The Impact of COVID-19 Pandemic in Psychiatric Outpatient Visits in Abu Dhabi – A Retrospective Study
Introduction: Coronavirus pandemics has affected mental health services around the globe. A marked reduction in psychiatric admission and emergency visits were reported recently. With regards to outpatient services, there was an adoption of tele-psychiatry in mental health facilities in many countries. Objectives: To examine the impact of COVID-19 pandemics on the psychiatric outpatient visits in the largest Psychiatric Hospital in Abu Dhabi, UAE, during the month of April 2020. Methodology: A descriptive retrospective study of medical records of all patients attended the general adult psychiatry clinic in the month of April 2020. Results: 1,050 patients were included in the analysis. The sample consists of 55.9% males. The mean age was 40.7 years. The predominant ethnicity was Arab (88.3%). The most prevalent diagnosis was depressive disorder 32.7%. Only 1.6 % patients attended the clinic as new appointments. Tele-assessment was conducted in 64% (N=672) visits. 9.3 % reported to be in relapse during April. Patient with schizophrenia showed the lowest relapse rate 5.7%. Only 8.5% had taken PCR COVID test, with two patients tested positive. Conclusion: The great shift to tele-assessments and the service of medications home delivery were the main reason for maintaining the service in the psychiatric outpatient settings.
In this COVID-19 lockdown Survey Monkey study, as many as 75% of 260 respondents reported feeling fatigued. Correlation analyses suggested that feeling fatigued was significantly correlated with demographic variables and virtually every item on every scale of the survey. The demographic correlations suggested that fatigue occurred more frequently in younger participants, in males, and in those not working from home during the lockdown. The significant correlations for the scales suggested that those feeling fatigued engaged in fewer health activities including exercise and self-care; they spent more time on social media including gaming and Facebook; they engaged in less cooking and creative projects; they scored higher on the Stress Scale including worrying more about the virus and their finances; they reported feeling more isolated, lonely, bored and touch deprived; they did more snacking and napping and expressed more “cabin fever”; they had lower scores on connecting and activities at home; and they had higher scores on anxiety, depression, sleep disturbances, and PTSD scales. A regression analysis suggested that 51% of the variance in the fatigue scores was explained by the depression (37% variance), sleep disturbances (12%) and anxiety (1%) scores. These results are limited by their being self-reported data from a non-representative, cross-sectional sample. Nonetheless, they highlight the negative effects of feeling fatigued during a COVID-19 lockdown.
This paper examines the meeting between the artist Salvador Dalí and Sigmund Freud that took place in London in July of 1938. Freud had just escaped from the Nazi regime in Austria and was about a year away from death. Dalí had been influenced by Freud’s work for many years and had sought to meet his idol on several previous occasions. The meeting, arranged by Freud’s friend, Stefan Zweig, and attended by the poet, Edward James, is noteworthy in that Dalí brought his painting, “Metamorphosis of Narcissus,” a treatise on the subject of paranoia, and sketched Freud’s head conceived as a snail. The paper offers perspectives on each of these events. The meeting is seen in the context of Freud’s artistic sensibility and his relationship to Surrealism. For Dalí the meeting served as a way to break with Surrealism and led to a revised philosophy of art. The paper concludes with the speculation that the meeting was experienced by the artist as an idealizing/envious narcissistic transference with Freud, thus replicating the theme of the painting that the artist had brought with him.
Education of Healthcare Professionals on an Integrated Care Pathway in order to Standardize Practice and Improve Outcomes for Individuals with Intellectual and Developmental Disability (IDD) who engage in Self-Injurious Behavior (SIB)
This paper addresses the lack of knowledge and lack of standardization for treating individuals who engage in self-injurious behavior (SIB) to the head. An evidence-based integrated clinical care pathway is described that was created for health care professionals treating individuals with intellectual and developmental disability (IDD) who engage in frequent and/or significant SIB. It is anticipated that this pathway will increase treatment team knowledge of best practices, decrease clinical variation, standardize care, and improve clinical outcomes with this vulnerable population.
The New Approaches Therapeutics That Complement Medicinal Therapy of Patients in Mental Health: an Analysis
Mental illnesses represent a challenge for healthcare worldwide. In Brazil, this reality is not different, with the Unified Health System (SUS) providing or improving the therapeutic treatment of patients assisted by public health policies, through the implementation of integrative and complementary practices in mental health patient therapy. Drug therapy associated with the increase in integrative practices contributes to improvements in the patient, in addition to promoting updates to the protocols and clinical guidelines that address pathologies of the mental nature. In this context, this chapter should analyze the main mental disorders, such as drug therapies used to treat these patients, as well as the use of integrative practices that complement the use of medications.
The term “autism spectrum disorder” (ASD) describes today a heterogeneous group of neurodevelopmental disorders with diverse etiologies. Autism spectrum disorder is obviously a neurodevelopmental disorder that seems to be a big challenge today for both: the family doctor and the pediatrician. The core of this disorder is mainly integrated by the patient’s communication and social interaction difficulties and by the presence of repetitive or restricted behaviors and / or interests. (AUGUSTYN, PATTERSON, TORCHIA, 2019 p. 1)1-10 Autistic Spectrum Disorder is a pervasive and permanent disorder. It has no cure, no especific treatment, and this must be clarified from the begining, however, early intervention can drastically alter prognosis and soften symptoms (SOCIEDADE BRASILEIRA DE PEDIATRIA, 2019) 1-10. To benefit from early intervention, the patient with autistic spectrum disorder needs an early diagnosis. The key to their better social integration is the time. It is obvious that children identified with risk for autism spectrum disorder should be referred to a specialist with the purpose to establishing the diagnosis. However, it is primarily up to the primary-care physician to identify children at risk through developmental follow-up, behavioral follow-up and eventually through a valid screening and clinical judgment. In fact, early, accurate and appropriate diagnosis usually requires a clinician with experience in diagnosis and treatment. However, the contribution of a multiprofessional team to assess key symptoms, functional impairment, severity, and comorbid conditions is very important. The management of this patient should be individualized according to the child’s age and specific needs. The primary care provider can refer the child to local consultants or the public school system for ancillary evaluations (speech language, cognitive and adaptive testing, psychoeducational testing) (AUGUSTYN, PATTERSON, TORCHIA, 2019 p. 2)1-10 The key to our attitude as professionals is continuous follow-up. And it needs to be done together with an expert…
Anxiety and Depression Throughout history, humans have created various “instruments” for the survival of their species, including a need for socialization. These social relationships do not always occur successfully and when they do, there are behavioral changes, such as anxiety disorder, depression and even risk of suicide (SAVALLI; ADES, 2016; SOUSA; OLIVEIRA; CALOUI, 2018). Social Anxiety Disorder (SAD) presents as main resources exacerbated fear or anxiety in social situations. Also called Social Phobia, SAD usually manifests itself before or during moments of interaction, as well as in situations where the individual feels observed or exposed to the approval of others (APA, 2013). This disorder is a consequence of one or several factors, whether psychological, biological or arising from lived situations (GOMES, 2014). Those who suffer from SAD tend to exhibit more reclusive habits, reducing their social circle to only their family members and to avoid situations in which they need to speak or even eat in the public. Physically, anxiety disorder usually manifests as hand tremors, flushing, nausea, frequent urination and/or panic attacks, signs that negatively influence the behavior of the affected individual and may cause a more intense degree of social isolation. Social Phobia physiologically impairs the functionality of the hypothalamus, pituitary gland, and adrenal glands, producing changes in production and releasing of several important hormones, such as adrenaline and cortisol. This physiological change implies the maintenance of alertness, increases heart rate, alter body blood flow, and digestive processes and pupil dilation, these signals being the preparation of the body for situations of fight or escape. From the biological point of view, these characteristics are important for the survival of individuals. However, in the anxiety scenario, these effects are constantly manifesting, leading to the predominance arc of deleterious effects on the individual’s life. Early aging and cognitive signs, such…
With the changing age structure of the population, epidemiological shifts are observed. The incidence of infectious diseases has declined over the years and has been replaced by chronic diseases such as cardiovascular, cancer, diabetes mellitus, and psychological disorders. Anxiety disorders are more common among people suffering from chronic medical disease, and the number of medical illnesses is positively associated with the presence of anxiety (RAMOS; STANLEY, 2018, p.57). Anxiety disorders are psychological disorders that have their basis in one of the most rudimentary and adaptive human functions: the innate stress response (‘fight or flight’’ response) (ABRAMOWITZ; DEACON, 2010, p. 104). So, it is possible that during our lifetime we may suffer some kind of anxiety disorder. In fact, the stress response is designed to motivate us to protect ourselves by preparing to cope with a perceived threat. But when this stress or fear is disproportionate to actual threat or danger and significantly interferes with normal daily functioning, the person is said to have an anxiety disorder (ABRAMOWITZ; DEACON, 2010, p.104, OLTHUIS; WATT; BAILE; HAYDEN; STEWART, 2015, p.12). While fear is the emotional response to an imminent threat, characterized by an acute autonomic system activation, anxiety is better described as the “anticipation of a future threat” (DONELLI; ANTONELLIA; BELLINAZZIB; GENSINIC; FIRENZUOLID, 2019, p. 2). Anxiety is a disease which affects a large part of the world population. According to (Kessler et al (2007), approximately one in four individuals are likely to have, or have previously had, an anxiety disorder.
Speech Language Therapy and Mental Health: analysis of communicative behavior and intervention in individuals with schizophrenia
Speech language intervention in mental health There are still a few literary reports of direct action of Speech Therapy in public care services to individuals diagnosed with mental disorders which is a current challenge for Speech language pathologist. The only mandatory presence of this professional in the minimum team is in Child and Youth Psychosocial Attention Center (PSACc), but not in the Psychosocial Attention Center (PSAC) for example, where the majority of the users are adults (SANTOS et al., 2012). If, on the one hand, mental health outpatient clinics were an important entry point for the speech therapist into the public health system, on the other hand, in front of PSAC implementation, its presence in the teams is not yet consolidated. In 20 years of SUS (Sistema Único de Saúde) and under the aegis of the advances of Psychiatric Reform it is also necessary to make consistent the practices into the field of language as a power of psychosocial rehabilitation and inclusion of children, teenagers and adults affected by psychiatric disorders of high complexity (SANTOS et al., 2012). The National Mental Health Policy (NPMH) supported by the law 10.216/2002, has as an object consolidate an open, community-based model of public mental health care. In other words, ensure the free movement of people with mental disorders through services and communities, and provide care based on the resources offered by them. The PSAC, Residential Therapeutic Services (RTS), the Centers of Coexistence and Culture and the services of integral attention (in general hospitals and PSAC) are part of a service network based on this model (BRASIL, 2001).
How can society live with anxiety and pain? The discussion about anxiety goes through dentistry as it affects the oral condition. Generalized Anxiety Disorder (GAD) is a very prevalent condition in the population, and mental disorders are often associated with disabilities that affect various activities, also being associated with various diseases and syndromes that present chronic pain, such as chronic Temporomandibular Disorder (TMD). Interactions of exposure to adverse psychosocial events and mental disorders can make the etiological diagnosis of chronic pain a major challenge. Chronic pain is an important public health problem, affecting a relevant portion of the population, interfering with psychological status, social activities and work. Therefore attention and care is needed to control anxiety and promote the quality of life of the population.