Psychological well-being of outpatients with mental disorders during the COVID-19 pandemic — a brief survey results

Aim. The aim of the study was to assess the impact of the COVID-19 pandemic and the social restrictions associated with it on the psychological well-being of outpatients with mental disorders. Methods. A total of 151 outpatients (60.9% female; mean age 34.412.9 years) who received treatment at psychiatric day hospitals in St. Petersburg during the first two weeks of May 2020 participated in the study. Results. The majority of respondents (72.8%) indicated that they became more stressed during the COVID-19 pandemic, including one-third of patients (29.1%) indicating deterioration in family relationships. Two-thirds of patients (60.3%) indicated that the COVID-19 pandemic and the restrictions imposed in connection with it resulted in and increased anxiety and distress. Conclusions. This study confirmed that outpatients with psychiatric disorders, as well as the general Russian population, experienced an increase in stress, anxiety, and distress during the COVID-19 pandemic. The results of the study underscore the importance of continuing to provide outpatient psychiatric care during epidemics or social upheaval, despite the imposition of social restrictions.

Psychotherapy, psychological education, medical education in the work of a particular child / adolescent psychiatrist

In order to develop a comprehensive methodology for outpatient psychiatric care for children and adolescents that can improve the social adaptation of patients, we analyzed the data of long-term clinical catamnestic follow-up of a cohort of patients with various mental disorders in childhood and adolescence. The methods of psychotherapy, psycho-education and medical education suitable for outpatient care are discussed.

Self-Inflicted Stab Wounds: A Single-Center Experience from 2010 to 2016

Despite low mortality rates, self-inflicted stab wounds (SISWs) can result in significant morbidity and often reflect underlying substance abuse and mental health disorders. This study aimed to characterize demographics, comorbidities, and outcomes seen in self-inflicted stabbings and compare these metrics to those seen in assault stabbings. A Level I trauma center registry was queried for patients with stab injuries between January 2010 and December 2015. Classification was based on whether injuries were SISWs or the result of assault stab wounds (ASWs). Demographic, injury, and outcome measures were recorded. Differences between genders, ethnicities, individuals with and without psychiatric comorbidities, and SISW and ASW patients were assessed. Within the SIWS cohort, no differences were found when comparing age, gender, or race, including need for operative intervention. However, patients with psychiatric histories were less likely to have a positive toxicology test on arrival than those without psychiatric histories (22% vs. 0%, P = 0.04). When compared with 460 ASW patients, SISW were older (41 vs. 35, P < 0.001), more likely to be white (92% vs. 64%, P < 0.001), more likely to have a psychiatric history (15% vs. 4%, P < 0.001), require operative intervention (65% vs. 50%, P = 0.008), and be discharged to a psychiatric facility (47% vs. 0.2%, P < 0.001). SISW patients have higher rates of psychiatric illness and an increased likelihood to require operative intervention as compared with ASW patients. This population demonstrates an acute need for both inpatient and outpatient psychiatric care with early involvement of multidisciplinary teams for treatment and discharge planning.

Outpatient Psychiatry

Spiritual and religious issues are very common among psychiatric outpatients, and more than half of patients report significant interest in speaking to clinicians about this domain. Yet, spiritual/religious issues are rarely broached with any substantial depth in the context of service delivery. This chapter uses a case vignette from our work at McLean Hospital to discuss clinical, cultural, and ethical issues in the provision of spiritually integrated outpatient psychiatric care. We provide a framework for systematically addressing patient spirituality/religion in treatment, highlight the relevant empirical literature, and discuss concerns as well as ethical issues that are germane to this important area of clinical innovation.