I. Belokrylov, Russian Federation
Peoples Friendship University of Russia (RUDN University) Department of Psychiatry and Medical PsychologyPresenter of 5 Presentations
EPP0362 - The prevalence of psychopathological symptoms in population during the COVID-19 pandemic
ABSTRACT
Introduction
The COVID-19 pandemic has caused significant lifestyle changes for the world's population. The infection poses a threat to mental health due to direct invasion of the central nervous system of SARS-CoV-2, as well as as a source of mental stress associated, in particular, with the deformation of the structure of interpersonal communications under quarantine conditions.
Objectives
The study was conducted to comparatively study the phenomenology and severity of psychopathological manifestations in quarantined and non-quarantined people during the COVID-19 pandemic.
Methods
From April 18 to June 15, 2020, an online questionnaire "Symptom List 90" (SCL-90) was conducted among 837 adults in Russia, Kazakhstan, Belarus and other countries. 426 respondents were in strict home quarantine; 302 observed social distancing, but could go to work; 109 were not socially isolated.
Results
There was a significant difference in the overall severity index (GSI) between strictly quarantine and non-quarantine groups with GSI values of 0.51 (0.24; 0.99) and 0.33 (0.16; 0.75), respectively ( p = 0.001). Indicators of anxiety, depression, somatization, obsessive-compulsive symptoms, phobic anxiety, hostility and psychoticism were also significantly higher in quarantined individuals than in non-quarantined individuals (p <0.05).
Conclusions
The results of the analysis indicate that in a pandemic, the most susceptible to psychopathological disorders are those living in the most severe quarantine, while the contingent whose lifestyle changes little under these conditions shows the best indicators of mental health. These data indicate the need to optimize the system of psychiatric preventive and curative care for the population in a pandemic.
EPP0366 - Innovations in the provision of psychiatric treatment and rehabilitation assistance to the population in the context of the COVID-19 pandemic and their preliminary results
ABSTRACT
Introduction
Numerous publications highlight the need to modify mental health services in the stressful environment of the COVID-19 pandemic. The psychiatric service of the city of Moscow undertook some reforms in this regard.
Objectives
The measures taken are aimed at reducing the risk of infection of mentally ill patients undergoing treatment in dispensaries and day hospitals, as well as at preventing the exacerbation of psychopathological disorders in patients under the prevailing conditions.
Methods
The frequency of visits to the dispensary by patients in stable condition has been reduced to 1 time per week. At the same time, the frequency of telephone consultations with patients and their relatives increased up to 3 times a week. Face-to-face psychotherapy sessions have been replaced by remote (online) sessions. During the study period, medical documents of 60 patients were studied. The number of hospitalizations of outpatients to the hospital was recorded due to the deterioration of the mental state, as well as in connection with the infection with COVID in the period from 04/15/2020 to 06/09/2020.
Results
There were no hospitalizations due to mental deterioration. According to this indicator, the situation in 2020 turned out to be better than last year for the same period. There were also no cases of hospitalization of outpatients in connection with Covid-19.
Conclusions
The presented results indicate the effectiveness of organizational innovations introduced in Moscow in the provision of outpatient psychiatric care. However, these data need clarification and objective scientific interpretation.
EPP0372 - The spectrum and severity of psychopathological symptoms in previously healthy individuals who have had severe COVID-19 pneumonia.
ABSTRACT
Introduction
The medical novelty of COVID-19 requires a comprehensive study of its impact on various areas of human health, including mental health.
Objectives
To study the spectrum and severity of psychopathological disorders in previously healthy patients of different age groups who have had moderate and severe COVID-19 pneumonia.
Methods
Immediately after stabilization of the physical condition, patients completed the Symptom Checklist-90-R, designed to assess 11 parameters: somatization (SOM), obsessive-compulsive (OS), interpersonal sensitivity (INT), depression (DEP), anxiety (ANX), hostility (HOS), phobic anxiety (PHOB), paranoid ideas (PAR), psychoticism (PSY). Patients with cognitive impairment were excluded.
Results
The study involved 148 patients aged from 26 to 84 years. In the general sample, psychopathological symptoms were detected mainly on the SOM, DEP, ANX, HOS scales. To a lesser extent - on the INT and PAR scales; were practically not determined on the PSY and PHOB scales. Most of the symptoms are significantly more intense in patients over 46 years old (n = 129) compared with the younger population (<46 years old, n = 19). Older patients according to SOM revealed 1.23 points (IQR 0.5) versus 0.85 (IQR 0.7) among young people, DEP - 0.88 (IQR 0.44) vs. 0.47 (IQR 0.44), ANX - 0.66 (IQR 0.44) vs. 0.43 (IQR 0.29), OS - 0.55 (IQR 0.5) vs. 0.31 (IQR 0.25) and HOS - 0.46 ( IQR 0.34) vs. 0.29 (IQR 0.09).
Conclusions
Patients recovering from severe COVID-19 pneumonia require psychiatric evaluation and subsequent differentiated psychotherapeutic rehabilitation, especially for the age group over 46.
EPP0607 - Dynamics of aggressive manifestations in eating disorders
ABSTRACT
Introduction
Anorexia nervosa and bulimia nervosa are often accompanied by aggressive manifestations that undergo typical dynamics at different stages of the disease. The presence of aggressive phenomena in eating disorders can cause severe maladaptation of patients, cause difficulties in diagnosis, establishing compliance, and prevent the normalization of family relations.
Objectives
To study the varieties of aggressive manifestations and their changes in the treatment of anorexia nervosa and bulimia.
Methods
Psychopathological, anamnestic, psychological.
Results
The most pronounced aggressive symptoms in typical anorexia nervosa are verbal and physical aggression against relatives and close people; feeding younger siblings, parents; threats and suppression of the opinion of relatives in relation to patients. The above aggressive statements and actions occur at the stage of correction and in the initial period of the stage of exhaustion. With deep exhaustion (pronounced cachexia) and in the process of food rehabilitation, aggressive behavior is significantly reduced. In the future, there is criticism of their own aggressive symptoms. In bulimia nervosa, only verbal aggression toward loved ones is noted, especially when they interfere with purifying behavior and massive compulsive overeating. The degree of aggression in bulimia nervosa is significantly less.
Conclusions
Aggressive manifestations in eating disorders depend on the stage of the disease, the degree of exhaustion and undergo reverse development in the course of therapy. Aggressive phenomena in eating disorders have a significant impact on the clinic, dynamics, outcomes of diseases and the effectiveness of treatment tactics.
EPP0610 - Modern approaches to psychopharmacotherapy of anorexia nervosa and bulimia nervosa.
ABSTRACT
Introduction
Currently, there are no ideal medications for treating anorexia nervosa (AN) and bulimia nervosa (BN). This is due to the variety of symptoms from the mental and somatic spheres.
Objectives
Describe the modern methods of psychopharmacotherapy AN and BN.
Methods
Data from available publications on the topic of psychopharmacotherapy AN and BN, and long-term practical experience of research staff the Department of psychiatry and medical psychology RUDN University, Moscow.
Results
Therapy includes antidepressants (AD) - serotonin reuptake inhibitors (SSRIs), antipsychotics and tranquilizers. AD groups of SSRIs reduce most of the symptoms AN and BN - depressive disorders, anxiety, obsessive and compulsive symptoms, episodes of overeating and purifying behavior, suicidal thoughts, and reduce the frequency of relapses. With severe and persistent dysmorphophobia, a high degree of impulsivity, and psychopathic behavior second-generation antipsychotics Quetiapine, Olanzapine, Risperidone and Aripiprazole are used. Benzodiazepine tranquilizers (Lorazepam) are used in small doses and as additional therapy. Data from the European national guidelines for the treatment of AN and BN very different, and the world Federation of societies for biological psychiatry (WFSBP) does not provide specific recommendations at all. There are many reasons for disagreement and lack of specificity regarding drug selection, including the lack of an equally solid evidence base, that reflects the modern state of research on the psychopharmacological treatment of eating disorders.
Conclusions
In General, therapy AN and BN should be comprehensive - psychopharmacotherapy, psychotherapy, diet therapy, social rehabilitation. Treatment should be carried out both in the hospital and on outpatient basis and should be decided individually.