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Raspopova NI. [Pathogenetic basis of modern approaches to the therapy of sleep disorders in the clinic of depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:69-74. [PMID: 38676680 DOI: 10.17116/jnevro202412404169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
Epidemiological studies indicate that about 35% of the world's population periodically suffer from insomnia. Many authors in their studies note sleep disturbances in the clinic of both somatic and mental disorders, often considering sleep disturbances as one of the predictors of these diseases. In psychiatric practice, sleep disorders are most often described in the clinic of depression, which is determined by the general pathophysiological mechanisms of their development due to disruption of the activity of the main neurotransmitter systems of the brain. The results of clinical studies show that the drug of choice in the treatment of sleep disorders in the depression clinic is the antidepressant Mirtazapine, which has a unique profile of pharmacological activity. According to international recommendations, Mirtazapine is a first-line drug in the treatment of anxiety and depressive disorders with sleep disorders and sexual dysfunction caused by taking other antidepressants.
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Affiliation(s)
- N I Raspopova
- Kazakhstan-Russian Medical University, Almaty, Republic of Kazakhstan
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Barkhatova AN, Sorokin SA, Bolgov MI, Smolnikova AO. [The impact of depression symptoms on postmorbid adaptation of patients who have undergone SARS-CoV-2 infection (assessment from the position of the multimorbidity model)]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:70-74. [PMID: 36946400 DOI: 10.17116/jnevro202312303170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To evaluate the impact of psychosomatic and anxiety symptoms of depression on the formation of postmorbid adaptation in patients who have undergone SARS-CoV-2 infection. MATERIAL AND METHODS The data of 54 patients, aged 18-55 years, with a current depressive episode who had outpatient SARS-CoV-2 infection were analyzed. The Hamilton depression rating scale (HDRS) was used and somatic condition was assessed using a general assessment of the patient's function limitation at the stage of reconvalescence. A linear regression analysis was performed to assess the association of psychosomatic and anxiety symptoms with somatic condition in SARS-CoV-2 infection, regardless of other factors. RESULTS The multimorbidity model took into account, in addition to SARS-CoV-2 caused by organic somatic disorders, psychosomatic manifestations (B=-1.9, p=0.004) and anxiety (B=-3.7, p=0.04) symptoms of depression. Somatic anxiety was significantly correlated with a pronounced impairment of postmorbid readaptation (p<0.05), while mental anxiety did not demonstrate such a relationship (p=0.46). The observed trend seems to be due to the overlap of manifestations of somatic anxiety with the construct of residual somatic symptoms, even though there is no multicollinearity between them. CONCLUSION Identification of clusters of symptoms associated with reduced opportunities for full recovery in the SARS-CoV-2-postmorbid period can significantly help in providing a high-quality and targeted psychopharmacological care.
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Affiliation(s)
| | - S A Sorokin
- Mental Health Research Center, Moscow, Russia
| | - M I Bolgov
- Mental Health Research Center, Moscow, Russia
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Iznak AF, Iznak EV, Damyanovich EV, Oleichik IV. [EEG correlates of suicidal intentions in depressive patients who survived and have not been ill with COVID-19]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:92-95. [PMID: 38127707 DOI: 10.17116/jnevro202312311292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To search for EEG correlates of suicidal intentions in young depressive patients who survived and have not been ill with COVID-19. MATERIAL AND METHODS We studied 46 female patients, aged 16-25 years, with depressive disorders who had previously had a mild or asymptomatic coronavirus infection («COVID» group) and 40 female patients with depressive disorders matched in age, syndromic structure of disorders and the initial severity of depression to patients of the «COVID» group but who are known not to have COVID-19 («non-COVID» group). The severity of suicidal intentions was assessed by the number of points of item 3 of HDRS-17. In all patients, pre-treatment multichannel background EEG was recorded with spectral power analysis in narrow frequency sub-bands. RESULTS In patients of the «COVID» group, the mean number of points of item 3 of HDRS-17 was slightly higher (at the trend level) than in the «non-COVID» group (2.1±1.5 and 1.8±1.6 points, respectively), and positively correlated (p<0.05) with the spectral power values of theta2 (6-8 Hz) and delta (2-4 Hz) EEG sub-bands. In the «non-COVID» group, the severity of suicidal intentions positively correlated (p<0.05) with the values of the spectral power of alpha2 (9-11 Hz) EEG sub-band. CONCLUSION Suicidal intentions increased in depressive patients survived from COVID-19, and their severity is associated with EEG signs of a reduced functional state of the cerebral cortex.
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Affiliation(s)
- A F Iznak
- Mental Health Research Cenetr, Moscow, Russia
| | - E V Iznak
- Mental Health Research Cenetr, Moscow, Russia
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Jabbour D, Masri JE, Nawfal R, Malaeb D, Salameh P. Social media medical misinformation: impact on mental health and vaccination decision among university students. Ir J Med Sci 2023; 192:291-301. [PMID: 35119644 PMCID: PMC8814778 DOI: 10.1007/s11845-022-02936-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/24/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND The COVID-19 pandemic highlighted the need of social media as a medium for gathering health-related information. Simultaneously, a slew of false information, primarily about COVID-19's origin, dissemination, prevention, treatment, and fatality surfaced, making it difficult to distinguish fake from genuine material. However, the possible effects on mental health and the extent to which this influences our decisions, particularly regarding vaccination, are unknown. AIM The purpose of this questionnaire-based cross-sectional study was to examine Lebanese University students' perceptions of social media influence during the COVID-19 pandemic, as well as to measure the impact of misinformation on respondents' mental health and vaccination decisions. METHODS In total, 440 students took part and were asked to complete an online survey that included questions on social media trust, the "general health questionnaire index" (GHQ-12), and a scale measuring "attitude towards vaccination". RESULTS Our data demonstrated a low frequency of mental health disorders among Lebanese University students, which was correlated to frequent social media exposure during the COVID-19 pandemic. These findings suggested that students are more aware of misinformation and had lower rates of despair and anxiety than the general population. Furthermore, Facebook use was associated with worse attitude and behaviour towards vaccination (p = 0.001), but a better mental health. Twitter had the inverse effect (p = 0.002). CONCLUSION It is a necessity to use social media correctly in health-related topics, to push governments and platforms towards making decisions about false and invalidated posts.
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Affiliation(s)
- Diana Jabbour
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
| | - Jad El Masri
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
| | - Rashad Nawfal
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
| | - Diana Malaeb
- Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon ,INSPECT-LB, Institut National de Santé Publique, Épidémiologie Clinique Et Toxicologie-Liban, Beirut, Lebanon ,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
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Khoreva MA. Postcovid Syndrome – The New Reality. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:619-624. [PMID: 36119648 PMCID: PMC9468516 DOI: 10.1007/s11055-022-01286-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 01/06/2025]
Abstract
The second year of the COVID-19 pandemic has demonstrated the need for detection and assessment of the long-term consequences SARS-CoV-2 infection, including adequate cognitive functioning. This review addresses our current understanding of the direct and indirect mechanisms of nervous system infection in COVID-19, paying special attention to cause-effect relationships between SARS-CoV-2 infection and long-term neuropsychological disorders. Understanding the pathogenesis of neurological impairments in COVID-19 is important for studies of the long-term sequelae of the disease and for identifying preventive and therapeutic possibilities in relation to brain damage. Further studies of nervous system lesions in COVID-19 are clearly needed to expand existing knowledge. Early initiation of therapeutic measures for emerging disorders will probably have decisive importance for improving quality of life for many COVID-19 survivors.
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Syunyakov T, Pavlichenko A, Morozov P, Fedotov I, Filatova V, Gayduk A, Ignatenko Y, Spikina A, Yashikhina A, Patsali M, Fountoulakis K, Smirnova D. Modeling Suicidality Risks and Understanding the Phenomenon of Suicidality Under the Loupe of Pandemic Context: National Findings of the COMET-G Study in the Russian Population. CONSORTIUM PSYCHIATRICUM 2022; 3:15-36. [PMID: 39045116 PMCID: PMC11262110 DOI: 10.17816/cp167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/23/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Suicidality is a complex clinical phenomenon reflecting vulnerability to suicidal behavior which can be explained via the biopsychosocial paradigm and in relationship with a variety of country-specific factors. Data on suicides within the Russian population are inconsistent (from 11.7 up to 25.1 per 100.000), whereas the population's suicidality risks have not been investigated in detail. Suicidality estimates during the multifactorial influence of the COVID-19 pandemic could serve as a basis to learn more about this mental health indicator. METHODS The current study is a part of the COMET-G international project (40 countries, n=55.589), which represents an analysis of data collected from Russia's general population (n=7714, 33±12 y.o., 61% female) to estimate suicidality using the Risk Assessment Suicidality Scale (RASS) and its relationships with socio-demographic, clinical, and life-habit characteristics during the COVID-19 pandemic. The evaluation of the statistical data (descriptive statistics, ANOVA, LASSO linear regression, significant at α=0.05) was undertaken using TIBCO Statistica. RESULTS According to the RASS, at least 20.68%, and up to 29.15%, of the general population in Russia demonstrated increased risk of suicidality during the pandemic. Modelling these risks pointed to the key vulnerabilities related to mental and behavioral disorders, such as (i) current severe depression and a history of mental disorders, (ii) bipolar disorder, (iii) use of illicit drugs surprisingly outranking the alcohol misuse, and psychiatric compounds (hypnotics), highlighting sleep quality deterioration, (iv) a history of suicide attempts and self-harm - though not self-reported changes in depression - in response were predictors of the risk of suicidality, which can be explained by the phenomenon of "learned suicidality", a habitual behavioral suicidality pattern completion accumulated over the background. Such (v) socio-demographic indicators as younger age (disregarding the gender factor), a marital status of single, having no children, living with fewer people in the household, a recent increase in family conflicts, increased need for emotional support, decreased need for communication, and not believing in precautionary measures against COVID-19, contributed to the increase of suicidality risk in the context of the pandemic. CONCLUSIONS The findings of this study revealed new suicide risk factors that should be taken into account in suicidality risk assessments for the Russian population and in the implementation of suicide prevention programs in the region.
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Mosolova E, Sosin D. Stress, anxiety, depression and burnout in healthcare workers during the first two outbreaks of COVID-19 in Russia. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:128-133. [DOI: 10.17116/jnevro2022122061128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The second year of the COVID-19 (Coronavirus Disease 2019) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 (Severe acute respiratory syndrome coronavirus-2) infection on an individual's, including adequate cognitive functioning. This review is attempting to highlight the current understanding of the various direct and indirect mechanisms of nervous system damage, describing the causality of similar symptoms following SARS-CoV-2 infection. This understanding is essential to establish the long-term consequences from the disease (including the potential for increased risk of dementia in some cases) and to identify means of preventing or ameliorating the brain damage. There is urgent need for research to better understand the pathogenesis of neurological disturbances in COVID-19, some of which have probably been covert and the prevalence of which may be considerably underestimated. Neuropsychiatric monitoring follow-up of COVID-19 patients will be important in determining the extent and prevalence of long-term neurological and psychiatric consequences of COVID-19. Early intervention for emerging these problems will be critical for improving quality of life for many COVID-19 survivors.
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Affiliation(s)
- M A Khoreva
- Altai State Medical University, Barnaul, Russia
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Abraham A, Jithesh A, Doraiswamy S, Al-Khawaga N, Mamtani R, Cheema S. Telemental Health Use in the COVID-19 Pandemic: A Scoping Review and Evidence Gap Mapping. Front Psychiatry 2021; 12:748069. [PMID: 34819885 PMCID: PMC8606591 DOI: 10.3389/fpsyt.2021.748069] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 01/07/2023] Open
Abstract
Background: The COVID-19 pandemic has highlighted telemedicine use for mental illness (telemental health). Objective: In the scoping review, we describe the scope and domains of telemental health during the COVID-19 pandemic from the published literature and discuss associated challenges. Methods: PubMed, EMBASE, and the World Health Organization's Global COVID-19 Database were searched up to August 23, 2020 with no restrictions on study design, language, or geographical, following an a priori protocol (https://osf.io/4dxms/). Data were synthesized using descriptive statistics from the peer-reviewed literature and the National Quality Forum's (NQF) framework for telemental health. Sentiment analysis was also used to gauge patient and healthcare provider opinion toward telemental health. Results: After screening, we identified 196 articles, predominantly from high-income countries (36.22%). Most articles were classified as commentaries (51.53%) and discussed telemental health from a management standpoint (86.22%). Conditions commonly treated with telemental health were depression, anxiety, and eating disorders. Where data were available, most articles described telemental health in a home-based setting (use of telemental health at home by patients). Overall sentiment was neutral-to-positive for the individual domains of the NQF framework. Conclusions: Our findings suggest that there was a marked growth in the uptake of telemental health during the pandemic and that telemental health is effective, safe, and will remain in use for the foreseeable future. However, more needs to be done to better understand these findings. Greater investment into human and financial resources, and research should be made by governments, global funding agencies, academia, and other stakeholders, especially in low- and middle- income countries. Uniform guidelines for licensing and credentialing, payment and insurance, and standards of care need to be developed to ensure safe and optimal telemental health delivery. Telemental health education should be incorporated into health professions curricula globally. With rapidly advancing technology and increasing acceptance of interactive online platforms amongst patients and healthcare providers, telemental health can provide sustainable mental healthcare across patient populations. Systematic Review Registration: https://osf.io/4dxms/.
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Affiliation(s)
- Amit Abraham
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anupama Jithesh
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | | | | | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
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Odintsova GV. COVID-19 and epilepsy: Russian and international experience. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2021. [DOI: 10.14412/2074-2711-2021-3-88-92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This article reviews the issues of epilepsy course in patients with COVID-19 and predictors of the worsening of the course of the disease in the context of the COVID-19 pandemic. Risk of seizures associated with COVID-19 is relatively low both in patients with epilepsy and in general population, with the exception of critically and terminally ill patients. Studies that evaluated the impact of the COVID-19 pandemic on the condition of patients with epilepsy are characterized by complex medical, social and pathophysiological approaches to the problem. Predictors of negative epilepsy dynamics in the context of the COVID-19 pandemic include drug interactions between antiepileptic drugs (AEDs) and drugs used to treat COVID-19; disruption of AEDs supply; stress in patients; comorbid somatic pathology.
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Affiliation(s)
- G. V. Odintsova
- Prof. A.L. Polenov Russian Research Neurosurgical Institute – Branch of V.A. Almazov National Medical Research Center, Ministry of Health of Russia
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Sankova MV, Kytko OV, Meylanova RD, Vasil’ev YL, Nelipa MV. Possible prospects for using modern magnesium preparations for increasing stress resistance during COVID-19 pandemic. RESEARCH RESULTS IN PHARMACOLOGY 2020. [DOI: 10.3897/rrpharmacology.6.59407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The relevance of the issue of increasing stress resistance is due to a significant deterioration in the mental health of the population caused by the special conditions of the disease control and prevention during the COVID-19 pandemic. Recently, the decisive role in the severity of clinico-physiological manifestations of maladjustment to stress is assigned to magnesium ions.
The aim of the work was to study the magnesium importance in the body coping mechanisms under stress for the pathogenetic substantiation of the magnesium correction in an unfavorable situation of disease control and prevention during the COVID-19 pandemic.
Materials and methods: The theoretical basis of this scientific and analytical review was an analysis of modern Russian and foreign literature data posted on the electronic portals MEDLINE, PubMed-NCBI, Scientific Electronic Library eLIBRARY.RU, Google Academy, and CyberLeninka.
Results and discussion: It was shown that the total magnesium level in the body plays the indicator role of the body functional reserves. Acute and chronic stresses significantly increase the magnesium consumption and cause a decrease in its body content. Magnesium deficiency is one of the main pathogenetic mechanisms of reducing stress resistance and adaptive body reserves. Arising during the COVID-19 pandemic, increased nervous and emotional tension, the lack of emotional comfort and balance can lead to the onset or deterioration of magnesium deficiency, which manifests itself in mental burnout and depletion of adaptive capacities. The inability to synthesize magnesium in the body necessitates including foodstuffs high in magnesium in the population diet during this period. The appointment of magnesium preparations is pathogenetically justified with moderate and severe magnesium deficiency. This therapy should take into account the major concomitant diseases, severity of magnesium deficiency, and a patient’s age.
Conclusion: magnesium correction, carried out during the COVID-19 pandemic, will contribute to increasing stress resistance, preventing mental diseases and improving the population’s life quality.
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Abstract
Under the conditions of the COVID-19 pandemic, a rapid change in the epidemiological situation, and introduced quarantine measures, there are conditions for a sharp deterioration in the mental health of a wide range of people. There are specific stressors that negatively affect mental health; there are population groups that are more vulnerable to psychological stress and the development of pathological psychological defense reactions; there is a sharp rise in the number of cases of heterogeneous mental disorders (depression, anxiety, post-traumatic stress disorders, etc.) among the population and healthcare workers in the foci of infection. The manifestation or exacerbation of mental illness in turn contributes to the spread of viral infection and is associated with a more frequent development of somatic complications and a poor prognosis. The practical problem is to choose effective psychopharmacological agents for the relief and treatment of mental disorders, by taking into account the need to combine the agents with antiviral drugs in somatically weakened COVID-19 patients.
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Affiliation(s)
- V. E. Medvedev
- Medical Institute, Peoples' Friendship University of Russia (RUDN University)
| | - O. A. Dogotar
- Accreditation and Simulation Training Center, Medical Institute, Peoples' Friendship University of Russia (RUDN University)
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Lin L, Niu LL, Zheng E, Yuan Y, Ning N, Yang M. Management strategies in a thoracic surgery ward during COVID-19 pandemic: Experience from West China Hospital. World J Virol 2020; 9:47-53. [PMID: 33442536 PMCID: PMC7770468 DOI: 10.5501/wjv.v9.i4.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/03/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 was first reported in Wuhan in December 2019 and then spread rapidly throughout the world. On March 11, 2020, the World Health Organization declared coronavirus disease 2019 a pandemic. In response to the pandemic, the management division of West China Hospital oversaw the implementation of hospital-wide emergency measures. In accordance with these measures, the hospital's thoracic surgery ward implemented a new management system by reformulating staff training plans, patient admission procedures, and other systems for managing the ward and protecting perioperative patients. Overall, the ward was successful in restoring normal working order, protecting all staff from occupational exposures, and ensuring the safety of inpatients and their families.
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Affiliation(s)
- Lin Lin
- West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ling-Li Niu
- West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - E Zheng
- West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yong Yuan
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ning Ning
- Department of Orthopedic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Mei Yang
- West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
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Vasileva AV. [Pandemic COVID-19 and mental disorders international experience and therapeutic approaches]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:121-129. [PMID: 33081457 DOI: 10.17116/jnevro2020120091121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The article considers the COVID-19 pandemic impact on the population mental health, the main psychogenic and somatogenic mental disorders associated with COVID-19 are distinguished. The comorbid PTSD clinical features are described. The mental health risk factors for health workers are presented. The psychotherapeutic and psychopharmaceutical approaches are proposed.
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Affiliation(s)
- A V Vasileva
- Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia.,Mechnikov North-Western State Medical University, St. Petersburg, Russia
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