key: cord-0729750-79q1aduu
authors: Caldiroli, A.; Capuzzi, E.; Tringali, A.; Tagliabue, I.; Turco, M.; Fortunato, A.; Sibilla, M.; Montana, C.; Maggioni, L.; Pellicioli, C.; Colmegna, F.; Buoli, M.; Clerici, M.
title: P.0447 The psychopathological impact of the SARS-CoV-2 epidemic on subjects suffering from mental disorders: an observational retrospective study
date: 2021-12-30
journal: Eur Neuropsychopharmacol
DOI: 10.1016/j.euroneuro.2021.10.420
sha: 6f48cb7d940bebf834e6bf9b925ee0db7ab60805
doc_id: 729750
cord_uid: 79q1aduu

nan

Abstracts right hemiface. These symptoms were associated with anxiety and had a severe functional impact. However, considering the existing diagnosis of schizophrenia, these symptoms were regarded as tactile hallucinations. Several treatments were utilized, with limited results, namely: augmentation of antipsychotics (Aripiprazole) and introduction of antidepressants (Fluoxetine; Duloxetine) and benzodiazepines (Diazepam). In June 2018, the patient reported no symptomatic improvement regarding the burning sensation. The diagnosis of Burning Mouth Syndrome was considered and the patient started treatment with Pregabalin, titrated to 200mg/day. Two months later, she reported a partial symptomatic improvement, maintaining only paresthesias on the lips and oral mucosa. The dose of Pregabalin was further increased to 300mg/day. In November 2018, there was complete remission of all symptoms. Due to self-reported complaints of "blurry vision", the patient decided to interrupt treatment with duloxetine and pregabalin. Gabapentin was then started and titrated to 300mg/day. Due to clinical improvement, the patient decided to discontinue Gabapentin in 2019. She maintained clinical stability until 2020, when she again mentioned xerostomia and a burning sensation on the occipital region and the oral mucosa. The patient started Amitriptyline 10mg, with complete remission of the symptoms. Conclusions: This case report highlights the importance of adequate clinical evaluation in patients suffering from chronic psychiatric conditions, in which unusual or poorly understood symptoms are sometimes attributed to the underlying psychiatric conditions and consequently not adequately investigated. Regarding treatment for BMS, as seen in previous studies, gabapentin, amitriptyline and pregabalin appear to show some modest clinical improvement. However, the number of clinical trials is still limited, and further investigation is necessary to establish evidencebased treatments for this chronic condition.

The psychopathological impact of the SARS-CoV-2 epidemic on subjects suffering from mental disorders: an observational retrospective study Introduction : SARS-CoV-2 infection causes a pulmonary disease (COVID-19) which spread worldwide in 2020, leading the World Health Organization (WHO) to declare a pandemic [1] and the Italian government firstly to declare a state of emergency, then to impose restrictive measures lasting about two months. COVID-19 pandemic generated fear, anxiety, depression and post-traumatic symptoms in the general population [ 2 , 3 ] as well as among subjects affected by mental disorders [4] . Little is known about which different psychopathological changes the pandemic caused among individuals affected by different psychiatric disorders. Aims : To investigate potential psychopathological changes over time during the first wave of COVID-19 pandemic comparing different psychiatric disorders. Methods : Data about demographic/clinical variables and psychopathological status were retrospectively collected. Specific psychometric scales were administered at three time points: T0 as outbreak of pandemic, T1 as lockdown period, T2 as reopening. Primary outcomes: Brief Psychiatry Rating Scale (BPRS), Clinical Global Impression (CGI), Hamilton Anxiety Rating Scale (HAM-A). Secondary outcomes: Disability Scale (DISS), Positive and Negative Syndrome Scale (PANSS), Hamilton Depression Rating Scale (HAM-D), Montgomery and Å sberg Depression Rating Scale (MADRS), Young Mania Rating Scale (YMRS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Descriptive analyses and linear regression models were performed. Summary of results : A total of 166 outpatients were included. Overall, psychometric scores showed a significant worsening at T1 with a mild improvement at T2 (p < 0.05). Only psychotic and OC symptoms did not significantly improve at T2. Primary outcomes: time had a significant effect on the change of BPRS (F = 26.56; p < 0.001), CGIseverity (F = 8.29; p < 0.001), CGI-improvement (F = 41.88; p < 0.001) and HAM-A (F = 33.63; p < 0.001) scores. BPRS and CGI-S scores were higher among subjects affected by personality disorders (PDs) than in the depressed (MDD) and anxiety/obsessive-compulsive (OC) groups (p < 0.05). PD patients also showed higher HAM-A scores than schizophrenia (SKZ) ones (p = 0.02). were higher in the PD group with respect to bipolar disorder (BD) (p = 0.009), MDD (p < 0.001) and anxiety/OCD (p = 0.03) groups; SKZ and BD patients had lower DISS-stress scores than PD ones (both p values = 0.02). Conclusions : Patients affected by PDs showed to be particularly affected by the negative effects of outbreaks on mental health and perhaps they require specific clinical attention in case of traumatic events such as pandemics. Moreover, although SKZ patients reported lower anxiety levels than PD ones, the worsening of psychotic and OC symptoms should be strictly monitored by clinicians, as these aspects did not improve with the end of lockdown measures. Further studies on larger samples would allow an in-depth comparison of the psychopathological impact of pandemics between the different psychiatric diagnoses. The study has been registered on ClinicalTrials.gov with the following ID number: NCT04694482 Background: Several studies in literature pointed out the negative impact of Personality Disorders (PDs) on different areas of functioning in terms of lack of relationships, family difficulties, poor academic and working performance [ 1 ; 2 ] . Nevertheless, even though the negative association between PDs and social functioning was robustly established, little is known about the prognosis of patients presenting specific personality traits with different degree of severity. Objective: The purpose of the present preliminary study was to evaluate the influence of personality traits on functioning and outcome, regardless of the main PD diagnosis and using the Shedler-Westen Assessment Procedure (SWAP-200) as assessment tool. Methods: A total of 38 PD patients were recruited at the community mental health services in Cesano Maderno (Monza, Italy). Collected data included demographic and clinical variables as markers of functioning. The assessment of personality traits was performed using the SWAP-200, administered after five clinical interviews. Linear and binary logistic regression analyses were carried out to investigate whether personality dimension scores (independent variables) were associated with functioning and clinical outcome (dependent variables). Results: The antisocial dimension was associated to poor functioning and clinical outcome: impaired relationships ( β= -1.17; p = 0.02), more admissions to Psychiatric Residential Treatment Facilities (PRTFs) ( β= 1.30; p = 0.03), a shorter duration of pharmacological treatment ( β= -1.22; p = 0.05) and a poor compliance to psychotherapy (OR = 1.79; p = 0.03). The hostile-externalizing dimension, despite being associated with poly-therapy (OR = 1.34; p = 0.05), resulted to be associated to a favorable prognosis in terms of social relationships ( β= 1.06; p < 0.01) and consecutive days at work ( β= 0.78; p = 0.05). The obsessive dimension was associated with high rate of employment ( β= -2.75; p = 0.02) and less invalidity at work ( β= -2.33; p = 0.03), but high rates of admissions to Rehabilitation Units (RU) (OR = 2.47; p = 0.05). The schizoid-schizotypal dimension resulted to predict compliance to long-term care programs (OR = 3.68; p = 0.02). The avoidant dimension was associated with a good compliance to both pharmacotherapy (OR = 0.30; p = 0.05) and psychotherapy (OR = 3.98; p = 0.03), and it resulted to be predictive of mono-therapy (OR = 0.44; p = 0.05). The paranoid dimension was associated with a long DUI ( β= 1.23; p = 0.05) and resulted to be predictive of poly-therapy (OR = 0.64; p = 0.03). The emotionally-dysregulated dimension was associated with more hospitalizations ( β= 1.31; p = 0.03) and with low Personality Health Index (PHI) ( β= -0.19; p < 0.01). The histrionic dimension was associated to a low PHI ( β= -0.24; p < 0.01) and high rates of psychotherapy drop-out (OR = 3.52; p = 0.02). The narcissistic dimension predicted good compliance to long-term care programs (OR = 1.21; p = 0.04). The high-functioning depressive dimension resulted to be predictive of compliance to psychotherapy (OR = 6.41; p = 0.05), probably due to the higher personal resources ( β= 0.65; p < 0.01). The dependent dimension was associated to low PHI ( β= -0.28; p < 0.01) and a poor compliance to psychotherapy (OR = 0.26; p = 0.02). Conclusions: The antisocial personality dimension was related to scarce social functioning (differently from the hostile-externalizing one) and to clinical variables associated with poor prognosis. The schizoid-schizotypal, avoidant, narcissistic and high-functioning depressive traits predicted a better prognosis than the hostile-externalizing, obsessive, paranoid, emotionally-dysregulated, histrionic and dependent ones. The obsessive trait was associated to

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