The psychological effect of the COVID 19 pandemic on the staff of the Mohammed VI University Hospital in Marrakech

Background: Health professionals have undergone very high levels of workload and pressure since the COVID-19 epidemic. Purpose: This study aims to assess the psychological impact of COVID-19 on health professionals at the Mohammed VI University Hospital. From May 31 to June 22, 2020. Methods: This is a cross-sectional study carried out among professionals of the Mohammed VI University Hospital in Marrakech using a questionnaire measuring the psychological impacts; the event impact scale - revised (IES-R), An exploratory and bivariate factor analysis was carried out to exploit the results. Results; 117 people answered the questionnaire, 66.67% were women, the average age was 30 years with extremes ranging from 25 to 60 years, 46.15% were doctors, 46.15% were nurses, 25.65% of participants lived alone, while 74.35% with families, after the start of the epidemic, 51 people lived in one of the hotels dedicated to housing and confinement. 28.2% or 33 people had declared transport problems. Of the participants in the study, 53.84% presented with insomnia, 12.82% (15) described aggression, and somatization was presented by 9 people (7.69%), nightmares by 9 others (7.69%) and intense fear by 3 people. 7.7% or 9 people who have already consulted the psychiatric listening cell during this period. The IES-R score is calculated at 41.94 or in favor of a post-traumatic stress disorder prevalent in this sample, with a score of avoidance at 12.76, intrusion of memories at 18.58 and hyperactivity at 10.58. Conclusion: unwanted psychological impacts are prevalent among our healthcare professionals.

Unveiling Metabolic Phenotype Alterations in Anorexia Nervosa through Metabolomics

Anorexia nervosa (AN) is a mental disorder characterized by an intense fear of weight gain that affects mainly young women. It courses with a negative body image leading to altered eating behaviors that have devastating physical, metabolic, and psychological consequences for the patients. Although its origin is postulated to be multifactorial, the etiology of AN remains unknown, and this increases the likelihood of chronification and relapsing. Thus, expanding the available knowledge on the pathophysiology of AN is of enormous interest. Metabolomics is proposed as a powerful tool for the elucidation of disease mechanisms and to provide new insights into the diagnosis, treatment, and prognosis of AN. A review of the literature related to studies of AN patients by employing metabolomic strategies to characterize the main alterations associated with the metabolic phenotype of AN during the last 10 years is described. The most common metabolic alterations are derived from chronic starvation, including amino acid, lipid, and carbohydrate disturbances. Nonetheless, recent findings have shifted the attention to gut-microbiota metabolites as possible factors contributing to AN development, progression, and maintenance. We have identified the areas of ongoing research in AN and propose further perspectives to improve our knowledge and understanding of this disease.

April 19, 2005—Leaving Gifts

In this dialogue, Nell lets go of possessions and gifts them to friends and relatives. She was especially pleased with transferring 120,000 frequent-flyer miles to her niece’s family so they could make their annual pilgrimage to Michigan from Seattle. This is the second time she has downsized in two years. When she and Al moved from their home to this apartment, they had to place furniture in storage or sell it. A major loss with the move was her highly valued garden with its associated activities, especially digging in the good earth. Nell once again spoke of her intense fear of suffocation and likened it to “skating in the dark.” She feels the same type of fear and panic when she cannot swallow due to dry mouth. Her shortness of breath has been a continual challenge; the addition of an oxygen apparatus has helped. Unfortunately, she had difficulty getting the machine to work properly because it was delivered without an essential component, the humidifier. Consequently, her nasal passages were drying out and bleeding. She subsequently needed to increase her self-advocacy efforts with the hospice healthcare providers. We practiced a breathing exercise to help her settle herself when she feels short of breath.

Clomipramine and alprazolam to treat noise phobia in a dog: case report

Behavioral disorders, including noise phobia, have a great impact on small animals internal medicine, impairing their quality of life as well as their life expectancy. The objective of this work is to report the case of a male dog who suffered from noise phobia and panic attacks triggered by thunderstorms and fireworks, and did not respond to previous training and treatment. After clinical and laboratory evaluations, he was treated with 2mg/kg clomipramine twice daily for 90 days associated with 0.06mg/kg alprazolam as needed on those days of intense fear. During the first week of treatment, a significant improvement could already be observed, with reduction in destructive behaviors, which lingered on for up to eight months of follow-up. The treatment stabilized the clinical condition and improved the patient’s quality of life.

RELATIONSHIP BETWEEN ANOREXIA NERVOSA (DESIRE FOR THINNESS) AND MENTAL HEALTH AMONG JUNIOR COLLEGE STUDENTS

Anorexia nervosa, a type of eating disorder is commonly seen in teenagers. An intense fear of gaining weight and distorted body image compels the teenagers to go on diet, which is resulting in eating less and skipping the meal and ultimately making the teenagers more prone to stress,anxiety,depression and other mental health issues. The study was taken with an intention to find the association of anorexia and mental health. A sample of 913 adolescents from junior college were selected as sample and a standardized test was administered. The findings showed that there is a positive correlation between eating disorder and mental health among adolescents.

Fear of COVID-19 among Healthcare Workers: The Role of Neuroticism and Fearful Attachment

Fear of becoming infected is an important factor of the complex suite of emotional reactions triggered by the COVID-19 pandemic. Among healthcare workers (HWs), fear of infection can put at risk their psychological well-being and occupational efficiency. The aim of this study was to analyze the role of personality (i.e., the big five traits) and adult attachment in predicting levels of fear (as measured by the FCV-19S) in 101 HWs employed in a COVID-19 university hospital. The three significant predictors retained by the stepwise regression model were age (beta = 0.26, t = 2.89, p < 0.01), emotional stability (i.e., the inverse of neuroticism) (beta = −0.26, t = −2.89, p < 0.01), and fearful attachment (beta = 0.25, t = 2.75, p < 0.01). Older HWs with higher levels of neuroticism and fearful attachment reported more intense fear of COVID-19. Our results can be useful to identify vulnerable subgroups of HWs and to implement selective programs of prevention based on counseling and psychological support.

A teenage girl with low body mass index due to restricting food intake

Anorexia nervosa (AN) is an eating disorder that is characterized by restriction of energy intake leading to significantly low body weight, an intense fear of gaining weight or persistent behavior that interferes with weight gain, and disturbance in the way one’s body weight or shape is experienced. Because many patients with AN attempt to conceal their efforts to lose weight and minimize their symptoms, obtaining information from a caregiver is an important part of the assessment. A medical history and physical examination must be completed to assess medical stability, including review of vital signs, electrocardiogram, and laboratory studies. Medically unstable patients require a medical admission for refeeding and stabilization, including monitoring for refeeding syndrome. Pharmacotherapy should not be used as the primary treatment for patients with AN. The most evidence-based psychotherapy approach for children and adolescents is family-based treatment (Maudsley family therapy).

Recurrent episodes of intense fear, shortness of breath, racing heart, and sweating

Panic disorder consists of recurrent, unexpected panic attacks accompanied by persistent worry about future attacks and/or a maladaptive change in behavior related to the attacks. A panic attack is defined as an abrupt surge of intense fear or discomfort that reaches a peak within minutes that occurs in conjunction with several other associated symptoms such as palpitations, sweating, trembling, shortness of breath, and chest pain. Features of panic disorder that are more common in adolescents than in adults include less worry about additional panic attacks and decreased willingness to openly discuss their symptoms. All patients with suspected panic disorder should undergo a medical history, physical examination, and laboratory workup to exclude medical causes of panic attacks. Cognitive behavioral therapy (CBT) including interoceptive exposures is the gold standard therapy intervention. Medications including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) can also help reduce symptoms.

‘A good death: non-negotiable personal conditions for clinicians, healthcare administrators and support staff’

ObjectivesTo ask all clinical, administrative and support staff affiliated with a large network of healthcare facilities to identify the conditions that they consider as non-negotiable for their own deaths to be regarded as good.MethodsAll 3495 staff of a healthcare network were asked to rank 10 conditions according to how non-negotiable they would be for themselves during their final 3 months or few hours for their own deaths to be considered as good. They were also asked about whether they had thought about their own death in the last 3 months, if they had a will, believed in God, and in the possibility of a good death, and the intensity of their fear of death.Results2971 (85%) completed the survey. Most were female (79%) and clinical staff (65%). 93% believed in God, 60% had thought about their death recently, 33% had an intense fear of death, and 4% had a will. 64% considered a good death possible. Participants ranked dying at a preferred place, emotional support from family and friends and relief from physical symptoms as their top priorities. The lowest ranked conditions were (from the bottom) relief from psychological distress, performance of rituals and the right to terminate life. There were no statistically significant differences across genders or individual occupational groups.ConclusionMost of conditions for a good death of interest to healthcare professionals could be provided without sophisticated medical infrastructure or specialised knowledge, opening the door for new support services to make it possible for everyone, anywhere.

Anxiety Disorders: Recent Global Approach to Neuro-pathogenesis, Drug Treatment, Cognitive Behavioral Therapy, and Their Implications

Anxiety is a group of mental disorders characterized by the sudden feeling of intense fear, panic, shortness of breath, chest pain, restlessness, GIT problems, insomnia, fatigue, muscle tension, sweating, loss of memory, blurred vision, and impaired learning. It occurs typically in response to a stressful situation that may become pathological when it is no longer controlled or occurs in the absence of real threat. This review aimed to appraise the literature on the prevalence, classification, neuro-pathogenesis, diagnoses, and treatment of anxiety disorders (AD). The search was made using PubMed, Embase, MEDLINE, and PsycINFO databases. Anxiety disorders are the most common mental disorders affecting humans, especially among developing nations. In general, the lifetime prevalence of AD is about 14%, with an annual prevalence of 31%. Unfortunately, AD, in general, is underdiagnosed and undertreated globally. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.487-503