Cytological Analysis of CSF in Patients with Acute Schizophrenia

Cerebrospinal fluid (CSF) analysis is one of the most important tests in the diagnosis of central nervous system (CNS) diseases. Although CSF analysis is most commonly used in neurological pathological conditions, it also has its place in psychiatry. Studies to date have described several valuable specific cytomorphological phenomena in the cerebrospinal fluid of patients with acute schizophrenia, which indicate inflammatory or immune-mediated etiopathogenesis of the disease. Additional and long-term research is needed to confirm and standardize the importance of cytological analysis of cerebrospinal fluid in the diagnosis and etiopathogenesis of acute schizophrenia.

Electroconvulsive Therapy During the COVID-19 Pandemic

In March 2020, three months after the first cases surfaced in the Chinese city of Wuhan, WHO declared a global pandemic of the novel coronavirus, which by than had already spread through a great number of countries all over the world. In order to protect the health of healthcare workers and patients, activities and measures of disease prevention have been taken; in such circumstances, psychiatry found itself faced with various challenges, one of them being the preservation of the continuity of electroconvulsive therapy (ECT) in patients with severe or refractory psychiatric disorders. Such patients are a priority and demand immediate treatment in hospital settings adapted to epidemiological circumstances. Having studied the instructions and recommendations of the competent authorities, as well as reviewing available literature, this paper presents the most important measures for the smooth performance of ECT in conditions associated with the COVID-19 disease.

New Perspectives in Attention Deficit Hyperactivity Disorder: Possible Link to Oxytocin

Letter to Editor

The Impact of the COVID-19 Pandemic and Lockdown on Anxiety in the Elderly population: a cross sectional study

Background: The coronavirus pandemic is an epidemiological and psychological crisis. The elderly population is considered to be high risk for potential complications arising from the COVID-19 pandemic, and this fact can also potentially lead to anxiety symptoms amongst the elderly. Therefore, a study was conducted to assess the anxiety symptoms in elderly living in few major cities of Rajasthan state in India. Methods: The study was conducted from April 2020 to May 2020 using an online questionnaire which measured the levels of anxiety amongst the elderly population (age ≥ 65 years) living in the community via the GAD-7 (General Anxiety Disorder-7) scale. Responses were received from 162 participants. Data were analyzed using the Chi-square test and logistic regression. The level of statistical significance was kept at p value < 0.05. Results: Around 69.14% of the participants belonged to the age group of 65 -74 years; 61.72% of whom were male. Moreover, up to 82.72% of the participants were suffering from one or more chronic medical illnesses. Based on the GAD-7 scores, 30.25%, 12.35%, and 6.17% of the respondents were suffering from mild, moderate, and severe forms of anxiety, respectively. After applying a ≥ 5 score as a cut off score for the GAD-7 scale, 48.77% of the elderly participants were experiencing anxiety symptoms indicating further assessment. In those respondents with anxiety symptoms, significant association was observed with age (p = 0.00), sex (p = 0.04), and the zone of residence (p = 0.00). On the other hand, no significant association was observed with the presence of chronic medical illness such as Diabetes, Hypertension, COPD, etc. with anxiety symptoms (p = 0.77). Conclusion: This study has revealed a high prevalence of anxiety symptoms among the elderly population during the COVID-19 pandemic lock down. We recommend that a pre-planned strategy should be prepared for early identification of vulnerable elderly in the community who are at a greater risk of suffering from anxiety disorder under this stressful period.

The Psychological Impact of the COVID-19 Pandemic on Oral Health Care Workers and its Impact on Their Willingness to Work During this Pandemic

This study was aimed to investigate the relationship between the psychological status of oral health care workers (OHCWs) and the willingness to treat a patient during the COVID-19 pandemic. This cross-sectional study was carried out on oral health care workers at ten different dental hospitals in Pakistan from March to July 2020. Information on the socio-demographic status, and willingness to report for duty and treat patients during the COVID-19 pandemic were assessed using a self-administered questionnaire. The psychological impact of the COVID-19 pandemic was assessed using the Urdu version of the Generalized Anxiety Disorder Scale and Impact of Events Scale. Simple and multiple linear regression tests were used for analysis. A total of 392 OHCWs participated in this study and 25% of them had moderate to severe anxiety levels and only 14% had post-traumatic stress disorder. About 26% of the OHCWs were willing to work and treat patients during the COVID-19 pandemic and they had lower anxiety and stress scores. Greater anxiety and stress were associated with participants who were older, female, single, married, living with family and friends. The adjusted coefficients of GAD and IES scores were greater in participants who were not willing and unsure to work compared to their colleagues who were willing. The OHCWs are anxious and stressed because of the COVID-19 outbreak and that affects the perception of whether they should work and treat patients during the pandemic.

Case Report on a Misdiagnosed Case of Subcortical Vascular Dementia – the Importance of Sound Knowledge of Psychiatry With Proper History Taking

Psychiatric symptoms at presentation may often be missed, if not suspected or specifically explored. A missed psychiatric diagnosis may lead to dire consequences in terms of poor quality of life and function for the patient, affecting overall quality of healthcare provided. This lady presented with depressive symptoms after multiple strokes and was initially diagnosed as post stroke depression. However, after it was observed that she did not show any improvement in symptoms despite being on antidepressants, subsequent further investigations revealed a history more suggestive of subcortical vascular dementia. Consequently, detailed neuropsychological and neuropsychiatric assessments, including NUCOG, and relevant investigations including MRI brain scans were performed suggesting a diagnosis of vascular dementia. This case illustrates that an insufficiently thorough assessment and treatment process results in unnecessary morbidity, prolongs duration of illness, and increases social and occupational dysfunction to the patient. Hence, it further underscores the need to perform a thorough history, physical examination and relevant investigations to ensure organic etiologies are ruled out in clients with relevant sociodemographic and clinical risk factors.

Psychiatric and other Diseases of Russian Composers

In this article the authors are presenting medical diseases of the Russian composers. On the first place the authors analyzed “The Five” (M. A. Balakirev, A.P. Borodin, C.A. Cui, M.P. Musorgski and N. Rimski-Korsakov). “The Five” created special and different musical expression in the contrast to the rest of the Europe. Their work is a spontaneous continuation of one tradition and also the inspiration for the other composers. The other 29 Russian composers and their patographies are presented chronologically.

Paliperidone Palmitate 6-month (PP6M)

Back to the Future of Psychopharmacology

Review of “The Gambler” and F.M. Dostoevsky in the light of addiction inclination

Dostoevsky’s spirit is broken by a difficult childhood, years of imprisonment and forced military service in the difficult conditions of remote Russia, and the shackles of married life with the “sick, hysterical widow ”. Wandering through dreamy Europe made him aware of the attachment to the Russian homeland and revealed love and allusion of peace; he falls in love with Ana by dictating the text of the “Gambler ”, which will provide them with bread and shelter in the days of losing the gambling luck and questionable existence. In his wandering through Europe as the “land of holy wonders”, Dostoevsky informs us through the confessions of the gambler Alexei about the temptations of the “world” addicted to the gambling table. The significance of divisive passions is questioned: those towards women, love and even more, gambling, destructive, demonic. In 27 days while he was presenting Ana with the thoughts of the main character of the “Gambler ”, and she was recording them in a transcript, the writer was going through his own agony. The novel will see the light of day, but unlike Alexei, a character waiting for a new tomorrow to decide on ending a life driven by an unhealthy addictive habit, Dostoevsky, after the novel ends, experiences catharsis and sails into economic security by taking royalties for this and subsequent novels. As when after a stormy night at sea, a sunny morning dawns, a hint of love, happiness and the desired family peace is prayed to the author. Ana will focus the writer, a gambler, on family life and caring for children, and abduct him from addiction by sailing with him to the next “storm”. The basic theme of the novel – the obsession with gambling – is the experience of Dostoevsky, a writer with “a heart in which God and Satan fight, and the pledge is human life.” In the days when in the hustle and bustle of modern life, COVID-19, complete human alienation and escalation of violence we turn to the spiritual, looking for a way out in the metaphysical, surreal, healing and nurturing, andrational and explainable does not offer a final answer, someone seeks a way out of addiction and someone in a classic, something familiar and valuable. Or in metaphysics that goes beyond the physical and the knowable, in an attempt to reach the higher, the spiritual. The return to the great connoisseur of the human psyche, Dostoevsky, in a return to the interest in man, the inspiration of the human and the humane, but also the space behind knowable and the “metaphysical drama”. The idea of the French writer Albarez that for Dostoevsky, “in contrast to most other novelists, man is primarily not a biological, social, economic, psychological, but a metaphysical being”, becomes understandable.

Psychological Impact of the Corona Virus Lockdown on the General Population: A Cross Sectional Online Survey

Purpose: To assess the psychological impact of COVID-19 infection lockdown on the general population. Methods: From 28th April to 4th May 2020, an online survey was conducted using snowballing sampling and invitation through online social media to participate. Socio-demographic and clinical variables were collected. Psychological impact was assessed with the help of self designed questionnaire adapted from DSM-5 Self-Rated Level 1 CCSM-Adult scale. Results: In total, there were 568 responses from different cities / villages of the country. Out of these eight responses were excluded from the study because of lack of consent and final sample size analyzed was 560 (358 male, 202 female). Half of the participants were under 35 years of age, 63.9% were male, 49% have done post graduation and 59.1% were living in nuclear family. Analysis of response revealed presence of a high prevalence of psychiatric symptoms ranging from 5.5 % to 49.3% in the participants. Anxiety symptoms (49.3%), manic symptoms (37.3%) depressive symptoms (36.1%), anger issues (28.6%), somatic symptoms (26.3%) and sleep problems (24.5%) were the most common domains of psychiatric symptomatology reported by participants. Conclusion: Our study provides early evidence of a significant psychological impact of COVID-19 infection and lockdown on common people living in the community indicating a need for quick, comprehensive and longitudinal assessment of mental health needs of the population for early diagnosis and prevention of psychiatric disorders.