Previous History Of Mental Illness Research Articles

IJCM_334A: The struggle within: suicidal ideation and its risk factors among the undergraduate medical students

Background: Suicide is one of the top three causes of death among the adults worldwide, which is increasingly seen among students. Medical education is often considered highly stressful, in addition to the usual psychological issues in the youth. Mental health issue is a subject of taboo even among the medical students leading to non-help seeking behaviour. Studies report a high prevalence of suicidal ideation among medical students in India, ranging from 1.8% to 53.6%. Objectives: 1. To assess the prevalence of ‘suicidal ideation’ and associated risk factors among undergraduate medical students Methodology: A descriptive cross-sectional study was conducted among Phase 2 and 3 undergraduate students of a government medical college after taking IEC approval. Information on socio demographic details along with known risk factors was obtained. Beck scale for suicide ideation was used for screening and assessment of suicidal ideation. Data was analysed as proportions and percentages and chi square was applied to test the significance of association. Results: Out of the total 192 participants 118 (61.4%) were boys and 74 (38.6%) were girls. History of mental illness was present among 33 (16.6%) students. Fourteen students (7.2%) had high BSS score on screening. Within this subgroup of students reporting suicide ideation (n=14), 9 students (69.2%) had seriously contemplated suicide, while 2 students (15.3%) had attempted suicide at least once in their life time. Students who had previous history of mental illness showed higher prevalence of suicide ideation which was statistically significant (p<0.001). However, no significant associations were identified between gender of the student, mother’s occupation, or a history of mental illness among family members and suicide ideation among the medical students. Conclusion: Medical students need to be assessed for their mental health and appropriate care and support should be provided to the needy to prevent fatal outcomes among them.

Depression symptoms, anxiety, and stress among undergraduate entrance admission seeking students in Bangladesh: a cross-sectional study.

Intense academic pressure and unhealthy competition have turned the university entrance exam scenario in Bangladesh into a Pandora's Box, which might cause mental health difficulties among young students. However, there is a severe scarcity of studies concerning such issues of university entrance examination-seeking students in Bangladesh. This study aimed to assess the prevalence and associated factors of depression symptoms, anxiety, and stress among undergraduate entrance admission-seeking students in Bangladesh. A cross-sectional study design was followed using an online tool including socio-demographic questions, and the 21-item Bangla Depression, Anxiety and Stress Scale (BDASS-21). The survey form was completed by 452 Bangladeshi students who passed the higher secondary certificate (HSC) examination in 2020 and were planning to get admission to the undergraduate level during the data collection. The prevalence of mild to extremely severe levels of depression symptoms, anxiety, and stress was 57.7%, 61.4%, and 44.6%, respectively. Females were more likely to have depression, anxiety, and stress symptoms than males. The students from science backgrounds were at higher risk of developing depression and stress symptoms when compared with students from business studies backgrounds. Besides, students with a previous history of mental illness, a preference for getting admitted into the public university, and less monthly family income (<25,000 BDT) were more likely to develop depression, anxiety, and stress symptoms. In addition, students with a previous history of neurological disorders were more likely to develop anxiety symptoms than those without. This study revealed a high level of depression, anxiety, and stress symptoms among undergraduate entrance admission-seeking students, which calls for in-depth exploratory investigations. Adequate low-intensity interventions should be designed to support this young population.

Frequency and Risk Factors of Subsyndromal Delirium in the Intensive Care Units: A Prospective Cohort Study.

Subsyndromal delirium (SSD) is a common neuropsychiatric disorder among the intensive care units (ICU) patients. SSD is characterized by the presence of delirium symptoms but it does not meet the diagnostic criteria of delirium, resulting in poor patient prognosis. The aim of this study was to explore the prevalence and risk factors for SSD among adult patients admitted to the ICU of XXX hospital in Southwest China. The study participants comprised 309 patients referred to the ICU in XXX hospital between 10th August 2021 and 5th June 2022. Demographic information, medical history, and other patient information were recorded. ICDSC assessment, physical examination and laboratory tests were performed on enrolled patients. Cognitive evaluation was conducted using the MMSE method. The results showed that out the 309 patients, 99 had possible SSD (prevalence of 32.0%), with 55 SSD1 cases (ICDSC score of 1, 17.8% prevalence), 29 SSD2 cases (ICDSC score of 2, 9.4% prevalence) and 15 SSD3 cases (ICDSC score of 3, 4.9% prevalence). Previous history of mental illness (OR, 3.741; 95% CI, 1.136-12.324; P <0.05), auxiliary ventilation (OR, 3.364; 95% CI, 1.448-7.813; P <0.01), hemodialysis (OR, 11.369; 95% CI, 1.245-103.840; P <0.05), MMSE score (OR, 0.845; 95% CI, 0.789-0.904; P <0.001) and a temperature ≥ 37.5 °C (OR, 3.686; 95% CI, 1.404-9.732; P <0.01) were independent risk factors for occurrence of SSD among ICU patients. Approximately one-third of the patients in the intensive care unit had high risk of SSD. Nursing staff should pay attention to management of the high-risk patients to prevent SSD from progressing delirium to improve patient prognosis.

Perception of Clergymen on the Care and Stigmatization of Persons with Mental Illness in Nigeria

Objectives: This study was designed to investigate clergymen's training, knowledge, perception and experience of mental illness.&#x0D; Methods: The study adopted both quantitative and qualitative study designs conducted among a total of 148 student population of the Nigerian Baptist Theological Seminary Ogbomoso. The stratified random sampling technique was used for the quantitative approach using the (Community Attitudes towards Mental Illness (CAMI) scale and the socio-demographic questionnaire while purposive sampling of the respondents was used for the qualitative approach. Data collated for the quantitative technique was analyzed using the Statistical Packages for the Social Sciences (SPSS) version 21.&#x0D; Results: The Focused Group Discussions (FGDs) and Key Informant Interviews (KII) respondents believe that all mental illnesses are traceable directly or indirectly to spiritual factors, that certain sociocultural discriminations exist and that the local church is a healing community. The Community Attitudes towards Mental Illness (CAMI) benevolence subscale reveals that 76.4% of them want tax money to be spent on treating mental illness although 57.4% view mental hospitals as prisons. The Social restrictiveness subscale showed that 46.6% did not agree to engage women with a previous history of mental illness as babysitters and 37.2% did not agree to have them as neighbours. On the community mental health ideology subscale; about 70.3% have them live in neighbourhoods although 82.4% of them feel the mentally ill are awkward.&#x0D; Conclusions: With improved mental health knowledge; the Baptist clergymen may ensure referral to orthodox medical services, encourage compliance and banish discrimination against the mentally ill crucial for the WHO scale up program in Nigeria.

Depressive symptoms among residents of south Wollo zone in Northern Ethiopia after the liberation of invasion of TPLF led force

BackgroundDepressive symptom is the most widely reported mental health consequence of natural or man-made disasters and traumatic events. Research on depressive symptoms in low-income nations is still scarce, although it can be a public health burden in post-conflict situations. Therefore, the primary objective of this study was to identify the prevalence and contributing factors of depressive symptoms among people of south Wollo zones following liberation from TPLF-led army invasions. MethodsA community-based cross-sectional study was conducted on South Wollo zone residents after the liberation of invasions of the TPLF-led force, from May 1st to June 1st, 2022. A self-administered questionnaire was used to collect data from residents chosen using a simple random sampling technique. This study used both descriptive and inferential analysis. To investigate the relationship between response and predictor variables, the chi-squared test of association was performed. The logistic regression was performed to identify predictors of depressive symptoms among residents. ResultsThe overall prevalence of depressive symptoms among residents was 51.0% [95% C.I: 48.01, 53.99]. Being female [AOR = 1.428, 95% C.I: 1.044–1.955], being an alcohol consumer [AOR = 2.051, 95% C.I: 1.349–3.119], chewing Khat [AOR = 4.617, 95% C.I: 2.873–7.418], history of mental illness [AOR = 4.316, 95% C.I: 1.263–14.751], destruction of personal property [AOR = 2.909, 95% C.I: 2.028–4.175], lacked basic needs such as food and water [AOR = 2.738, 95% C.I: 1.922–3.900], and illness without medical care [AOR = 2.369, 95% C.I: 1.684–3.331] were all found to be statistically significant at the 5% level of significance in a multivariable binary logistic regression. ConclusionsThe main finding of this study discovered that residents had a higher prevalence of depressive symptoms following liberation from TPLF-led army invasions. Being an alcoholic, chewing Khat, having a previous history of mental illness, destruction of personal property, lack of food or water, and illness without medical care were associated with an increased risk of developing depressive symptoms. Interventions based on influencing factors should be performed to ensure residents' mental health.

A pandemia de COVID-19 e seu impacto na saúde mental dos profissionais de saúde

ABSTRACT The COVID-19 pandemic has imposed a health crisis around the world. Health professionals are frequently exposed to stressors that put them at high risk for the development or progression of disabling mental disorders, including posttraumatic stress disorder (PTSD). To understand how pandemic stressors have affected the mental health of healthcare workers, our group conducted a longitudinal and nationwide survey. We investigated the occurrence of traumatic events related to the COVID-19 pandemic and the association between exposure to these events and PTSD symptomatology. Importantly, we also investigated factors that might increase or decrease the risk for PTSD. Depression symptoms were also investigated. The results of the first wave of the project were published in a series of three articles, each focused on different risk or protective factors. The results showed that female sex, young age, a lack of adequate personal protective equipment, social isolation and a previous history of mental illness were consistent predictors of PTSD symptoms. Healthcare workers who reported high levels of peritraumatic tonic immobility, a defensive response that is involuntary, reflexive, and evoked by an intense and inescapable threat, also exhibited an increase in the probability of being diagnosed with PTSD. On the other hand, professional recognition had a negative relationship with PTSD and depression symptoms, emerging as a significant protective factor for psychological health. The identification of protective and risk factors in these situations is crucial to guide the adoption of long-term measures in work environments that will enhance the psychological health of these professionals.

Call for Faith: Religiousness, Religious Coping and Psychological Disturbance of Chinese Christians During COVID-19.

This study is aimed at investigating the relationships between religious practice, religious coping strategies, and mental health among Chinese Christians in the context of the COVID-19 outbreak. A total of 915 participants from several cities in China completed online questionnaires, including sociodemographic data, mental disorder history, and years as a Christian, as well as frequency of weekly religious practice, Religious Coping Scale, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder scale (GAD-7). The result of multivariate analysis indicated that during the COVID-19 pandemic, among Chinese Christians without a history of mental disorder, negative religious coping were associated with depression, and anxiety symptoms. Among Chinese Christians with a history of mental disorders, comorbidity with 1 mental disorder, comorbidity with 2 or more mental disorders, negative religious coping, and positive religious coping were associated with depression symptoms. Comorbidity with 2 or more mental disorders, negative religious coping, and positive religious coping were associated with anxiety symptoms. Christians with a previous history of mental illness are more likely to experience anxiety during the epidemic. In the future, mental health services during disasters may put more attention on certain religious groups and provide more spiritual care to maintain their well-being accordingly.

Posttraumatic stress disorder and posttraumatic cognitions in patients with myocardial infarction

Objective: Myocardial infarction is a life-threatening condition that occurs unexpectedly and can cause posttraumatic stress disorder (PTSD) symptoms. The aim of this study was to investigate the frequency and predictors of PTSD symptoms for patients with myocardial infarction and to investigate the relationship between posttraumatic cognitions and PTSD symptoms. Method: This study included 152 patients with a history of myocardial infarction. The patients were administered the Impact of Event Scale to assess PTSD symptoms, the Posttraumatic Cognitions Inventory for evaluating negative cognitions about the self and world after the traumatic event, and the Hospital Anxiety Depression Scale for anxiety and depression symptoms. Binary logistic regression analysis was performed to determine factors associated with PTSD symptoms. Results: Twenty-two (14,5%) patients had clinically significant PTSD symptoms. Having clinically significant PTSD symptoms was associated with the intensity of negative posttraumatic cognitions (negative cognitions about self p=0.010, negative cognitions about the world p<0.001), previous history of mental illness (p=0.028), the severity of pain during an acute myocardial infarction (p=0.038), and the severity of fear of death (p=0.047), which are subjective severity indicators of a heart attack. Conclusion: In patients with myocardial infarction, close monitoring of high-risk individuals in terms of PTSD symptoms and treatment of those with PTSD may be beneficial in preventing the negative effects of PTSD symptoms on the individuals and the course of the heart attack.

Prevalence of depression among elderly in an urban setting of Southern India

Background: The reported prevalence of depression by WHO in the elderly varied between 10% to 20% in various societies. Some of the 121community-based studies in India had reported a prevalence of 13 to 43% depression in elderly. Kerala had a 12.8% of geriatric population according to census 2011. The aim of the study was to find out the prevalence of depression among geriatric population in an urban area which comes under Thiruvananthapuram Corporation, Kerala state, India.Methods: Study design is cross sectional. Elderly over 60 years were interviewed using PHQ -9 questionnaire. Depression is diagnosed when the total score is equal to more than 5 in PHQ-9 questionnaire.Results: Total 405 elderly were included in the study. 195 (52%) were females and 213 (48%) were males. The prevalence was found to be 37.3% (CI, 30.78-43.98). Among them mild and moderate depression accounted for majority of cases (35.7%) than severe depression (1.5%). Bivariable analysis yielded factors such as previous history of mental illness, family history of mental illness, stress and absence of recreation that were associated with the development of depression. Family history of mental illness (adjusted OR 4.59) and stress (adjusted OR 7.43) were emerged as predictors of depression in this study in multivariable analysis.Conclusions: Prevalence of depression in elderly was found to be 37.3% (30.78-43.98) in an urban population of Sothern Kerala. In logistic regression analysis family history of mental illness and stress were emerged as independent predictors of depression among elderly.

Identifying Suicidal Ideation in Cancer Patients

EXTRACT&#x0D; &#x0D; Keywords: Medical treatment, cancer diagnosis, suicide, suicidal thoughts, cancer patients, psychooncology.&#x0D; Introduction: Suicidality among oncology patients in Slovenia is still a relatively unexplored topic. After a review of the literature, it was found that the risk of suicide among people diagnosed with cancer is higher compared to the general population. Therefore, we wanted to determine the presence of suicidal ideation in patients undergoing cancer treatment.&#x0D; Methods: Qualitative research involved interviews (n=5) with people undergoing cancer treatment. In this paper, the transcripts of the interviews are analysed using grounded theory principles.&#x0D; Results. Some of them had a plan. Anxiety, insecurity, need for antidepressants and help from a psychologist were prominent. The very diagnosis and experience of the illness is extremely painful. They reported fear of starting treatment, a feeling of helplessness, of being affected, intertwined with a feeling of denial, then hope for a cure. The most disturbing aspect of the initial treatment process was the waiting for treatment and treatment. The illness itself and the treatment also have an impact on self-image, all leading to mental consequences due to physical changes. We found that a previous history of mental illness has a significant impact, but nevertheless all participants expressed a desire to live. The category analysis showed the category of support from family and surroundings, and the high importance of an orderly family status. In the experience of the medical staff, all participants felt that the need for individualised treatment in terms of person-centredness and the need for a psychooncologist at the beginning of treatment was inevitable.Pain is also an important element. More than physical pain, they mentioned psychological, internal pain, which was linked to feelings of helplessness and suicidal thoughts.&#x0D; Discussion and conclusion: Identification of suicidal oncology patients is a difficult process, as depressed mood and anxiety may be hidden during treatment. It is necessary to establish a trusting, empathic relationship with the patient. With mutual respect and trust, when suicidality occurs, healthcare staff can work together with the patient to try to solve the problem. Nurses who are present at all times with the patient should be educated in the identification of risk factors that increase the potential for suicide and in the use of prevention tools (e.g. questionnaires and interviews) and screening programmes that identify oncology patients at risk of suicidality at an early stage.

Post-traumatic stress disorder and associated factors among people who experienced traumatic events in Dessie town, Ethiopia, 2022: A community based study

Posttraumatic stress disorder (PTSD) may develop as a serious long-term consequence of traumatic experiences, even many years after trauma exposure. Dessie town residents have experienced prolonged armed conflict due to inter-communal conflict in 2021. Those people are exposed to different kinds of trauma, and violence, making them more prone to psychological disorders. Despite the highest number of people affected due to conflict and its negative impact on mental health, post-traumatic stress disorders among people are overlooked in Ethiopia. This study aimed to assess the prevalence and associated factors of post-traumatic stress disorder among people who experienced traumatic events in Dessie town, Ethiopia, 2022. Community based cross-sectional study was conducted on June 8-July 7, 2022, by using a multi-stage cluster sampling with a total sample of 785. Pretested, structured questionnaires and face-to-face interviews were used for data collection. PTSD was assessed by the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5). Data was entered using Epi-data version 3.1 and, then exported to SPSS version 26 for analysis. The association between outcome and independent variables was analyzed with bi-variable and multivariable logistic regression. P-values less than 0.05 was considered statistically significant. The prevalence of PTSD among Dessie town residents was found to be 19.4% (95% CI, 16.7, 22.0). In multivariable analysis, being females (AOR = 1.63, 95% CI 1.10-2.44), previous history of mental illness (AOR = 3.14, 95% CI 1.14-7.06) depressive symptoms (AOR = 3.12, 95% CI 1.92-5.07), witnessing a serious physical injury of a family member or friend (AOR = 2.82, 95% CI 1.18-6.70) and high perceived life threats (AOR = 5.73, 95% CI 3.05-10.78) were found to be significant predictors of PTSD. The prevalence of PTSD among Dessie town residents was found to be huge. Being female, having a previous history of mental illness, depressive symptoms, witnessing a serious physical injury of a family member or friend, and high perceived life threats were variables that are independent predictors of PSTD. People who have experienced such a severe traumatic event require psychosocial support to aid in their recovery from the terrible experiences.

Measuring and exploring mental health determinants: a closer look at co-residents’ effect using a multilevel structural equations model

ObjectivePrevious research has demonstrated that individual risk of mental illness is associated with individual, co-resident, and household risk factors. However, modelling the overall effect of these risk factors presents several methodological challenges. In this study we apply a multilevel structural equation model (MSEM) to address some of these challenges and the impact of the different determinants when measuring mental health risk.Study design and settingTwo thousand, one hundred forty-three individuals aged 16 and over from 888 households were analysed based on the Household Survey for England-2014 dataset. We applied MSEM to simultaneously measure and identify psychiatric morbidity determinants while accounting for the dependency among individuals within the same household and the measurement errors.ResultsYounger age, female gender, non-working status, headship of the household, having no close relationship with other people, having history of mental illness and obesity were all significant (p < 0.01) individual risk factors for psychiatric morbidity. A previous history of mental illness in the co-residents, living in a deprived household, and a lack of closeness in relationships among residents were also significant predictors. Model fit indices showed a very good model specification (CFI = 0.987, TLI = 0.980, RMSEA = 0.023, GFI = 0.992).ConclusionMeasuring and addressing mental health determinants should consider not only an individual’s characteristics but also the co-residents and the households in which they live.

Prevalence of Depression, Problematic Drinking and their Correlates among University Students in Southwest Nigeria

Aim: To determine the prevalence and correlations of depression and problematic drinking among undergraduates in a Nigerian University.&#x0D; Study Design: The study design was a descriptive cross-sectional survey&#x0D; Methodology: The study was conducted among 412 full-time undergraduates of LAUTECH, 18 years and above and apparently well without previous history of mental illness. Alcohol Use Disorder Identification Test (AUDIT) and Patient Health Questionnaire-9 (PHQ-9) are instruments used for the study. Data analysis was done with the statistical package for social sciences version 21.&#x0D; Results: Approximately half (49.5%) of the respondents were depressed and 20.4% of them had major depression. The prevalence of problematic alcohol use in the study population was 10.4% mostly among males. There was no significant association between depression, alcohol use and problematic alcohol use (χ2 = 1.125, df = 1, P-value = 0.289) in the study sample.&#x0D; Conclusion: The increasing prevalence of depression and problematic drinking among university students is worrisome as this will not only adversely impact their academic performance but future productivity and the risk of other psychosocial and health problems.

Varenicline-induced sucidal behavior: Case report and literature review

IntroductionNowdays there are different strategies for the treatment of smoking cessation. The treatment include drugs such as varenicline, which acts as a high-affinity partial agonist for the alpha-4 beta-2 nicotinic acetylcholine receptor subtype (nACh). We report a case of a suicidal behaviour in a 39 year-old woman with no previous history of mental illness, who was brought to the emergency department after intentional intoxication with benzodiazepines. The patient was on 10th day of treatment with varenicline.ObjectivesTo present a case of sucidal behavior that developed in a 39 year-old woman after starting varenicline. Review of literature and total number of cases reported in the european database of suspected adverse drug reactions (EudraVigilance).MethodsWe carried out a literature review in Pubmed electing those articles focused on mental disorders in those patients that have been taking varenicline. Review number of cases suicidal behavior reported by the European database of suspected adverse drug reactions.ResultsA 39-year-old female was brought to the emergency department after voluntary ingestion of Lorazepam 1mg (40 tablets) in a sucide attempt. The family reported the starting of thoughts of suicide after 1 week of treatment. No previous history of mental disorders. The patient reported low mood and drowsiness in the last 5 days not linked to any cause. After 5 days of discontinuation these mood symptoms and sucidal behavior remited.ConclusionsVarenicline is associated with different neuropsychiatric sypmtoms. In patients with or without history of mental disorders we should warn about the symptoms for discontinuation of the treatment.DisclosureNo significant relationships.

Impact of the Covid-19 pandemic on people with a pre-existing psychiatric disorder

IntroductionThe Covid-19 pandemic has had a deleterious impact on populations across the world. Yet it remains unclear how this pandemic is affecting the psychological health of people with a previous history of mental illness.ObjectivesThis study aims to investigate the impact of Covid-19 on patients with established mental disorders.MethodsThe PubMed and science direct databases were systematically searched using the keywords combination “Covid-19” and “psychiatric disorders”, “the pandemic” and “mental disorders “, from inception up to November 2021. We adopted a broad inclusion criterion for the study requiring patients to have a pre-existing mental disorder, excluding narrative reviews and preclinical studies. In addition, a search of google scholar was conducted to identify any additional relevant publications.ResultsWe have found 26 studies but only 19 met our inclusion criteria. Included studies were published between 2020 and 2021. 2 major results were identified. Symptoms deterioration was reported in individuals with severe mental disorders and those with schizophrenia in particular, such as depressive or anxiety symptoms, substance use and suicidal ideation, due to the psychological stress and physical distancing measures associated with the Covid-19 outbreak. The symptomatic treatments used in Covid-19 had frequent interactions with the most used antipsychotic drugs leading to a substantial increase in relapse rates in people with mental disorders.ConclusionsThe Covid-19 pandemic has a serious impact on individuals with pre-existing mental illness reinforcing symptom severity and psychological stress. Additional studies are needed to strengthen current findings with pre-pandemic records.DisclosureNo significant relationships.

Screening for anxiety and its determinants among secondary school students during the COVID-19 era: a snapshot from Qatar in 2021

BackgroundAnxiety among adolescents may lead to disability and has a tremendous impact on one’s quality of life. The alarming COVID-19 pandemic is expected to increase the anxiety level of adolescents especially with enforced governmental management strategies. This study will assess anxiety symptoms among secondary school students during the COVID-19 pandemic in Qatar.MethodsWe conducted an analytical cross-sectional study among adolescents attending independent secondary schools in Qatar. First, potential participants were invited through Microsoft teams. Next, a total of 750 participants were assessed through the Generalized Anxiety Disorder-7 (GAD-7) tool. We then conducted descriptive analyses and the Chi-square test to examine significant determinants of anxiety, which was followed by logistic regression analysis. In the end, the scale was tested for its internal consistency using Cronbach’s alpha.ResultsAnxiety symptoms were seen in 37.2% of the participants. Female gender, previous history of mental illness, comorbidities, permissive parenting style, and spending more than 12 h per day on the internet were significant determinants of anxiety. Furthermore, a previous history of mental illness, low perceived social support, isolation, and social distancing predicted anxiety.ConclusionsAnxiety is common among secondary school students in Qatar, and preventive interventions must target the determinants, especially during a pandemic.

A gender comparison of psychological distress among medical students in Nigeria during the Coronavirus pandemic: a cross-sectional survey.

The Coronavirus disease (COVID-19) pandemic as a large scale stressor could have negative effects on the mental health of medical students. Since gender differences in mental health may exist, it is important to see if a large scale stressor like the pandemic may be associated with variances in the psychological distress between both genders. To assess and compare the psychological distress of male and female medical students during the COVID-19 pandemic. A cross-sectional survey was carried out among 1010 medical students from three universities in southwestern Nigeria within the first six months of the first reported case of the COVID-19 pandemic. The respondents were purposively selected. Data was obtained online on participants' demographic and psychological distress using the General Health Questionnaire 12 (GHQ-12). Data was analyzed using the SPSS version 21, student t and chi-square tests were used to assess gender differences, and multivariate regression to assess the predictors of psychological distress among both genders. p values less than 0.05were considered statistically significant. Overall, female participants (OR=1.455, 95% CI= 1.095-1.936) were twice more likely to have experienced psychological distress than males during the COVID-19 pandemic. Age (OR=0.922, 95% CI= 0.867-0.979), being in pre-clinical years (OR= 1.394, 95% CI= 1.004-1.938), having a family income less than 100,000 naira (OR= 1.379, 95% CI=1.442-6.723) a previous history of mental illness (OR=3.077, 95% CI= 1.430-6.615) and having a relative/acquaintance diagnosed with COVID 19(OR=1.646, 95% CI= 1.062-2.551) were independently associated with psychological distress among the respondents. When comparing both genders, among females, age (OR=0.886, 95% CI= 0.803-0.978), family income less than 100,000 naira (OR=1.898, 95% CI= 1.306-2.759) and a previous history of mental illness (OR=5.266, 95% CI= 1.894-14.635) were associated with psychological distress, while, being in pre-clinical years (OR= 1.713, 95% CI= 1.052-2.790) was associated with psychological distress among males. Females had more psychological distress compared to male students. It is recommended that gender-specific interventions addressing psychological distress among medical students are instituted.

The prevalence and correlates of anxiety and depression amongst essential workers during the COVID-19 lockdown in Ekiti State, Nigeria.

BackgroundEssential workers are imperative in the fight against the coronavirus disease (COVID-19) pandemic.AimTo assess the prevalence and factors associated with anxiety and depression among essential workers during the COVID-19 pandemic and lockdown.SettingThis study was set in Ekiti State, Nigeria.MethodThis was a cross-sectional study involving essential workers in Ekiti State Nigeria, during the COVID-19 pandemic and lockdown. A total of 588 essential workers were sampled. Online socio-demographic variables and the Hospital Anxiety and Depression Scale, a 14 item self-reported questionnaire were used.ResultsThe prevalence of anxiety and depression among the respondents was 93.4% (CI = 91.2–95.2) and 64.3% (CI = 60.4–68.4) respectively. Among the health workers, the prevalence of anxiety and depression were 96.5% (CI =94.8–98.1) and 66.5% (CI = 60.5–69.8) respectively while the prevalence of anxiety and depressive symptoms among non- health workers were 84.6% (CI = 78.7–90.1) and 61.5% (CI = 54.2–69.4) respectively. The odds ratio (OR) of depressive symptoms was increased among, respondents who were not satisfied with the support they received from the government during the pandemic (AOR = 2.071, CI = 1.350–2.213), respondents that were 35 years and younger (AOR = 1.512, CI = 1.033–2.213) and reduced amongst Christians (AOR = 0.501, CI = 0.286–0.879). The odd of anxiety was increased among health workers compared to non-health workers (AOR = 3.700, CI = 1.744–7.851) and the odds of anxiety was reduced among respondents with previous history of mental illness (AOR = 0.215, CI = 0.049–0.943).ConclusionAnxiety and depressive symptoms were common mental illness among essential workers working during the COVID-19 lockdown, therefore their mental health should be adequately considered to sustain the fight against the virus.

The river of postnatal psychosis: A qualitative study of women's experiences and meanings

ObjectiveThis paper reports findings from a study about women's experience of postpartum psychosis which affects 1-2 women in 1000 in the first four to six weeks following childbirth. Previous research reports many women are relucent to disclose symptoms of mental ill health to healthcare professionals, although they are most likely to discuss symptoms and concerns with a health professional known to them. DesignA qualitative interpretive study using semi-structured interviews. ParticipantsTen women in Australia who had recovered from postpartum psychosis in the last ten years were interviewed. Data analysisData were analysed thematically by three researchers to enhance trustworthiness. ResultsThe women described their overall experience as traumatic and described what they saw as contributing factors such as a previous history of mental illness or a significant life event that was present before or during pregnancy; the women described how they made meaning of the symptoms they experienced, such as a lack of sleep or changes in their thoughts or behaviours; and the difficulties they experienced during recovery. The women also identified novel ways to support themselves and each other as they recovered. Conclusion and implications for practiceMidwives require further education to recognise the symptoms of postpartum psychosis, to ask further probing questions to identify postpartum psychosis in its early stages and to support women as they recover from this illness.

CASE SERIES OF SEVERE ACCIDENTAL HYPOTHERMIC CARDIAC ARREST TREATED SUCCESSFULLY WITH CARDIOPULMONARY BYPASS IN A UNIVERSITY HOSPITAL IN UNITED KINGDOM

Introduction Accidental hypothermia is unintentional decrease in body temperature below 35°C. Severe hypothermia is when temperature drops below 28°C and have a high mortality rate. Methods Case 1 A 48 year old man suspected CVA fall into freezing canal. He was clinging on the side of canal. He developed cardiac arrest when retrieved by crew. Three unsuccessful shocks administered. His temperature was 21° C in ED. A midline sternotomy performed and CPB achieved. He was slowly rewarmed and acidosis corrected. When temperature was 27.5° C,internal DC Cardioversion delivered, reverted him to sinus rhythm. He was successfully weaned of CPB. Total CPB time was 4 hours and 38 min. The patient was extubated next day. He had mild dysarthria and expressive dysphasia. He was discharged to stoke unit on day 3 and improved after stroke rehabilitation. Case 2 A 53 year old female, with previous history of mental illness, found unresponsive adjacent to reservoir, with weighted bag and ankles tied with chains and padlocks. She had cardiac arrest and temperature recorded as 14.1°C. She was airlifted to ED. Initial ABG pH 7.23, Lactate 2.5 and K of 4.0. No shockable rhythm achieved. She was profoundly coagulopathic with INR>10, APTT ratio>5 and Fibrinogen level A femoro-femoral bypass was done. She was slowly rewarmed, coagulopathy and acidosis corrected. She was severely vasoplegic and developed pulmonary oedema. At temperature of 28°C, developed sinus rhythm. She was successfully weaned off CPB after six hours with high doses of vasopressors. She developed TRALI and was ventilated for 12 days. She was confused, withdrawn and non-engaging with staff, with no focal neurological signs and a normal EEG. She received mental health support and rehabilitation and was discharged to a mental health unit on day 30. Results Severe accidental hypothermia is associated with high mortality rate ranging from 30-80% [1]. The neurological outcomes of the survivors are usually good, when the reason for cardiac arrest is not asphyxia. There are retrospective observational studies suggesting prognostic indicators which may predict survival on admission to hospital. Hyperkalemia, pH 400, increased ammonia levels and raised PaCO2 are bad prognostic indicators. A study by Eich et al showed that early initiation of basic life support, hypokalemia, female gender and slow rewarming to be indicators of superior outcomes. CPB is recommended for hypothermic patients in arrest and for patients with core temperatures lower than 25°C. CPB and ECMO has encouraging survival rate of unto 63%. CPB ensures controlled gradual increase in core body temperature and adequate tissue oxygenation. Discussion This case series demonstrates successful recovery with good neurological outcome from severe accidental hypothermic cardiac arrest with CPB in our institution over one year period. For severe hypothermia, CPB is extremely useful treatment device. The prognostic indicators are unclear and more evidence is required.