Covid update in psychiatry 2022 Flashcards
What are some neuropsychiatric things that have occurred during the pandemic?
Delirium is associated with poorer outcomes esp in ITU cases where up to 1/3 can have cognitive and behavioural symptoms
Fatigue in up to 1/5 post resolution
Psychosis, mood disorder, catatonia, encephalitis, encephalopathy, and other neurological disorder (stroke can be a presenting feature)
High rates of anxiety, depression and PTSD in those discharged from hospital
Long COVID
What are the links between psychosis and covid-19?
Retrospectively analyzed the electronic databases of patients with COVID-19 diagnosis in a sample of 236,379 patients and found that nearly one-third of the patients (33.62%) had a psychiatric or neurological diagnosis at 6 months follow-up period
Patients with COVID-19 diagnosis hospitalized to an intensive care unit had a psychiatric or neurological diagnosis, as high as 46.42% at 6 months follow-up
6 months follow-up after COVID-19 diagnosis, 17.4% of people diagnosed with anxiety disorder, whereas 1.40% people had diagnosable psychotic disorder;
Of ICU patients, the diagnosis of anxiety disorder and psychosis at 6 months follow-up becomes 19.15% and 2.77%, respectively
Likely immune modulated – both the infection and treatment playing a part
What is the link between learning disability and covid?
Death rate for people with learning disabilities was 240 deaths per 100,000. 2.3 times the rate in the general population for the same period.
After adjusting for under-reporting the estimated rate was 369 per 100,000 adults, which is 3.6 times the rate in the general population.
Fewer care homes for LD have had outbreaks (according to PHE) than other care homes
What are some service changes in covid?
NHS went into emergency operations on 16th March 2020
Some reopening has occurred and then tightened again.
Change from face to face to remote consultations using technology;
Challenging populations
Not all are easy to reach
Telephone vs internet based such as Attend Anywhere
Privacy and Governance issues
There were modifications made to the Mental Health Legislation in England and in Scotland HOWEVER these have never been enacted
What has been the effect of covid-19 on suicide?
Difficulties in collecting real time data on suicide as there needs to be investigation into death
In the SARS pandemic there was an increase in suicide
National Confidential Inquiry into Suicide and Homicide based at the University of Manchester – Real time surveillance found no change in pre vs post lockdown suicide rates
Increase in suicidal ideation
What has been the effect of COVID-19 on self-harm?
A study of 1500 general practices in the UK using the Clinical Practice Research Datalink found that the recorded incidence of self-harm was 38% lower in April, 2020, than the rate expected on the basis of previous years.
This decrease was particularly marked in women, people younger than 45 years, and those from the most deprived quintile of practices.
