first three months after the declaration of the pandemic. The average age was 44,25 ± 14,97 years.

All patients met the International Statistical Classification of Diseases (ICD-10) criteria for acute and transient psychotic disorder. All of the episodes were triggered by the stress generated from the COVID-19. Complementary tests were unremarkable. They all tested negative for SARS-CoV-2. Rapid discharge with favorable response to relatively low doses of antipsychotics was possible with a mean length of stay of 7,25 ± 2,86 days. In two of the cases the delirious content was predominantly marked by the coronavirus itself.

It has been suggested that the intense psychosocial stress associated with a new life-threatening disease and national lockdown restrictions could be triggers for new-onset psychotic disorders. Some authors have reported cases similar to ours, which means that we could be experiencing and increase in the incidence of psychotic disorders due to the exceptional circumstances we are living around the world.