Reports of psychiatric morbidity associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection tend to be limited by geography and patients’ clinical status. Representative samples are needed to inform service planning and research.

To describe the psychiatric morbidity associated with SARS-CoV-2 infection (confirmed by real-time polymerase chain reaction) in referrals to a consultation-liaison psychiatry service in Qatar.

Retrospective review of 50 consecutive referrals.

Most patients were male. Median age was 39.5 years. Thirty-one patients were symptomatic (upper respiratory tract symptoms or pneumonia) for coronavirus disease 2019 (COVID-19) and 19 were asymptomatic (no characteristic physical symptoms of COVID-19 infection). Seventeen patients (34%) had a past psychiatric history including eight with bipolar I disorder or psychosis, all of whom relapsed. Thirty patients (60%) had physical comorbidity. The principal psychiatric diagnoses made by the consultation-liaison team were delirium (n = 13), psychosis (n = 9), acute stress reaction (n = 8), anxiety disorder (n = 8), depression (n = 8) and mania (n = 8). Delirium was confined to the COVID-19 symptomatic group (the exception being one asymptomatic patient with concurrent physical illness). The other psychiatric diagnoses spanned the symptomatic and asymptomatic patients with COVID. One patient with COVID-19 pneumonia experienced an ischaemic stroke. Approximately half the patients with mania and psychosis had no past psychiatric history. Three patients self-harmed. The commonest psychiatric symptoms were sleep disturbance (70%), anxiety (64%), agitation (50%), depressed mood (42%) and irritability (36%).

A wide range of psychiatric morbidity is associated with SARS-CoV-2 infection and is seen in symptomatic and asymptomatic individuals. Cases of psychosis and mania represented relapses in people with schizophrenia and bipolar disorder and also new onset cases.

Though a number of agents are available to treat acute manic episode but either because of their comparable efficacy to lithium or their dose related side effects, need for better agent is always being felt.

To study the efficacy and side effect profile of lamotrigine and its double blind comparison with lithium in acute mania.

We recruited 50 patients with diagnosis of manic episode according to DSM-IV and were divided into two groups. One group was given lamotrigine 100mg and another lithium 900mg in a double blind fashion. Patints were assessed subsequently on BPRS, CMRS,UKU side effect scale and CGI till next 28 days.

Subjects in lamotrigine group did not show much improvement at the end of 4th week as compared to lithium group. Side effect profile of both groups were in accordance with reported literature except that 61.9% patients in lamotrigine group showed weight loss. Also rash were found in only 3.5% of the lamotrigine group even with such a rapid escalation of the dose.

We found that lamotrigine is ineffective in case of acute manic episode when compared with lithium.

Previously, we reported the clinical efficacy of MPH-LA in adult ADHD evaluated in a 40-week, randomised, double-blind, placebo-controlled, multicentre core study [comprising of dose confirmation (9-week), real-life dose optimisation (5-week) and maintenance of effect phases (6- month)] (Atten Defic Hyperact Disord. 2013;(5):219–220). Here, we report the long-term efficacy from the 26-week extension phase of the same study.

During the extension phase, patients initiated treatment with MPH-LA 20 mg/day (oral, once daily capsules); uptitrated to optimal dose of 40, 60 or 80 mg/day in increments of 20 mg/week. Change in DSM-IV ADHD rating scale (RS) and SDS total scores at the end of study, were evaluated from the baseline of maintenance of effect phase of the core study and the baseline of extension phase.

At the end of the extension phase, the mean change in DSM-IV ADHD RS and SDS total scores from baseline of the maintenance of effect phase was −0.9 and −1.4 points respectively; and from baseline of extension phase was −7.2 and −4.8 respectively (Table). No new or unexpected safety concerns were observed during the extension phase.

MPH-LA continued to maintain clinical efficacy in adult ADHD patients over long-term.

Table DSM-IV ADHD RS, SDS total scores and change from baseline at the end of extension phase

Asylum seekers and refugees experience psychological distress at various phases, such as during pre-migration, migration and post-migration. In the post-migration phase, the period of asylum process has many risk factors for severe mental health implications.

The aim of this study was to identify research evidence that suggest asylum process as a cause of psychological distress among the forced migrants in the United Kingdom (UK).

The study was carried out by searching the NHS database for the relevant information and interviewing asylum seekers and refugees.

The literature search identified several relevant studies in this area. However, only one study was found as the most relevant for my study focus. The study was ‘Psychological distress and the asylum process: a longitudinal study of forced migrants in Ireland’ by Ryan et al. The qualitative data gathered from the interviews of forced migrants showed a strong link between the asylum process and mental distress.

This research strongly suggests that the asylum process does contain many risk factors causing psychological distress among the asylum seekers. In particular, the restrictions from freedom to work or study, and the constant fear of deportation are the key stressors identified. Increasing the mental health awareness of all personal who come into contact with forced migrants could prevent severe psychological consequences. These points should be taken into consideration for improving the asylum policy and training medical and non-medical staff who may encounter forced migrants.

Schizophrenia is a mental disorder characterized by social problems and disorders of thought, behaviour and cognitive functions. These impaired cognitive functions may be associated with alterations in resting state functional connectivity in schizophrenia. Therefore, the present study has been carried out to determine the resting state functional brain connectivity changes associated with schizophrenia in all the resting state networks (RSNs) using independent component analysis approach (ICA) and dual-regression based approach.

The objective of this study was to investigate the aberrant resting-state functional connectivity patterns in schizophrenia patients as compared to healthy controls.

35 schizophrenia patients and 31 healthy controls were recruited for the study and scanned by using resting state functional magnetic resonance (rsfMRI). Pre-processing and post-processing of the resting state functional data were performed using the FMRI Expert Analysis Tool (FEAT), which is a part of FSL (FMRIB's Software Library, www.fmrib. ox.ac.uk/fsl).

Our results showed significantly decreased functional connectivity in the regions of left fronto-parietal network, lateral visual network, medial visual network, motor network and default mode network (DMN) in schizophrenia patients as compared with healthy controls.

The overall findings suggest that the alterations in these resting state network connectivity may, in part, contribute to the impairments in cognitive functions associated with schizophrenia. These findings also suggest that aberrant resting state network connectivity contributes to regional functional pathology in schizophrenia and bears significance for core symptoms.

Recent epidemiology studies have reported the prevalence of adult ADHD to be approximately 4%, however approved treatments are limited.

Primary objectives were to confirm the clinically-effective and safe dosage range of MPH-LA in adults with ADHD and evaluate the 6-month maintenance of effect.

Treatment Period (TP) 1: Patients were randomized to double-blind placebo, MPH-LA 40, 60, or 80 mg/day for 9- weeks (3-week titration, 6-week fixed-dose) to evaluate change in DSM-IV ADHD-RS and Sheehan Disability Scale (SDS) total score in TP1. TP2: 5-week titration to individual optimal dose. TP3: Patients were randomized to their optimal dose or placebo for 6-months double-blind withdrawal period to evaluate percentage of treatment failures during TP3.

Improvement from baseline in total score on the DSM-IV ADHD-RS and SDS was significantly greater than placebo for all MPH-LA dose levels (table). Patients treated with MPH-LA had significantly lower treatment failure rates (21.34%) compared to placebo in TP3 (49.6%; odds-ratio (95%CI=0.3 (0.2, 0.4); p< 0.0001). The safety results were consistent with the established safety profile for MPH-LA.

[Improvement by week 9: DSM-IV ADHD-RS and SDS].

MPH-LA administered at 40-80mg/day demonstrated superior ADHD symptom control and reduction in functional impairment compared to placebo and demonstrated maintenance of effect over 6 months. No unexpected adverse events were observed.

Mental Illness is a very unique and intimate experience. Over the ages various art forms, particularly writing have been used to document experiences of mental illness. Though the history of Psychiatry is a feature of mainstream Psychiatric training, complementary study of literature and its relevance to mental illness is underused.

To undertake an exploratory search of writing as tool to reflect the phenomenology of mental illness and to evaluate the role of medical humanities in understanding and coping mental illness.

To present an explorative review of a selection of poems and prose by authors with mental illness who have written in English Language.

We conducted a comprehensive search of online databases including the Madness and Literature Network (UK), Medical Humanities Resource Database (UK), the Arts Literature and Medicine Database (US) and other popular books.

We compare various extracts by well known authors along with the lesser known contemporary accounts of writers to evaluate the role of writing.

There is a long tradition of writing about depression mental illness in the canon of English literature. Compared to autobiographical writing about depression, it is difficult to identify many autobiographical accounts of severe mental illness. Examples of writing projects illustrate that people with severe mental illness, and with dementia, may use the support of others to produce creative writing. It may be useful to Psychiatrists in training, and to wider society, to reflect on the creative agency inherent in their writing.

We encountered similar problem where the results of the tests ordered by the staff were not immediately accessible to them, as these investigations are carried out by the local acute hospital. To address this issue a project was chartered.

Of the project was to develop a protocol between the trusts so that the staff of Mental Health Trust could access the results of investigation on local computers as soon as they become available and to evaluate its impact on service.

A steering committee including Specialty Registrar, Pharmacist and Matron was constituted. The committee met regularly and evolved strategy with representatives of the Acute Trust. The main concern of the Acute Trust was patient confidentiality and software access. Following regular meetings and correspondence shared-protocol was developed.

It was agreed that the acute trust would install the software on all mental health trust computers. The staff would be trained to use the software and access results. To address the issue of confidentiality, flowchart of sponsorships of the shared-protocol was developed. Accordingly, all the medics would be sponsored for access by Medical Director, Nursing Staff by Matron and Pharmacists by Chief Pharmacist. This protocol ensured that all the staff trained are accounted and IT department could monitor any unauthorised access of data.

We have noticed a big improvement in the quality of clinical practice as a result. Unnecessary delays in clinical decisions have been avoided. We feel such a shared-protocol could be developed in other hospitals that are faced with similar access issues.

Exhaustive literature is available in the portrayal of mental illness in the English language films. However no major studies are available around the portrayal of mental health in Bollywood movies which in fact is consumed by nearly 25-30% of the world population.

in the era of unprecedented growth in visual medium, we wish to study the portrayal of mental illness in Bollywood cinema and how effective this medium is to create awareness around mental health and stigma.

Literature search with a specific purpose to identify any available literature on mental illness in South Asian cinema was undertaken. to create a synthesis of portrayal of mental illness, its impact on cultural consumption with its advantages and deficiencies. This was followed by a listing a cluster reviews of Bollywood films that have characters with mental health problems to identify how these illustrate both the condition and reactions to them.

These findings were compared with the literature surrounding mental health and the Indian culture to show if the perceptions correlate. The information was collated to see any patterns and 6 such patterns were identified.

Results

Recognising these motifs are crucial for public and clinician alike in contact with the population open to the influence of these films to not only understand the phenomenology of mental illness in this populace but also some of unique cultural factors, medication, stigma and charting out appropriate management plan. (On-going)

The details of the synthetic factors will be presented in the results and discussion.