Search

Background It is reported that patients who have recovered from Covid-19 continue to experience various symptoms and adverse outcomes. However, this aspect has not been studied well. We aimed to evaluate these variables and the perceived impact of Covid-19 among patients discharged from a Covid hospital in northern India. Methods We conducted this study among patients discharged from a Covid-19 hospital in northern India in June 2020. As per the official policy at that time, patients detected to have Covid-19 (symptomatically or via contact tracing) were mandatorily admitted. A sequential, mixed-methods design was followed. Patients discharged from the hospital were contacted telephonically, and the cross-sectional prevalence of symptoms, the prevalence of depression and anxiety and the social consequences of admission were assessed. A subgroup of patients was interviewed for qualitative assessment of their experience. Results A total of 274 patients provided consent and were assessed, of which 8 patients underwent detailed interviews. The prevalence of somatic symptoms was 3.4%; 36.2% of the patients had depressive and 12% of the patients had anxiety symptoms. A majority of patients experienced adverse social and economic consequences of hospitalization for Covid-19. These themes were reinforced by a qualitative analysis of in-depth interviews. Conclusions Our study population experienced a high prevalence of adverse psychosocial consequences of Covid-19. These included depression and anxiety symptoms, stigma and economic and occupational consequences. These deserve more recognition and study.

Background: The inflammatory state that characterizes COVID-19 may contribute to depression, anxiety, other morbidities, and mortality. Interleukin-6 blocker tocilizumab has been used as a treatment modality in COVID-19 as an anti-inflammatory agent. Tocilizumab has also been studied for its potential use in preventing depression in other patient groups, with mixed results. This study was designed to study subsequent depression, anxiety, and quality of life (QOL) in patients treated with tocilizumab plus standard care versus standard care alone, for moderate to severe COVID-19 pneumonia. Methods: Patients admitted with moderate to severe COVID pneumonia, treated with tocilizumab plus standard treatment, and discharged from the hospital were identified. Age- and gender-matched controls who had received standard treatment alone for COVID-19 pneumonia during the same time frame were identified. After obtaining consent, these patients were followed up and assessed at 3 and 6 months on measures of depression (PHQ-9), anxiety (GAD-7), and QOL (EQ-5D-5L). Results: 39 patients in the tocilizumab group and 41 in the control group were followed up at 3 and 6 months. Patients in both groups were comparable in sociodemographic and clinical parameters. The prevalence of clinically significant depression in the tocilizumab group at 3 and 6 months was 33.33% and 5.12%, respectively, whereas in control group it was 31.7% and 4.87%, respectively. Analysis of EQ-5D health profiles revealed that the maximum problems were reported in the dimension of mobility: 43.7% at 3 months and 35% at 6 months. Conclusions: Depressive and anxiety symptoms and impairment in QOL were reported more frequently and with greater severity in patients in the tocilizumab group at three months but not at six months. Psychological morbidity and impairment in QOL were modest and improved from 3 to 6 months.

Background and objectives Significant psychological morbidity exists in patients with active pemphigus. Pemphigus being a chronic disease, psychological morbidity may exist in pemphigus patients in remission as well. The objectives of the study were to assess the psychological morbidity in pemphigus patients in clinical remission and to correlate it with clinico-demographic parameters. Patients and methods Pemphigus patients in clinical remission were consecutively included and were asked to respond to the Hindi/English version of Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) and panic disorder module of PHQ. Results Of 107 patients recruited, 41 (38.3 %, 95 % CI: 29.1-48.2 %) patients were found to have either depression (33 [30.8 %, 95 % CI: 22.2-40.5 %]) or anxiety (38 [35.5 %, 95 % CI: 26.5-45.4 %] syndrome based on cut-offs of PHQ-9 score and GAD-7 score, respectively. Number of patients with mild, moderate and moderately severe/severe depression syndrome were 26 (24.3 %, 95 % CI: 17.2-33.2 %), 7 (6.5 %, 95 % CI: 0.3-12.9 %) and 0 respectively and patients with mild, moderate, severe anxiety syndrome were 29 (27.1 %, 95 % CI: 19.6-36.2 %), 9 (8.4 %, 95 % CI: 4.5-15.2 %) and 0 respectively. Patients with anxiety or depression syndrome had significantly higher clinical disease activity in the past, number of days spent in dermatology inpatient and significantly shorter clinical remission at the time of assessment as compared to those without these symptoms. Conclusions Significant burden of mild/moderate depression or anxiety syndrome associated with past severity of disease and shorter duration of clinical remission was found.

IntroductionSchizophrenia is a severe mental disorder. There is ample evidence to suggest that there are various multi-systemic co-morbidities in the patients with schizophrenia. However, data for dermatological comorbidities in these patients is scarce. This is relevant because of the common embryological basis of the central nervous system and skin, and also the disabling nature of schizophrenia itself.ObjectiveTo analyze the profile and distribution of cutaneous conditions in patients with schizophrenia.MethodsConsecutive adult patients with schizophrenia attending the follow-up service of the outpatient clinic of the department of psychiatry of a tertiary hospital in North India were evaluated for the presence of a skin disorder by a dermatologist.ResultsDermatological findings were seen in 71 patients (69.60%), 39 patients (38.23%) had multiple skin conditions. As a group, infections were the most prevalent diagnosis seen in 18 patients (17.64%) and fungal infections were commonly observed (n=14, 13.72%). Other common dermatoses were nevi, age related cutaneous changes, dyschromias and drug-induced acne. Among medical disorders, blood pressure was found to be elevated in 28 patients (27.45%) while sixty-four patients (69.74%) were either overweight or obese.ConclusionA high prevalence of dermatological diseases is seen in patients with schizophrenia. Both caregivers and psychiatrists managing these patients should familiarize themselves with these conditions and dermatology consultation should be sought for the prompt diagnosis and management.

Background Schizophrenia is a life-shortening disease. The standardized mortality ratio has been higher than that of the general population, and it has doubled what it was 3-4 decades ago. This rise is mostly attributed to the increased cardiovascular risk associated with high second-generation antipsychotic (SGA) use. Evidence from the first-generation antipsychotic (FGA) era shows a lower prevalence of hypertension (HTN) but data regarding SGAs is scarce. Purpose The purpose of the study was to assess the prevalence of HTN and related factors using standardized methodology in patients with schizophrenia on treatment with SGAs. Methods A cross-sectional study through convenient sampling was done. Blood pressure, anthropometry, physical activity, and health-related lifestyle factors were assessed using the standard World Health Organization (WHO) methodology of cardiovascular survey methods and the Global Physical Activity Questionnaire (GPAQ) version 2. The prevalence of HTN, obesity, inadequate physical activity, and other demographic and clinical correlates like antipsychotic use, duration of illness, and family history of non-communicable diseases (NCDs) were studied. Results The prevalence of HTN is 20.50%, and it increases with age. SGAs with the use of a single agent are the most common. In total, 45.50% of persons with schizophrenia have a positive family history of a NCD; 22.00% and 07.50% are current tobacco and alcohol users, respectively; and 70% have abdominal obesity, and 54% have generalized obesity. Waist circumference, obesity, and family history of NCDs are significant correlates of HTN. A family history of NCDs is the most significant predictor. Conclusion The prevalence of HTN is lower than that of the general population despite the high prevalence of SGA use, obesity, and inadequate physical activity.

Background: Most countries around the world have been affected by the COVID-19 pandemic. Although there are quantitative studies on the effects of the COVID-19 pandemic on health-care professionals and other population groups, there are few studies that have evaluated the experiences of patients in the initial phases of the pandemic. Aim: This study aims to conduct a qualitative study assessing the experiences of the patients in isolation and quarantine in the initial stage of the COVID-19 pandemic. Methodology: The present study was a qualitative study through telephonic interviews with patients in isolation and quarantine due to COVID-19 from April 4 to 12, 2020. Patients in isolation had confirmed COVID-19 and were mandatorily admitted in specially designated COVID hospitals. Patients in quarantine were suspected to have COVID-19 due to symptoms or contact with confirmed patients with COVID-19. Results: The experiences could be classified as having psychological impact, interpersonal impact, social impact, behavioral changes and impact on occupational aspects. The experience was predominantly unpleasant and characterized by anxiety, stigma, ostracization, guilt, and worry about the future. Conclusion: The experiences of the individuals in both the groups emphasize the importance of addressing psychological stressors. It could be concluded that individuals and their families would accordingly benefit from effective interventions to deal with the negative experiences they have been through due to the present pandemic.

Background and Aim Caustic ingestion is associated with long‐term sequelae in the form of esophageal and/or gastric cicatrization requiring endoscopic or surgical intervention. Quality of life (QoL) and disability in patients with caustic‐induced sequelae is less explored. Methods In this prospective study, we included consecutive patients with symptomatic caustic‐induced esophageal stricture undergoing endoscopic dilatation. QoL was measured using the World Health Organization Quality of Life questionnaire (WHOQoL‐BREF). Disability was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Subjective dysphagia score was calculated by Likert scale. Results A total of 42 patients were included in the study; 25 (59.5%) patients were male. Patients had poor WHOQoL‐BREF and WHODAS scores compared to normality data in all domains of the scores among both the genders. A majority (66.7%) of patients had a current psychiatric diagnosis, with the most common being mood disorder (50%) followed by suicidality (45.2%). Males had a higher prevalence of a previous psychiatric diagnosis compared to females, while females had a higher prevalence of suicidality. Dysphagia score had strong correlation with the WHOQoL (r = −0.66; P, Caustic ingestion is associated with long‐term sequelae in the form of esophageal and/or gastric cicatrization requiring endoscopic or surgical intervention. We assessed quality of life, disability, and depression in a cohort of patients who ingested a caustic agent. These patients were found to have high levels of disability and depressive symptoms and poor quality of life.

Background: Waiting for results is often associated with a state of anxiety and restlessness. The current study is intended to study the emotional state of people waiting for their results after undergoing COVID-19 testing. Methods: A descriptive study was done among 140 participants enrolled by simple random technique over a period of 1 month in May 2020. The participants who gave sample for COVID-19 were assessed for their emotional state at two stages – after giving sample and during the waiting period before telling results to them. A self-designed questionnaire focusing on the demographics and emotional state was submitted by the participants distributed to them as Google Forms. Wilcoxon signed-rank test and McNemar test were used to compare the statistical change in emotions over a period of time. Results: Around 63.6% and 68.8% of the participants had neutral emotional state after giving sample and before announcement of results, respectively. The mean score of agreement with decision to test was 9 ± 1.6 and discomfort related to testing was 4.6 ± 2.6 on Likert scale of 1–10. A statistically significant difference (P = 0.01) was observed in mean response for “something can be done to help” after giving sample (1.6 ± 0.4) and before announcement of results (1.8 ± 0.3). Conclusions: Patients undergoing testing for COVID-19 undergo psychological turmoil and use various coping methods. Patients endorsed various suggestions including quicker generation of results, environmental changes and counselling services to help them cope better. Incorporating these suggestions may improve the diagnostic process in patients with COVID-19.

Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the knowledge, practice, and concerns regarding coronavirus disease 2019 (COVID-19) among the residents of an urban slum in Chandigarh, India. Materials and Methods Participants were screened using Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Results The mean (standard deviation) age of 200 enrolled participants was 33 (13) years with 83% (n = 166) being females. The prevalence of depression and anxiety was 3.5% (95% confidence interval [CI]: 0.95–6.05) and 2.5% (95% CI: 0.34–4.66), respectively. Of total, 46% (n = 92) knew that COVID-19 can transmit through droplets and 30.5% (n = 61) were concerned that they might get infected with disease. Half of the participants (n = 100) believed that there was unnecessary worry regarding COVID-19 and 78% (n = 156) covered mouth while coughing or sneezing. Conclusion To cope with this critical situation, it is necessary to strengthen the awareness programs targeting the mental health issues of the people.

People with severe mental illnesses may experience barriers in accessing community mental health services. We used the key informant method to detect people with untreated severe mental illness in seven villages in the Indian state of Punjab. The key informant was a local community leader. We were able to contact 11 patients who were identified as suffering from severe mental illness by the key informants. On assessment, eight of them had intellectual disability and three had psychotic and affective illness. We discuss the barriers and opportunities for providing mental health services in the community.

Electroconvulsive therapy (ECT) is an effective modality of treatment for a variety of psychiatric disorders. However, it has always been accused of being a coercive, unethical, and dangerous modality of treatment. The dangerousness of ECT has been mainly attributed to its claimed ability to cause brain damage. This narrative review aims to provide an update of the evidence with regard to whether the practice of ECT is associated with damage to the brain. An accepted definition of brain damage remains elusive. There are also ethical and technical problems in designing studies that look at this question specifically. Thus, even though there are newer technological tools and innovations, any review attempting to answer this question would have to take recourse to indirect methods. These include structural, functional, and metabolic neuroimaging; body fluid biochemical marker studies; and follow-up studies of cognitive impairment and incidence of dementia in people who have received ECT among others. The review of literature and present evidence suggests that ECT has a demonstrable impact on the structure and function of the brain. However, there is a lack of evidence at present to suggest that ECT causes brain damage.

BACKGROUND Schizophrenia is a severe mental disorder. There is ample evidence to suggest that there are various multi-systemic co-morbidities in the patients with schizophrenia. However, data for dermatological comorbidities in these patients is scarce. This is relevant because of the common embryological basis of the central nervous system and skin, and also the disabling nature of schizophrenia itself. OBJECTIVE To analyze the epidemiology of cutaneous conditions in patients with schizophrenia. METHODS Consecutive adult patients with schizophrenia attending the follow-up service of the outpatient clinic of the department of psychiatry of a tertiary hospital in North India were evaluated for the presence of a skin disorder by a dermatologist. RESULTS Dermatological findings were seen in 71 patients (69.60%), 39 patients (38.23%) had multiple skin conditions. As a group, infections were the most prevalent diagnosis seen in 18 patients (17.64%) and fungal infections were commonly observed (n=14, 13.72%). Other common dermatoses were nevi, age related cutaneous changes, dyschromias and acne. Among medical disorders, blood pressure was found to be elevated in 28 patients (27.45%) while sixty-four patients (69.74%) were either overweight or obese. CONCLUSIONS A high prevalence of dermatological diseases is seen in patients with schizophrenia. Both caregivers and psychiatrists managing these patients should familiarize themselves with these conditions and dermatology consultation should be sought for the prompt diagnosis and management. CLINICALTRIAL Not applicable

Physicians across the world have been disproportionately affected by the COVID-19 pandemic. This study was designed and conducted to assess the emotional and behavioural reactions of physicians to the initial phase of the COVID-19 pandemic.An online survey questionnaire using the google forms platform was constructed by the authors. The items in the questionnaire were based on clinical experience, relevant literature review and discussion with peers. A list of issues that were deemed as essential components of the experience of the pandemic relevant to physicians was arrived at. Thereafter these issues were operationalized into question form and hosted on the google forms platform. The link to this questionnaire was circulated by the authors among their peer groups in the month of April 2020.We received 295 responses and 3 were unusable. Most of the responses were from India, the United States of America, Australia, Canada and the United Kingdom. About 60% of the respondents identified themselves as frontline and had a decade of clinical experience. Most respondents reported being anxious due to the pandemic and also observed the same in their peers and families. A majority also observed changes in behaviour in self and others and advanced a variety of reasons and concerns. A sense of duty was the most commonly employed coping mechanism.Physicians are not immune from information and misinformation, or cues in the environment. Behavioural choices are not always predicted by knowledge but by a combination of knowledge, emotional state, personality and environment. Healthcare settings need to be ready for emergencies and should focus on reducing uncertainty in physicians. These factors may also be gainfully used in the mental health promotion of physicians in COVID-19 care roles.

Objective: To evaluate the demographic and clinical profiles of patients admitted to the psychiatry ward during the coronavirus disease 2019 (COVID-19) pandemic and compare with profiles of patients admitted 1 year before the onset of the pandemic (ie, before the lockdown announcement in India). An additional objective was to evaluate the incidence of COVID-19 infection in the psychiatry inpatient unit and discuss the measures taken to run the unit during the pandemic, including the measures taken if any patient or staff member was detected to have COVID-19 infection. Methods: This retrospective study was conducted in a tertiary care hospital in North India. Data of patients admitted to the inpatient unit from March 24, 2019, to March 23, 2020, were compared with data from March 24, 2020, to March 23, 2021. The data were extracted from the inpatient registry. Results: Compared to the pre-pandemic period, fewer patients were admitted during the pandemic, and the patients admitted had more severe illness. During the ongoing pandemic, the incidence of COVID-19 infection among the residents was 5%, nursing staff was 4.7%, and support staff was 6.66%. The incidence rate of COVID-19 among the patients was 3.2%. Patients were not found to be the primary source of infection; on the other hand, COVID-positive status among the health care professionals was responsible for patients becoming infected. Conclusions: During the ongoing COVID-19 pandemic, psychiatry inpatient facility can be managed with reduced capacity and by following COVD-19 protocol.

COVID-19 pandemic is the first modern pandemic and has occurred in an era of social media ubiquity. Despite being in stage 1 of the pandemic, and low numbers of patients, various emotional and behavioral changes were observed in junior doctors. This study was designed to assess the experience and reactions of junior doctors in a tertiary teaching hospital in North India and Tamil Nadu in the immediate aftermath of the nation-wide lockdown.This was an observational cross- sectional study of junior doctors working in tertiary care hospitals in Chandigarh and Tamil Nadu. It was conducted from 28Mean age was 28.64 years (n=362). Though mostly well informed, only 8% restricted themselves to obtaining information from a single source. Around 46% were feeling anxious and many more (73.20%) perceived the same emotion in their peers and even more of them (85.10%) in their family members. Most of them (90.1%) endorsed more than change in behavior, mainly to avoid potential risk (52%) and females tend to self-quarantine themselves more than males.Knowledge does not play as important a role in the way people behave in an outbreak. Many other covert factors may possible be involved. Strategies leading to reduction in uncertainty, interventions for reassurance in the workplace and better role models would be of help in this outbreak.

Background Survivors of COVID-19 pneumonia may have residual lung injury and poor physical and mental health even after discharge. We hypothesized that COVID-19 severe acute respiratory distress syndrome (ARDS) patients needing mechanical ventilation may be at a greater risk of deterioration in pulmonary function, mental health, and quality of life (QOL). This study analyses the differences in pulmonary function, mental health, and QOL after recovery, in patients having received non-invasive oxygen therapy versus invasive mechanical ventilation during ICU stay. Methods Patients aged >18 years, who had completed 3 months post ICU discharge, with moderate to severe COVID-19 ARDS, were consecutively enrolled from May 1 to July 31, 2021. Patients were allocated into Group A - having required high flow nasal cannula (HFNC)/non-invasive ventilation (NIV) and Group B - having received invasive mechanical ventilation. Pulmonary function tests, 6-minute walk test (6-MWT), and health-related quality of life were compared. Results Of the 145 eligible patients, 31 were lost to follow-up and 21 died. Seventy-four patients were allocated into Groups A (57 patients) and B (17 patients). In Group A, abnormal forced expiratory volume in first second (FEV1), forced vital capacity (FVC), forced expiratory flow in mid-half of FVC (FEF25-75), and peak expiratory flow rate (PEFR) values were obtained in 27 (47.37%), 43 (75.44%), 11 (19.3%), and 25 (43.86%) patients, and in Group B, in 13 (76.47%), 17 (100%), 1 (5.88%), and 8 (47%) patients, respectively. No patient had abnormal FEV1/FVC. All Group B patients had a restrictive pattern in spirometry as compared to 77% in Group A. Group B had a lower arterial partial pressure of oxygen (PaO2) (p=0.0019), % predicted FVC (p

Abstract—Cerebellar transcranial direct current stimulation (ctDCS) has been shown to facilitate standing balance in stroke survivors where a good general linear model fit was found in the latent space between the mean lobular ctDCS electric field strength with the oxy-hemoglobin concentrations (HbO) from functional near-infrared spectroscopy (fNIRS) and log10-transformed electroencephalogram (EEG) bandpower at the prefrontal cortex (PFC) and the sensorimotor cortex in the responders. Recent works have also found that the infra-slow activity (0.01–0.10 Hz) and delta band (0.5–4 Hz) activity propagated in opposite directions between the cerebellum and cerebral cortex. Therefore, in this study, we tested the feasibility of fNIRS of cerebellum and PFC where infra-slow (0.01–0.10 Hz) PFC HbO activity was used to drive (phase amplitude coupling) 4Hz cerebellar transcranial alternating current stimulation (ctACS) at right lobules VI-CrusI/II-VIIb. We found that 2mA ctDCS evoked similar HbO response across cerebellum and PFC brain regions (a=0.01); however, 2mA ctACS evoked HbO across brain regions that was statistically different (a=0.01). Clinical Relevance—We showed the feasibility of fNIRS of cerebellum and PFC, and fNIRS-driven ctACS at 4Hz that may facilitate cognitive function via the frontoparietal network in cerebellar cognitive affective/Schmahmann syndrome.

Objective Screening for non-communicable disease (NCD) risk factors can help in prevention or reduction in the ill-effects of NCDs. Data on NCD risk factors in community-dwelling patients with common mental disorders (CMD) is lacking. This study was designed to screen for selected NCD risk factors in patients attending a community psychiatry service (CPS) in the states of Punjab and Haryana in North India. Methods Following ethical clearance, the study was conducted in 4 satellite clinics of the CPS of a tertiary hospital from North India. Consecutive adult patients were approached and 719 patients were assessed. A one-time cross-sectional assessment was carried out which included socio-demographic data, clinical details, history of tobacco and alcohol use, personal history of hypertension and diabetes, family history of diabetes, prevalence of hypertension, obesity (central and generalised) and levels of physical activity. Results 302 males and 417 females were assessed. Most patients were diagnosed with CMD. The prevalence of hypertension was 42.7% in males and 34.1% in females. The prevalence of central and generalised obesity in males and females was 41.4%, 71.2% and 34.8%, 45.6% respectively. 32.5% of males and 40.2% females were assessed to be inadequately physically active. Conclusions The results of the study suggest that there is high prevalence of NCD risk factors in patients with CMD. Hypertension is more common in males while obesity and inadequate physical activity is more common in females. NCD risk factor screening and management, health education should be integrated in CPS.

Introduction: Infectious diseases have had a significant role in shaping human history by engraving a subconscious sense of ‘fear of infection’. The three sequential stages of the rational response to fear- fear, denial, and frustration, have been reported as predominant among quarantined individuals during any outbreak. To our knowledge, this was one of the first studies to assess the impact of the first case of COVID-19 among the neighbouring dwellers. Methods: A semi-qualitative study was conducted through telephonic interviews. Detailed descriptions of the experiences of the inhabitants after coming to know about the first incidence of a patient of COVID-19 in the locality were obtained. Participants were recruited through purposive and snowball sampling. Semi-structured in-depth telephonic interviews were done at a time convenient for participants between April 9 to 11, 2020. Results: Source of information for all the participants was from a neighbour and the participants came to know about the news on 7th of April 2020. All the participants were aware of the correct attitudes and practices of the general public to be followed during the pandemic including hand hygiene, use of face masks, social distancing and adhering to the government lockdown rules. Mixed reactions of panic, fear and confusion were obtained. Most participants were concerned about children and elderly at home, financial constraints due to the blockage of the locality from adjoining areas, everyday hassles that they were about to experience, etc. Despite most participants having minimal fear of contracting the illness themselves, fear of a family member acquiring the same seemed to be significantly higher on hearing the news. ConclusionThe study adds to the existing literature that fear and anxiety during a pandemic are mostly due to the uncertainty related to the disease spread and misinformation. There is a need for phased and well informed lockdown implementation and better knowledge propagation among the general public in order to mitigate unwanted fear and panic among the general public.

Introduction The COVID-19 pandemic has spread to almost all the countries and regions in the world. The fear of getting infected while serving COVID patients and the stress due to separation from family during the quarantine period may impact over sexual functioning of healthcare workers (HCWs). Methodology The study protocol was approved by the institutional ethics committee. This was a nonfunded, cross-sectional, observational study. All participants provided written informed consent. This study was carried out in a multispecialty tertiary teaching hospital in North India. The participants were drawn from married and living with partner male nurses. Sexual functioning was assessed using the changes in sexual functioning questionnaire short-form (CSFQ-14). Results The study found that the prevalence of global sexual dysfunction was significantly higher in male nurses who had completed their rotations in the COVID hospital when compared to those who had not. There were no statistically significant differences between the groups on sociodemographic profiles and the profile of their spouses. Discussion HCWs working in COVID situations are known to suffer from stress, depression, and anxiety. This may impact the sexual functioning of the HCWs, especially when they have been in an infectious environment and the marital dyad may have doubts of the transmission of the infection. Conclusion Male nurses who have worked in a COVID care setting are likely to report higher levels of sexual dysfunction.

ObjectivesPhysicians across the world have been disproportionately affected by the COVID-19 pandemic. This study was designed and conducted to assess the emotional, cognitive, and behavioural reactions of physicians to the initial phase of the COVID-19 pandemic.Materials and methodsAn online survey questionnaire using the google forms platform was constructed by the authors. The items in the questionnaire were based on clinical experience, relevant literature review and discussion with peers. A list of issues that were deemed as essential components of the experience of the pandemic relevant to physicians was arrived at. Thereafter these issues were operationalized into question form and hosted on the google forms platform. The link to this questionnaire was circulated by the authors among their peer groups in the month of April 2020.ResultsWe received 295 responses and 3 were unusable. Most of the responses were from India, the United States of America, Australia, Canada and the United Kingdom. About 60% of the respondents identified themselves as frontline and had a decade of clinical experience. Most respondents reported being anxious due to the pandemic and also observed the same in their peers and families. A majority also observed changes in behaviour in self and others and advanced a variety of reasons and concerns. A sense of duty was the most commonly employed coping mechanism.ConclusionPhysicians are not immune from information and misinformation, or cues in the environment. Behavioural choices are not always predicted by knowledge but by a combination of knowledge, emotional state, personality and environment. Healthcare settings need to be ready for emergencies and should focus on reducing uncertainty in physicians. These factors may also be gainfully used in the mental health promotion of physicians in COVID-19 care roles.

Introduction Denial of Pregnancy is a women's subjective lack of awareness of being pregnant. It can be partial (from 20 weeks but lifted before delivery) or complete (the women notice she's pregnant when labour starts). The prevalence is around 1/500 for partial denial and 1/2500 for complete denial. This article's aim is to review the literature broadly on the subject of pregnancy denial, its psychopathological hypothesis and the state of knowledge on the outcome for mothers and children. Methods 26 references have been selected bases on a research on pubmed database and through bibliography on the selected papers. Results Despite a lot of psychopathological hypothesis and some epidemiological studies, no objective knowledge can lead to know what kind of women will deny their pregnancy and how to prevent it. After all the studies on mother characteristics, it seems there are no "clear-cut" explanations on why a woman denies a pregnancy or what type of women could be at risk of denial. There are no official guidelines on how to manage the condition and care for the patient long term. The first elements of research on the developmental outcome for infant seem to show a delay in psychomotor skills and possible speech disorder. They have been significant advancement on the subject of children development after pregnancy denial in the last year but the psychological and developmental impact of pregnancy denial on children and mothers is still majorly unknown. With a clinical picture known for so long, to have so little objective information on how to manage it and on the possible consequences is surprising. Conclusion More research needs to be conducted to objectively know the long term effects of pregnancy denial on the whole family. International consensus should be found on the definition and care management of pregnancy denial.

Introduction Mental health literacy (MHL) is an important mediator of mental health in the community. Recognition of schizophrenia by the presentation of a case vignette is often used to assess MHL. Various studies assessing MHL around the world have shown that the recognition of schizophrenia is low. This study was designed to use the case vignette method to assess the MHL in a sample of respondents in North India. Methodology We translated a well-known case vignette of schizophrenia from english into hindi. A cross-sectional study design was followed. This case vignette was presented in the written format to 200 respondents in rural Punjab and Haryana. The case vignette was followed by questions regarding the identification and nature of the problem, what could be done about it and the familiarity of the respondent to the term ‘schizophrenia’. The results were analysed through open coding. Results Around 22% of the responses identified mental illness. The recognition of schizophrenia by name was only in one response. Most people attributed the condition of the protagonist in the case vignette to be due to stressful life situations. The respondents used the terms ‘depression’ and ‘tension’ as descriptors of mental illness. The correction of situations leading to stress and counselling by a psychiatrist was considered by most respondents to be useful. The familiarity with schizophrenia was 18%. Conclusions MHL in our sample was low. Measures for improving the MHL in the community are needed. There may be a case for easier nomenclature with regards to MHL.

ObjectivesA majority of patients suffering from acute COVID-19 are expected to recover symptomatically and functionally. However there are reports that some people continue to experience symptoms even beyond the stage of acute infection. This phenomenon has been called longcovid.Study designThis study attempted to analyse symptoms reported by users on twitter self-identifying as longcovid.MethodsThe search was carried out using the twitter public streaming application programming interface using a relevant search term.ResultsWe could identify 89 users with usable data in the tweets posted by them. A majority of users described multiple symptoms the most common of which were fatigue, shortness of breath, pain and brainfog/concentration difficulties. The most common course of symptoms was episodic.ConclusionsGiven the public health importance of this issue, the study suggests that there is a need to better study post acute-COVID symptoms.

UNSTRUCTURED There have been a lot of confidence-building measures rapidly instituted in the current COVID-19 pandemic without any scientific evidence to back them up. Foremost among these measures is the so-called “Disinfection tunnel”. DT are likely to be a wasteful expenditure of scarce resources. As they are ad-hoc structures, that environmental impact in the form of run-off disposal is a matter of extreme importance. WHO has condemned the use of these sprays and tunnels and has released an advisory. As we have seen views and comments and data from the world. We want to present our perspective on the basis of current evidence present regarding DT that are mushrooming in cities providing a false sense of security that it will contain this virus and prevent further spread.

Background: A significant number of patients not requiring intensive care would experience psychological symptoms and distress. This may necessitate mental health care services which may be not be feasible given the number of patients involved and paucity of mental health care workers. An innovative solution for such a scenario may be in the form of a self-guided psychological intervention. The aim of the study was to test the acceptability of a brief self-guided psychological intervention for patients in quarantine and isolation with COVID-19.Methods: The authors developed a brief, self-guided psychological intervention handout targeted towards reducing psychological distress and enhancing the coping of patients in quarantine and isolation due to COVID-19. This was developed concurrently in English, Hindi and Punjabi languages. This was administered to 60 patients. Assessments were done at baseline and at two weeks.Results: Assessments were completed in 51 patients (21 isolated and 30 quarantined). A majority of the patients in both groups found the intervention to be appropriate in form and content, relevant to the situation, had a positive emotional impact on them, enhanced their understanding of the situation and was perceived as being useful overall. The intervention was found to be highly acceptable.Conclusions: The study demonstrates the acceptability and feasibility of using this intervention in patients in isolation and quarantine due to COVID-19. The intervention lends itself to ease of use and can be scaled up at little cost.

Background: Infectious diseases have had a significant role in shaping human history by engraving a subconscious sense of ‘fear of infection’. The three sequential stages of the rational response to fear- fear, denial, and frustration, have been reported among quarantined individuals during any outbreak. To our knowledge, this was one of the first studies to assess the impact of the first case of coronavirus disease 2019 (COVID-19) among the neighbouring dwellers.Methods: A semi-qualitative study using semi-structured in-depth telephonic interviews was conducted after ethical committee approval.Results: All the participants were aware of the correct attitudes and practices to be followed during the pandemic. Mixed reactions of panic, fear and confusion were observed. Most participants were concerned about elderly at home and financial constraints. Despite most participants having minimal fear of contracting the illness themselves, fear of a family member acquiring the same seemed to be higher.Conclusions: The study adds to the existing literature that fear and anxiety during a pandemic are mostly due to the uncertainty related to the disease spread and misinformation. There is a need for phased and well informed lockdown implementation and better knowledge propagation among the general public in order to mitigate unwanted fear and panic among the general public.