Background: Prolonged Grief Disorder (PGD) has recently been included in both the ICD-11 and DSM-5-TR diagnostic manuals. Studying its prevalence and correlates across cultures is vital for more effective identification, treatment, and prevention.Objective: This study aimed to examine prevalence rates of ICD-11-based PGD, in a representative Slovakian sample in response to deaths of loved ones occurring during the previous year. Further aims were to examine the factor structure of PGD symptoms and correlates of summed PGD item scores and PGD \'caseness\'.Method: Self-reported data on PGD, depression, anxiety, alcohol use, and descriptive characteristics were gathered from a representative sample of the Slovak population (N = 319).Results: Data were gathered from N = 1853 people; 319 participants (17.2%) reported a loss in the past year. The prevalence of probable PGD among these bereaved participants was 1.99% for recent losses (<6 months, n = 151) and 7.75% for more distant losses (6-12 months, n = 130). The most frequently endorsed symptoms included longing/yearning for the deceased, sadness, denial/unrealness, and difficulty accepting the death. PGD symptoms had a unitary factor structure which was consistent for subsamples bereaved 1-5 and 6-12 months. The severity of PGD varied with kinship. Depression and anxiety, but not alcohol misuse, were associated with PGD severity and PGD caseness.Conclusions: These findings underscore that a significant group of people develop PGD between 6-12 months following a loss. This emphasises the need for targeted psychological interventions.
Prolonged Grief Disorder (PGD) is newly included in ICD-11 and knowledge about its prevalence and correlates in the general population is urgently needed.In a representative Slovakian sample (N = 1853), 319 people (17.2%) reported a loss during the past year; 7.75% of people, bereaved 6–12 months earlier, met criteria for ICD-11-based PGD.PGD severity and caseness were associated with kinship (but less strongly with other sociodemographic and loss characteristics) and with depression and anxiety (but less strongly with problematic alcohol use).At 6–12 months following loss, PGD seems fairly common in the general population and timely identification and mitigation of PGD is an important public health issue.

BACKGROUND: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia].
OBJECTIVE: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021.
METHODS: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics.
RESULTS: In March 2020 and August 2021, 10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person.
CONCLUSIONS: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.

BACKGROUND: Medical education has been changing, and the evaluation strategies that make it possible to address not only theoretical knowledge but also clinical skills. In Mental Health, these skills play a central role. The Objective Structured Clinical Examination (OSCE) is one of the evaluations that could assess clinical skills. This article describes the implementation and performance for the evaluation of undergraduate students since the OSCE\'s introduction in 2015.
METHODS: An explanation of the implementation is made, and a description of the OSCEs carried out to undergraduate medical students in the second semester of mental health, using the databases of the final practical examinations during those years. The perception of mental health teachers is also described.
RESULTS: The mental health OSCE implemented in 2015-2, is developed in the Simulated Hospital of the University and has five stations (interview, mental examination, diagnosis, treatment and information to the family and ethics). Between 2016-2 and 2019-2, 486 students performed OSCE with an average score of 3.85 (scale 0-5). It was observed that the grade obtained when evaluating anxiety disorders was below average, that of affective disorders above average, while that of psychotic disorders was within the average. The professors highlight the versatility, the comprehensive objective evaluation of the practical and theoretical aspects, and the possibility of comparison between the different groups.
CONCLUSIONS: The OSCE is an examination that provides the possibility to evaluate the competences in psychiatry of medical students and allows the identification of the aspects to be improved in the teaching learning process.

Communimetric screening tools help clinicians identify and communicate their patient\'s areas of need and the corresponding level of action. However, few tools exist to identify mental health (MH) and developmental needs in young children. We aimed to implement and evaluate a new communimetric MH and developmental screening tool for children under 6 (HEADS-ED Under 6) in a community MH agency in Ontario, Canada. Using a prospective cohort design, we explored how intake workers used the HEADS-ED Under 6 screening tool from November 2019 to March 2021. 94.5% of children (n = 535/566) were screened with the HEADS-ED at intake. Total HEADS-ED scores and domains were used to inform the intensity of recommended services. Three clinical domains (Eating & sleeping, Development, speech/language/motor, and Emotions & behaviors) also independently predicted a priority recommendation. The tool showed good concordance with the InterRAI Early Years for children under 4 years old. The HEADS-ED Under 6 was a brief, easy, and valid screening tool, and can be used to identify important MH and developmental domains early, rate level of action/impairment, communicate severity of needs, and help determine intensity of service required.
تساعد أدوات الفحص المجتمعي الأطباء الاكلينيكيين على تحديد مجالات احتياجات مرضاهم ومستوى التدخل المناسب. ومع ذلك، يوجد عدد قليل من الأدوات لتحديد احتياجات الصحة النفسية واحتياجات النمو لدى الأطفال الصغار. تهدف هذه الدراسة إلى تنفيذ وتقييم أداة فحص مجتمعية جديدة للصحة النفسية والنمو للأطفال دون سن السادسة ((HEADS‐ED في هيئة مجتمعية للصحة النفسية في أونتاريو، كندا. باستخدام تصميم المجموعة الاستطلاعية، استكشفنا كيف استخدم العاملون في الاستقبال أداة الفحص HEADS‐ED تحت سن 6 سنوات من نوفمبر 2019 إلى مارس 2021. تم فحص 94.5٪ من الأطفال (العدد = 535/566) باستخدام أداة HEADS‐ED عند الاستقبال. وتم استخدام مجموع درجات HEADS‐ED ومجالاته للإبلاغ عن كم الخدمات الموصى بها. كما تنبأت ثلاثة مجالات إكلينيكية (الأكل والنوم، والنمو/النطق/اللغة/الحركة، والعواطف والسلوكيات) بشكل مستقل بأولويات الخدمات الموصى بها. أظهرت الأداة تطابقًا جيدًا مع مؤشر (InterRAI) للسنوات المبكرة للأطفال دون سن 4 سنوات. كانت أداة HEADS‐ED لأقل من 6 سنوات أداة فحص مختصرة وسهلة وصحيحة، ويمكن استخدامها لتحديد مجالات الصحة النفسية والنمو المهمة في وقت مبكر، وتقييم مستوى الفعل/العجز، وتوضيح شدة الاحتياجات، والمساعدة في تحديد حجم الخدمة المطلوبة.
“社区测量”筛查工具有助于临床医生识别和传达患者的需求领域及相应的行动水平。然而, 目前很少有工具能够识别幼儿的心理健康(MH)和发育需求。我们的目标是在加拿大安大略省的一家社区心理健康机构实施并评估一种新的针对6岁以下儿童的“社区测量”心理健康和发育筛查工具(针对6岁以下儿童的HEADS‐ED)。我们采用前瞻性队列设计, 研究了接诊工作人员在2019年11月至2021年3月期间, 如何使用针对6岁以下儿童的HEADS‐ED筛查工具。94.5%的儿童(n = 535/566)在接诊时使用HEADS‐ED进行了筛查。总的HEADS‐ED评分及各个领域评分被用于指导推荐服务的强度。三个临床领域(饮食与睡眠、发育/语言/运动、情绪与行为)也单独预测评估了优先推荐的需求。该工具与“InterRAI早期儿童版”(适用于4岁以下儿童)显示出良好的一致性。针对6岁以下儿童的HEADS‐ED是一种简便、易用且有效的筛查工具, 可用于早期识别重要的心理健康和发育领域问题、评估行动或损伤水平、传达需求的严重程度, 并有助于确定所需服务的强度。.
Les outils de dépistage communimétrique aident les cliniciens à identifier et à communicer les besoins et le niveau d\'action correspondant de leur patient. Cependant il existe peu d\'outil pour identifier les besoins en Santé Mentale (SM en français) et les besoins développentaux chez les jeunes enfants. Nous nous sommes donné pour but d\'appliquer et d’évaluer un nouveal outil communimétrique de SM et développemental pour les enfants de moins de 6 ans (HEADS‐ED de moins de 6 ans) dans une agence communautaire de SM dans l\'Ontario au Canada. En utilisant une conception de cohorte prospective nous avons exploré la manière dont les préposés à l\'accueil ont utilisé le HEADS‐ED de moins de six ans de novembre 219 à mars 2021. 94,5% des enfants (n = 535‐566) ont été dépister avec le HEADS‐ED à l\'accueil. Tous les scores et domaines HEADS‐ED ont été utilisé pour éclairer l\'intensité des services recommandés. Trois domaines cliniques (Manger et dormir, Développement/parole/langage/moteur, et les Emotions, comportements ont aussi prédit une recommandation de priorité indépendamment. L\'outil a fait preuve d\'une bonne concordance avec le InterRAI Early Years pour les enfants de moins de 4 ans. Le HEADS‐ED de moins de 6 ans s\'est avéré être un outil de dépistage valide, bref et facile, et peut être utiliser pour identifier des domaines de SM et des domaines du développement importants tôt, d’évaluer un niveau d\'action/de dépréciation, de communiquer la sévérité de besoins, et aider à déterminer l\'intensité des services requis. Kommunimetrische Screening‐Instrumente helfen klinisch Tätigen dabei, die Bedürfnisse ihrer Patienten zu erkennen, zu kommunizieren und die entsprechenden Maßnahmen zu ergreifen. Es gibt jedoch nur wenige Instrumente welche die Bedürfnisse von Kleinkindern hinsichtlich ihrer psychischen Gesundheit und Entwicklung ermitteln. Unser Ziel war es, ein neues kommunimetrisches Screening‐Instrument für die psychische Gesundheit und Entwicklung von Kindern unter 6 Jahren (HEADS‐ED unter 6 Jahren) in einer kommunalen Einrichtung der psychischen Gesundheitsversorgung in Ontario, Kanada, einzuführen und zu evaluieren. In einer prospektiven Kohortenstudie untersuchten wir von November 2019 bis März 2021 wie die Mitarbeitenden der Einrichtung bei Aufnahmen das HEADS‐ED‐Screening‐Tool für Kinder unter 6 Jahren einsetzten. 94,5 % der Kinder (n = 535/566) wurden bei Aufnahme mit dem HEADS‐ED gescreent. Die HEADS‐ED‐Gesamtergebnisse und ‐Domänen wurden verwendet, um die Intensität der empfohlenen Gesundheitsleistungen zu bestimmen. Ebenfalls sagten drei klinische Domänen (Essen und Schlafen, Entwicklung/Sprechen/Sprache/Motorik und Emotionen/Verhaltensweisen) unabhängig voneinander eine prioritäre Empfehlung voraus. Das Instrument zeigte eine gute Übereinstimmung mit dem InterRAI Early Years für Kinder unter 4 Jahren. Das HEADS‐ED für Kinder unter 6 Jahren erwies sich als ein kurzes, einfaches und valides Screening‐Instrument, das eingesetzt werden kann, um frühzeitig wichtige Bereiche psychischer Gesundheit und Entwicklung zu identifizieren, das Ausmaß von Interventionen/Beeinträchtigungen einzuschätzen, die Stärke dahingehender Bedürfnisse mitzuteilen und die notwendige Intensität von Gesundheitsleistungen zu bestimmen. コミュニメトリックスクリーニングツールは、臨床医が患者の必要な領域とそれに対応する行動レベルを特定し、伝えるのに役立つ。しかし、幼児のメンタルヘルス(MH)と発達のニーズを特定するツールはほとんど存在しない。本研究は、カナダ・オンタリオ州の地域MH機関において、6歳未満児を対象とした新しいコミュニメトリックMHおよび発達スクリーニングツール(HEADS‐ED under 6)の導入および評価を目的とした。前向きコホートデザインを用いて、2019年11月から2021年3月に、インテイク担当者が6歳未満児スクリーニングツールHEADS‐EDをどのように使用したかを調査した。94.5％の子ども(n = 535/566)がインテーク時にHEADS‐EDでスクリーニングを受けた。HEADS‐EDの総スコアと領域は、推奨されるサービスの程度を知るために使用された。また、3つの臨床領域(食欲と睡眠、発達・発語・言語・運動、感情/行動)が、個別の優先順位を予測した。このツールは、4歳未満児を対象とするInterRAI Early Yearsと良好な一致を示した。HEADS‐ED Under 6は、簡潔で、簡単で、有効なスクリーニングツールであり、早期に重要な精神保健および発達領域を特定し、活動/障害のレベルを評価し、ニーズの重症度を伝え、必要なサービスの強度を決定するために使用することができる。.
Las herramientas de examinación comunimétricas ayudan a los profesionales clínicos a identificar y comunicar las áreas de necesidad de sus pacientes y los niveles correspondientes de acción. Sin embargo, pocas herramientas existen para identificar la salud mental (MH) y las necesidades del desarrollo en niños pequeños. Nos propusimos implementar y evaluar una nueva herramienta comunimétrica de evaluación de salud mental (MH) y del desarrollo para niños menores de 6 años (HEADS‐ED para menores de 6) en una agencia de salud mental (MH) comunitaria en Ontario, Canadá. Usando un potencial diseño de grupo, exploramos cómo los trabajadores de admisión usaban la herramienta de evaluación HEADS‐ED para menores de 6, de noviembre de 2019 a marzo de 2021. 94.5% de los niños (n = 535/566) fueron evaluados con HEADS‐ED al momento de admisión. Se usaron los puntajes totales de HEADS‐ED y los dominios para determinar la intensidad de los servicios recomendados. Tres dominios clínicos (Comer y dormir, desarrollo/habla/lenguaje/movimiento, así como Emociones, comportamientos) también predijeron independientemente una recomendación prioritaria. La herramienta mostró buena concordancia con InterRAI en los Primeros Años para niños menores de 4 años. HEADS‐ED para menores de 6 fue una herramienta de evaluación breve, fácil y válida, y puede usarse para identificar tempranamente importantes dominios de salud mental (MH) y de desarrollo, clasificar el nivel de acción/daño, comunicar la severidad de las necesidades, así como ayudar a determinar la intensidad del servicio que se requiere.

Objective: This study investigated the impact of war exposure on post-traumatic stress symptoms (PTSS) and sleep disturbance across Ukraine. Subjective and objective indicators of war exposure were modelled as predictors of these symptoms.Methods: We created two predictors: first, we used governmental and crowd-sourced data to create an objective war exposure index for each of the 21 non-occupied regions of Ukraine, based on the number of air raid alarms, explosions, and proximity to frontline; and second, we obtained self-report cross-sectional data, using convenience sampling, from a nation-wide survey (N = 991) on subjective experience of threat triggered by the war. The survey also measured the outcome variables of PTSS and sleep disturbance. Hierarchical multilevel regressions modelled the relationship of this objective war exposure index with the two outcome variables, after accounting for demographics. A final regression step modelled subjective threat as predictor of these symptoms.Results: We observed strongly elevated levels of PTSS and sleep disturbance and strong regional differences in objective and subjective war indicators. Objective war exposure predicted PTSS but not sleep disturbance, whereas subjective threat predicted both symptom domains.Conclusion: The study demonstrates the utility of objective war exposure data for predicting the prevalence of PTSS in the different regions. The results further underscore the prominent role of subjective appraisal processes in the symptomatology of PTSS and sleep disturbance, thus informing theories on trauma-related disorders. Our results can guide the allocation of mental health services by identifying highly affected regions.
Objective data on air raid alarms and explosions have been prospectively collected in Ukraine.We related those objective data to symptom reports of 991 responders in most Ukraine regions.Objective data explained symptoms of post-traumatic stress but not sleep disturbance.

OBJECTIVE: To evaluate the opinions of the new internal resident physicians (IRP) on family and community medicine (FCM) and professional and personal issues.
METHODS: Anonymous survey of 837 new IRPs in the Madrid Region.
RESULTS: Mean age was 25.6±3.5 years, 525 (62.7%) had a specific subject of FCM during medical school, 799 (95.5%) did FCM practices during their medical degree, and 606 (72.4%) considered relevant to be some months in FCM during their medical residence. Only 103 (12.3%) consider becoming parents during residency, 416 (49.7%) have suffered from anxiety, 99 (11.8%) from depression, and 19 (2.3%) had previous suicidal thoughts. Although 638 (76.2%) have received training in ethical decisions, 345 (41.2%) did not know how to implement these decisions, 120 (14.3%) had studied artificial intelligence and 744 (88.9%) have a positive view of the College of Physicians. CONCLUSIóN: Most new medical residents of Madrid consider a Primary Care rotation relevant during their training, but only 63% have completed specific training in FCM as an undergraduate. A total of 12% reported previous depression and half anxiety.

This year marks 100 years since the death of Franz Kafka. Often in general medicine, and internal medicine in particular, doctors face situations in which they position themselves as the only guarantor of the patient in relation to society and how it conceives the disease. Many times, patients come to us without a diagnosis or with the fear of it; sometimes also rejected by their environment. This short text addresses this current topic, paying tribute to the brilliant writer and his best-known work, Metamorphosis.

OBJECTIVE: To describe the impact of the COVID-19 on the psychosocial health of patients with rheumatoid arthritis (RA), spondyloarthritis (SpA), and systemic lupus erythematosus (SLE).
METHODS: Longitudinal observational study of a series of patients with rheumatic disease.
METHODS: The main outcome measure was impairment of the ability to participate in social activities, as measured using the PROMIS-APS instrument Short Form-8a. We evaluated social activities in various settings and performed a multivariate analysis to study the association between worsening of social participation during the COVID-19 pandemic and implicated factors.
RESULTS: One hundred and twenty-five patients had completed the prospective follow-up: 40 with AR (32%), 42 with SpA (33.6%), and 43 with SLE (34.4%). Overall, poorer mean PROMIS scores were recorded after the COVID-19 pandemic for: satisfaction with social roles (p=0.029), depression (p=0.039), and ability to participate in social activities (p=0.024). The factors associated with ability to participate in social activities after the COVID-19 pandemic were older age (β=-0.215; p=0.012), diagnosis of SLE (β=-0.203; p=0.015), depression (β=-0.295; p=0.003) and satisfaction with social roles (β=0.211; p=0.037).
CONCLUSIONS: The ability to participate in social activities after the COVID-19 pandemic is affected in patients with rheumatic disease, especially in SLE.

BACKGROUND: Hypertension is a prevalent health challenge in India, with a bidirectional link to depression. Recognizing the prevalence of depression among hypertensive patients and associated factors are important for better health outcomes.
METHODS: A comprehensive search was conducted in PubMed, Embase, Scopus, and Google Scholar databases to identify relevant studies. R software was used for analysis, employing a random effects model with a 95% confidence interval. Subgroup analyses were done to explore sources of heterogeneity within the included studies.
RESULTS: The prevalence of depression among hypertensive patients in India was 39.8% (95% CI: 28.6; 52.1). Despite a higher prevalence observed in South region (44.7%) compared to North (26.9%), the difference was not significant (p=0.39). Studies utilizing different assessment scales and varying sample sizes yielded similar prevalence. However, a temporal trend analysis indicated a higher prevalence in studies published between 2020 and 2023 (52.6%) compared to those published between 2016 and 2019 (35.5%) (p=0.03). Major factors associated with depression included lower socioeconomic status, low education level, female gender, uncontrolled hypertension, and COVID-19 related factors.
CONCLUSIONS: A significant proportion of hypertensive patients suffer from depression. Therefore, screening for depression in hypertensive patients is essential to improve hypertension management in India.

Background: Intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) are associated with psychological distress and trauma. The COVID-19 pandemic brought with it a series of additional long-lasting stressful and traumatic experiences. However, little is known about comorbid depression and post-traumatic stress disorder (PTSD).Objective: To examine the occurrence, co-occurrence, and persistence of clinically significant symptoms of depression and PTSD, and their predictive factors, in COVID-19 critical illness survivors.Method: Single-centre prospective observational study in adult survivors of COVID-19 with ≥24 h of ICU admission. Patients were assessed one and 12 months after ICU discharge using the depression subscale of the Hospital Anxiety and Depression Scale and the Davidson Trauma Scale. Differences in isolated and comorbid symptoms of depression and PTSD between patients with and without IMV and predictors of the occurrence and persistence of symptoms of these mental disorders were analysed.Results: Eighty-nine patients (42 with IMV) completed the 1-month follow-up and 71 (34 with IMV) completed the 12-month follow-up. One month after discharge, 29.2% of patients had symptoms of depression and 36% had symptoms of PTSD; after one year, the respective figures were 32.4% and 31%. Coexistence of depressive and PTSD symptoms accounted for approximately half of all symptomatic cases. Isolated PTSD symptoms were more frequent in patients with IMV (p≤.014). The need for IMV was associated with the occurrence at one month (OR = 6.098, p = .005) and persistence at 12 months (OR = 3.271, p = .030) of symptoms of either of these two mental disorders.Conclusions: Comorbid depressive and PTSD symptoms were highly frequent in our cohort of COVID-19 critical illness survivors. The need for IMV predicted short-term occurrence and long-term persistence of symptoms of these mental disorders, especially PTSD symptoms. The specific role of dyspnea in the association between IMV and post-ICU mental disorders deserves further investigation.Trial registration: ClinicalTrials.gov identifier: NCT04422444.
Clinically significant depressive and post-traumatic stress disorder symptoms in survivors of COVID-19 critical illness, especially in patients who had undergone invasive mechanical ventilation, were highly frequent, occurred soon after discharge, and persisted over the long term.