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COVID-19-related consultation-liaison (CL) mental health services in general hospitals: A perspective from Europe and beyond. J Psychosom Res 2023; 167:111183. [PMID: 36801662 PMCID: PMC9912022 DOI: 10.1016/j.jpsychores.2023.111183] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/06/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE The COVID-19 pandemic posed new challenges for integrated health care worldwide. Our study aimed to describe newly implemented structures and procedures of psychosocial consultation and liaison (CL) services in Europe and beyond, and to highlight emerging needs for co-operation. METHODS Cross-sectional online survey from June to October 2021, using a self-developed 25-item questionnaire in four language versions (English, French, Italian, German). Dissemination was via national professional societies, working groups, and heads of CL services. RESULTS Of the participating 259 CL services from Europe, Iran, and parts of Canada, 222 reported COVID-19 related psychosocial care (COVID-psyCare) in their hospital. Among these, 86.5% indicated that specific COVID-psyCare co-operation structures had been established. 50.8% provided specific COVID-psyCare for patients, 38.2% for relatives, and 77.0% for staff. Over half of the time resources were invested for patients. About a quarter of the time was used for staff, and these interventions, typically associated with the liaison function of CL services, were reported as most useful. Concerning emerging needs, 58.1% of the CL services providing COVID-psyCare expressed wishes for mutual information exchange and support, and 64.0% suggested specific changes or improvements that they considered essential for the future. CONCLUSION Over 80% of participating CL services established specific structures to provide COVID-psyCare for patients, their relatives, or staff. Mostly, resources were committed to patient care and specific interventions were largely implemented for staff support. Future development of COVID-psyCare warrants intensified intra- and inter-institutional exchange and co-operation.
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Nakhaei MRS, Noorbala AA, Haghighi AS, Arbabi M. Neuropsychiatric symptoms in the psychiatric counseling of patients admitted with COVID-19 infection. Psychiatry Res 2022; 317:114855. [PMID: 36201896 PMCID: PMC9482717 DOI: 10.1016/j.psychres.2022.114855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 09/12/2022] [Accepted: 09/17/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Covid-19 patients suffer from psychiatric disorders too. The present study was designed to investigate the rate of psychiatric consultation requests in a general hospital. Reasons for consultation requests, types of psychiatric diagnoses, and factors in consultation requests were also investigated. METHODS This cross-sectional study included all patients admitted with Covid-19 and referred to psychiatric consultation service in a major Covid-19 center in Tehran, Iran (2020). After acceing patients' electronic files, records of patients' demographic information, positive psychiatric symptoms, past psychiatric history and DSM5 diagnoses were made. Statistical analyses were done in SPSS 26 using descriptive statistics and chi-square and Fisher's exact test (p<0.05). RESULTS Out of 1791 Covid-19 hospitalized patients, 132 patients (7.3%) had been referred to psychiatric consultation service. The most common reason for requests were restlessness and aggression (23.5%). Meanwhile, 92.4% of the patients were diagnosed to suffer from at least one psychiatric disorder including insomnia (64%), delirium (30.3%), anxiety due to hypoxia (15.3%) and generalized anxiety disorder (10.6%). CONCLUSION Although studies report a high prevalence of psychiatric disorders in Covid-19 patients, requests for psychiatric consultations and consideration of psychiatric disorders are still remarkably low. The most common disorders appeared to be insomnia, delirium and anxiety.
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Affiliation(s)
- Mohammad Reza Shegarf Nakhaei
- Assistant Professor of Psychiatry, Fellowship in Psychosomatics, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Ahmad Ali Noorbala
- Professor of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Arbabi
- Psychosomatic Medicine Research Center, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran,Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Schaefert R, Stein B, Meinlschmidt G, Roemmel N, Huber CG, Hepp U, Saillant S, Fazekas C, Vitinius F. COVID-19-Related Psychosocial Care in General Hospitals: Results of an Online Survey of Psychosomatic, Psychiatric, and Psychological Consultation and Liaison Services in Germany, Austria, and Switzerland. Front Psychiatry 2022; 13:870984. [PMID: 35815043 PMCID: PMC9270003 DOI: 10.3389/fpsyt.2022.870984] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/27/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic was accompanied by new challenges for psychosocial health care to enable the support of affected patients, their families, and staff in general hospitals. In this study, we aimed to describe the structures and procedures put in place by psychosomatic, psychiatric, and psychological consultation and liaison (CL) services in German, Austrian, and Swiss general hospitals, and to elucidate the emerging needs for cooperation, networking, and improvement. METHODS We conducted a cross-sectional online survey between December 2020 and May 2021, using a 25-item questionnaire derived from relevant literature, professional experience, and consultation with the participating professional societies. The survey was disseminated via national professional societies, relevant working and interest groups, and heads of the above-mentioned CL services. RESULTS We included responses from 98 CL services in the analyses, with a total response rate of 55% of surveyed hospital CL services; 52 responses originated from Germany, 20 from Austria, and 26 from Switzerland. A total of 77 (79%) of the 98 responding CL services reported that "COVID-19-related psychosocial care" (COVID-psyCare) was provided in their hospital. Among these, 47 CL services (61%) indicated that specific cooperation structures for COVID-psyCare had been established within the hospital. A total of 26 CL services (34%) reported providing specific COVID-psyCare for patients, 19 (25%) for relatives, and 46 (60%) for staff, with 61, 12, and 27% of time resources invested for these target groups, respectively. Regarding emerging needs, 37 (48%) CL services expressed wishes for mutual exchange and support regarding COVID-psyCare, and 39 (51%) suggested future changes or improvements that they considered essential. CONCLUSION More than three-quarters of the participating CL services provided COVID-psyCare for patients, their relatives, or staff. The high prevalence of COVID-psyCare services targeting hospital staff emphasizes the liaison function of CL services and indicates the increased psychosocial strain on health care personnel during the COVID-19 pandemic. Future development of COVID-psyCare warrants intensified intra- and interinstitutional exchange and support. TRIAL REGISTRATION ClinicalTrials.gov NCT04753242, version 11 February 2021.
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Affiliation(s)
- Rainer Schaefert
- Department of Psychosomatic Medicine, Faculty of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical Private University, Nuremberg General Hospital, Nuremberg, Germany
| | - Gunther Meinlschmidt
- Department of Psychosomatic Medicine, Faculty of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland.,Department of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University, Berlin, Germany
| | - Noa Roemmel
- Department of Psychosomatic Medicine, Faculty of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christian G Huber
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Urs Hepp
- Integrated Psychiatric Services Winterthur - Zurcher Unterland, Winterthur, Switzerland
| | - Stéphane Saillant
- Department of General and Liaison Psychiatry, Neuchâtel Psychiatry Center (CNP), Neuchâtel, Switzerland
| | - Christian Fazekas
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Frank Vitinius
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
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El Hayek S, Kassir G, Zalzale H, Gonzalez-Diaz JM, Bizri M. Emerging Psychiatric Themes in Post-COVID-19 Patients on a Psychiatry Consultation-liaison Service. Psychiatr Q 2021; 92:1785-1796. [PMID: 34463904 PMCID: PMC8405712 DOI: 10.1007/s11126-021-09944-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 01/19/2023]
Abstract
The need for consultation-liaison psychiatry on COVID-19 wards has substantially increased since the start of the pandemic. In this cross-sectional study, we aimed to summarize the characteristics of patients admitted to the post-COVID-19 ward of the American University of Beirut Medical Center who received a psychiatric consultation. We collected relevant sociodemographic and medical data, information about past psychiatric history, psychiatry consultation details, hospital course, and disposition outcome. We also conducted chi-square and binary logistic regression analyses to assess the association between the different variables and disposition outcome. A total of 52 patients (mean age 57.33 years; equal gender distribution) were seen by the psychiatry consult-liaison team. Most had medical comorbidities and 21.2% required intubation. The most prevalent psychiatric diagnoses were delirium (30.8%), major depressive episode (15.4%), and other anxiety disorder (15.4%). Pharmacological management was implemented in 90.4% of cases and mainly included second-generation antipsychotics (36.5%). Non-pharmacological interventions consisted of those related to delirium and therapy for anxiety. Only intubation was significantly associated with disposition outcome (p = 0.004). This study highlights the various psychiatric themes emerging during the acute and post-acute periods of hospitalization for COVID-19. Hospitalized individuals recovering from the infection should be diligently screened and referred to the psychiatry consultation-liaison team to ensure the implementation of appropriate interventions.
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Affiliation(s)
- Samer El Hayek
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ghida Kassir
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Hussein Zalzale
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jairo M Gonzalez-Diaz
- UR Center for Mental Health - CERSAME, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
- Clínica Nuestra Señora de La Paz, Bogota, Colombia
- Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Barcelona University, Barcelona, Spain
| | - Maya Bizri
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon.
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Arbelo N, López-Pelayo H, Sagué M, Madero S, Pinzón-Espinosa J, Gomes-da-Costa S, Ilzarbe L, Anmella G, Llach CD, Imaz ML, Cámara MM, Pintor L. Psychiatric Clinical Profiles and Pharmacological Interactions in COVID-19 Inpatients Referred to a Consultation Liaison Psychiatry Unit: a Cross-Sectional Study. Psychiatr Q 2021; 92:1021-1033. [PMID: 33411128 PMCID: PMC7788550 DOI: 10.1007/s11126-020-09868-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2020] [Indexed: 11/27/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) can affect mental health in different ways. There is little research about psychiatric complications in hospitalized patients with COVID-19. The aim of the study was to describe the psychiatric clinical profile and pharmacological interactions in COVID-19 inpatients referred to a Consultation-Liaison Psychiatry (CLP) unit. This is a cross-sectional study, carried out at a tertiary hospital in Spain, in inpatients admitted because of COVID-19 and referred to our CLP Unit from March 17,2020 to April 28,2020. Clinical data were extracted from electronic medical records. The patients were divided in three groups depending on psychiatric diagnosis: delirium, severe mental illness (SMI) and non-severe mental illness (NSMI). Of 71 patients included (median [ICR] age 64 [54-73] years; 70.4% male), 35.2% had a delirium, 18.3% had a SMI, and 46.5% had a NSMI. Compared to patients with delirium and NSMI, patients with SMI were younger, more likely to be institutionalized and were administered less anti-COVID19 drugs. Mortality was higher among patients with delirium (21.7%) than those with SMI (0%) or NSMI (9.45%). The rate of side effects due to interactions between anti-COVID19 and psychiatric drugs was low, mainly drowsiness (4.3%) and borderline QTc prolongation (1.5%). Patients affected by SMI were more often undertreated for COVID-19. However, the rate of interactions was very low, and avoidable with a proper evaluation and drug-dose adjustment. Half of the patients with SMI were institutionalized, suggesting that living conditions in residential facilities could make them more vulnerable to infection.
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Affiliation(s)
- Nestor Arbelo
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Hugo López-Pelayo
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
- GRAC, Addictions Unit, Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic, Fundació Clínic Recerca Biomèdica (FCRB), RETICS (Red de Trastornos adictivos), University of Barcelona, Villarroel, 170 08036, Barcelona, Spain
| | - María Sagué
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Santiago Madero
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Justo Pinzón-Espinosa
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
- Department of Clinical Psychiatry, School of Medicine, University of Panama, Panama City, Panama
| | - Susana Gomes-da-Costa
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Lidia Ilzarbe
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Gerard Anmella
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Cristian-Daniel Llach
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - María-Luisa Imaz
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - María-Mercé Cámara
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Luis Pintor
- Consultation Liaison Psychiatry Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain.
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6
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Cerimele JM, Kimmel RJ. Hospital Consultation-Liaison Telepsychiatry-Two Trends and Two New Reports. J Acad Consult Liaison Psychiatry 2021; 62:565-567. [PMID: 34450325 DOI: 10.1016/j.jaclp.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/13/2021] [Accepted: 08/15/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Joseph M Cerimele
- Department of Psychiatry and Behavioral Sciences University of Washington School of Medicine Seattle WA.
| | - Ryan J Kimmel
- Department of Psychiatry and Behavioral Sciences University of Washington School of Medicine Seattle WA
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Lele K, Cartoon J, Griffiths A. Increased referrals to an Australian Consultation Liaison Psychiatry service during the COVID-19 pandemic. Australas Psychiatry 2021; 29:340-343. [PMID: 33856921 DOI: 10.1177/1039856221992937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE It has been widely predicted that the COVID-19 pandemic will have a detrimental impact on the mental health (MH) of individuals. This has been dubbed as the MH 'second wave'. In Australia, these impacts have been partly mitigated by institutional responses such as increased access to psychotherapy. Consultation Liaison (CL) psychiatry services provide MH care to acutely unwell patients in general hospitals. It was hypothesised that the number of referrals to the studied service had increased since the start of the pandemic. METHODS From the Electronic medical records (eMRs), the authors collected daily referral numbers, over 3 consecutive years, to a large CL service in metropolitan Sydney. RESULTS Referrals were significantly increased by 25%, 95% CI [1.14, 1.36], p < .001 since the start of the pandemic. This increase was delayed, and remained elevated despite a reduction in COVID-19 infections. CONCLUSION This study adds evidence to the existence of the MH 'second wave', highlights a key impact on healthcare workers' well-being and will assist in guiding resource allocation decisions in the near future.
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Affiliation(s)
- Kiran Lele
- Westmead Hospital, Westmead, NSW, Australia
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8
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Brahmbhatt K, Mournet AM, Malas N, DeSouza C, Greenblatt J, Afzal KI, Giles LL, Charoensook J, Feuer V, Raza H, Mooneyham GC, Pergjika A, Schlesinger A, Chapman A, Strain A, Gandhi B, Johnson K, Mroczkowski MM, Ibeziako P, Graham R, Yoon Y, Plioplys S, Fuchs C, Shaw RJ, Pao M. Adaptations Made to Pediatric Consultation-Liaison Psychiatry Service Delivery During the Early Months of the COVID-19 Pandemic: A North American Multisite Survey. J Acad Consult Liaison Psychiatry 2021; 62:511-521. [PMID: 34033972 PMCID: PMC8141785 DOI: 10.1016/j.jaclp.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/05/2021] [Accepted: 05/16/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The COVID-19 pandemic led to rapid changes in clinical service delivery across hospital systems nationally. Local realities and resources were key driving factors impacting workflow changes, including for pediatric consultation-liaison psychiatry service (PCLPS) providers. OBJECTIVE This study aims to describe the early changes implemented by 22 PCLPSs from the United States and Canada during the COVID-19 pandemic. Understanding similarities and differences in adaptations made to PCLPS care delivery can inform best practices and future models of care. METHODS A 20-point survey relating to PCLPS changes during the COVID-19 pandemic was sent to professional listservs. Baseline hospital demographics, hospital and PCLPS workflow changes, and PCLPS experience were collected from March 20 to April 28, 2020, and from August 18 to September 10, 2020. Qualitative data were collected from responding sites. An exploratory thematic analysis approach was used to analyze the qualitative data that were not dependent on predetermined coding themes. Descriptive statistics were calculated using Microsoft Excel. RESULTS Twenty-two academic hospitals in the United States and Canada responded to the survey, with an average of 303 beds/hospital. Most respondents (18/22) were children's hospitals. Despite differences in regional impact of COVID-19 and resource availability, there was significant overlap in respondent experiences. Restricted visitation to one caregiver, use of virtual rounding, ongoing trainee involvement, and an overall low number of COVID-positive pediatric patients were common. While there was variability in PCLPS care delivery occurring virtually versus in person, all respondents maintained some level of on-site presence. Technological limitations and pediatric provider preference led to increased on-site presence. CONCLUSIONS To our knowledge, this is the first multicenter study exploring pandemic-related PCLPS changes in North America. Findings of this study demonstrate that PCLPSs rapidly adapted to COVID-19 realities. Common themes emerged that may serve as a model for future practice. However, important gaps in understanding their effectiveness and acceptability need to be addressed. This multisite survey highlights the importance of establishing consensus through national professional organizations to inform provider and hospital practices.
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Affiliation(s)
- Khyati Brahmbhatt
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, UCSF Weill Institute for Neurosciences, UCSF Benioff Children's Hospital, San Francisco, CA.
| | - Annabelle M Mournet
- National Institute of Mental Health, NIH, Office of the Clinical Director, Intramural Research Program, Bethesda, MD
| | - Nasuh Malas
- University of Michigan Medical School, Department of Psychiatry and Department of Pediatrics, 1500 East Medical Center Drive, Ann Arbor, MI
| | - Claire DeSouza
- University of Toronto, Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada
| | - Jeanne Greenblatt
- NYU Grossman School of Medicine, Departments of Child Psychiatry and Pediatrics, NYU Hassenfeld Children's Hospital and Bellevue Hospital Center, New York, NY
| | - Khalid I Afzal
- The University of Chicago, Department of Psychiatry and Behavioral Neuroscience, Chicago, IL
| | - Lisa L Giles
- University of Utah School of Medicine, Departments of Pediatrics and Psychiatry, Primary Children's Hospital, Salt Lake City, UT 84113
| | - Janet Charoensook
- Children's Hospital Los Angeles, Division of Psychiatry, Los Angeles, CA
| | - Vera Feuer
- Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY
| | - Haniya Raza
- National Institute of Mental Health, NIH, Office of the Clinical Director, Intramural Research Program, Bethesda, MD
| | | | - Alba Pergjika
- Ann and Robert H, Lurie Childrens Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, Chicago IL
| | - Amanda Schlesinger
- University of Minnesota Medical School. F262 West Building, Minneapolis, MN
| | - Andrea Chapman
- University of British Columbia, Department of Psychiatry, British Columbia Children's Hospital, Vancouver, BC
| | - Angela Strain
- The University of North Carolina at Chapel Hill, Department of Emergency Medicine, Chapel Hill, NC
| | - Bela Gandhi
- Nationwide Children's Hospital, Department of Psychiatry. 444 Butterfly Gardens Drive, Columbus, OH
| | - Kyle Johnson
- Oregon Health & Science University. Division of Child & Adolescent Psychiatry, Portland, OR
| | - Megan M Mroczkowski
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY
| | - Patricia Ibeziako
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston MA
| | - Regina Graham
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, UCSF Weill Institute for Neurosciences, UCSF Benioff Children's Hospital, San Francisco, CA
| | - Yesie Yoon
- University of Alabama at Birmingham, Department of Psychiatry and Behavioral Neurobiology, Birmingham, AL
| | - Sigita Plioplys
- Ann and Robert H, Lurie Childrens Hospital of Chicago, Pritzker Department of Psychiatry and Behavioral Health, Chicago IL
| | - Catherine Fuchs
- Vanderbilt University, Department of Psychiatry and Behavioral Sciences and Pediatrics, Division of Child and Adolescent Psychiatry, Vanderbilt University Medical Center, Nashville, TN
| | - Richard J Shaw
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences. 401 Quarry Road, Palo Alto, CA
| | - Maryland Pao
- National Institute of Mental Health, NIH, Office of the Clinical Director, Intramural Research Program, Bethesda, MD
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Jain A, Sahu KK, Mitra P. Treatment of Patients with Mental Illness Amid A Global COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:759-771. [PMID: 33973210 DOI: 10.1007/978-3-030-63761-3_42] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A newly discovered coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the ongoing pandemic of coronavirus disease 2019 (COVID-19), which is not only physically challenging but also has many subtle and overt mental impacts. The concern of being infected, lack of antiviral agents, preventive strategies of social distancing, and home isolation have created unrest in the society. The way of reacting to emergencies varies from individual to individual, and that this variability lies in our unique personality traits. The COVID-19 pandemic is testing the mental stability of all of us, and hence it is crucial to recognize the vulnerable population and support them to prevent or minimize the catastrophe like post-traumatic stress disorder (PTSD), emotional trauma, and suicides. In this context, the role of psychiatrists, psychotherapists, and other mental healthcare providers is indispensable.
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Affiliation(s)
- Ankit Jain
- Department of Psychiatry, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Kamal Kant Sahu
- Department of Medicine, Saint Vincent Hospital, Worcester, MA, USA.
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Worcester, MA, USA.
| | - Paroma Mitra
- Department of Psychiatry, Bellevue Hospital Center, New York University School of Medicine, New York, NY, USA
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10
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Sancak B, Ozer Agirbas U, Kilic C. Long COVID and Its Psychiatric Aspects. J Acad Consult Liaison Psychiatry 2021; 62:480-481. [PMID: 33817685 PMCID: PMC8005382 DOI: 10.1016/j.jaclp.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Baris Sancak
- Acıbadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Urun Ozer Agirbas
- Acıbadem Mehmet Ali Aydinlar University, Faculty of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Cenk Kilic
- Akşehir State Hospital, Department of Psychiatry, Konya, Turkey
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11
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Shapiro PA, Brahmbhatt K, Caravella R, Erickson J, Everly G, Giles K, Gopalan P, Greenspan H, Huijón RM, Key RG, Kroll D, Prince E, Rabinowitz T, Saad-Pendergrass D, Shalev D. Report of the Academy of Consultation-Liaison Psychiatry Task Force on Lessons Learned From the COVID-19 Pandemic: Executive Summary. J Acad Consult Liaison Psychiatry 2021; 62:377-386. [PMID: 34000470 PMCID: PMC8120806 DOI: 10.1016/j.jaclp.2021.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/06/2021] [Accepted: 05/09/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic forced consultation-liaison psychiatrists to adapt to unprecedented circumstances. The Academy of Consultation-Liaison Psychiatry (ACLP) recognized the need and opportunity to assess its response and convened a task force in mid-2020 to review the lessons learned from the initial experience of the COVID-19 pandemic. OBJECTIVE The aim of the study was to summarize experience and make recommendations to the ACLP Board of Directors about potential ACLP directions related to current and future pandemic response. METHODS In August-November 2020, the task force reviewed local experiences, ACLP list-serv contributions, and the published literature and generated recommendations for ACLP actions. RESULTS Recommendations addressed telepsychiatry, hospital staff wellness, support for consultation-liaison psychiatrists, the need for additional research on psychiatric and neuropsychiatric aspects of COVID-19, and the ACLP's role in advocacy and dissemination of information. The task force report was submitted to the ACLP Board of Directors in November 2020. CONCLUSIONS As the preeminent organization of consultation-liaison psychiatrists, the ACLP can implement actions related to pandemic awareness and preparedness for the benefit of consultation-liaison psychiatrists, other health care workers, patients, and the general population.
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Affiliation(s)
- Peter A. Shapiro
- Department of Psychiatry, Columbia University, New York, NY,Send correspondence and reprint requests to Peter A. Shapiro, MD, New York-Presbyterian Hospital, Columbia University Irving Medical Center, 622 W. 168 St Box 427, New York NY 10032
| | - Khyati Brahmbhatt
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA
| | - Rachel Caravella
- Department of Psychiatry, New York University Langone Health, New York, NY
| | | | - George Everly
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD
| | - Karen Giles
- Department of Psychiatry, Emory University, Atlanta, GA
| | - Priya Gopalan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | | | - R. Garrett Key
- Department of Psychiatry, University of Texas-Austin, Austin, TX
| | - David Kroll
- Department of Psychiatry, Harvard University, Boston, MA
| | - Elizabeth Prince
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD
| | | | | | - Daniel Shalev
- Department of Psychiatry, Columbia University, New York, NY
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12
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Beran C, Sowa NA. Adaptation of an Academic Inpatient Consultation-Liaison Psychiatry Service During the SARS-CoV-2 Pandemic: Effects on Clinical Practice and Trainee Supervision. J Acad Consult Liaison Psychiatry 2020; 62:186-192. [PMID: 33288272 PMCID: PMC7667404 DOI: 10.1016/j.psym.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND The SARS-CoV-2 pandemic has led to drastic changes in how psychiatric consultation-liaison (C-L) services conduct business and required rapid transition to telepsychiatry. We describe the practice changes implemented to rapid transition to virtual care in a large, academic psychiatry C-L service in response to the pandemic. OBJECTIVE To describe clinical service structural changes, timelines and impacts on consultation volume as well as present quantitative and qualitative data regarding the experience of this transition from the standpoints of both psychiatric trainees and attending physicians. METHODS We present the narrative descriptions of transition details based on focused interviews with inpatient C-L leadership. Inpatient consult volume and charge data were gathered using analysis of health system data. Attending and trainee experience of the transition to virtual care were assessed using anonymous, online surveys. RESULTS During the pandemic, the average weekly consultation volume and average weekly charges were significantly lower compared with prepandemic. Both volume and charges were affected by addition of video consultation capability. Both attendings and trainees had moderate or high comfort and moderate satisfaction with telephone and video consultations. Overall, the trainee satisfaction with supervision, learning, and their consult psychiatry experience did not seem to be affected by the pandemic. CONCLUSIONS Our results support the feasibility of the rapid implementation of virtual care in a psychiatric academic C-L service without negatively impacting the learner's consult psychiatry experience. This should provide comfort to academic C-L services that required rapid implementation of virtual care.
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Affiliation(s)
- Christine Beran
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
| | - Nathaniel A Sowa
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
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13
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Bojdani E, Rajagopalan A, Chen A, Gearin P, Olcott W, Shankar V, Cloutier A, Solomon H, Naqvi NZ, Batty N, Festin FED, Tahera D, Chang G, DeLisi LE. COVID-19 Pandemic: Impact on psychiatric care in the United States. Psychiatry Res 2020; 289:113069. [PMID: 32413707 PMCID: PMC7200362 DOI: 10.1016/j.psychres.2020.113069] [Citation(s) in RCA: 184] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/03/2020] [Indexed: 12/11/2022]
Abstract
The World Health Organization declared the coronavirus outbreak a pandemic on March 11, 2020. Infection by the SARS-CoV2 virus leads to the COVID-19 disease which can be fatal, especially in older patients with medical co-morbidities. The impact to the US healthcare system has been disruptive, and the way healthcare services are provided has changed drastically. Here, we present a compilation of the impact of the COVID-19 pandemic on psychiatric care in the US, in the various settings: outpatient, emergency room, inpatient units, consultation services, and the community. We further present effects seen on psychiatric physicians in the setting of new and constantly evolving protocols where adjustment and flexibility have become the norm, training of residents, leading a team of professionals with different expertise, conducting clinical research, and ethical considerations. The purpose of this paper is to provide examples of "how to" processes based on our current front-line experiences and research to practicing psychiatrists and mental health clinicians, inform practitioners about national guidelines affecting psychiatric care during the pandemic, and inform health care policy makers and health care systems about the challenges and continued needs of financial and administrative support for psychiatric physicians and mental health systems.
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Affiliation(s)
- Ermal Bojdani
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Aishwarya Rajagopalan
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Anderson Chen
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Priya Gearin
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - William Olcott
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Vikram Shankar
- Emergency Medicine Residency Program, Kern Medical, Bakersfield, CA, United States
| | - Alesia Cloutier
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Haley Solomon
- Harvard South Shore Psychiatry Residency Training Program, Brockton, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Nida Z Naqvi
- Department of Internal Medicine, University of Maryland Upper Chesapeake Medical Center, Bel Air, MD, United States
| | - Nicolas Batty
- Indiana University School of Business, Bloomington, IN, United States
| | - Fe Erlita D Festin
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Dil Tahera
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Grace Chang
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- VA Boston Healthcare System, Brockton, MA, United States
| | - Lynn E DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Cambridge Hospital, Cambridge, MA, United States
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14
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De Sousa A, Lodha P. Mental health perspectives of COVID-19 and the emerging role of digital mental health and telepsychiatry. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2020. [DOI: 10.4103/amhs.amhs_82_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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