Fingerprints multiply man in space and time. Educating man with his hand, he learns how to master spatial extent, weight, density, proportion, organizes the activity in order to experience the action. The beneficiary creates a unique universe in which he leaves his mark everywhere. Ergonomics is considered as the “science of work”, having the “man-work” relationship as its object of study. In art therapy, occupational and play therapy, which is based on traditional aesthetics, we talk about “sublimation”. (ChirilăE & Câmpean & Drăgan-Chirilă.D, 2021- 10-13 April)

By means specific to the visual arts, hidden, overdue individual skills are detected, which bring the beneficiary closer to normality, to real life. We can observe that all things in nature are shapes modeled in volumes made up of fillings and voids, which constantly transform the appearance of the world. All these angles are synthesized in the brain, in order to understand the three-dimensionality of the environment as a unitary whole. This happens when we are in a position to be aware, actively, of the deep relationships that the environment implies, in general.

Tactile value is the origin of any act of creation, the hand removes the sense of touch from receptive passivity. The evaluation of fine and gross motor skills is done by modeling, we use the sense of touch, we follow the use of hands during creation. In the testing activities through product analysis we use the visual language, that of the symbolic language of anthropomorphism. Holistic training is done on the potter’s wheel or through 3D multimedia installations. Creating works of art, artefacts, or using arts-based jobs are test activities for art therapy, occupational therapy and ergotherapy, which provide us with information about the author with the help of images and shapes. Each beneficiary can create the images themselves, with which they want interact or can use arts materials and games according to his needs of expression.

These activities allow the beneficiaries to reach a certain level of introspection and to “work through” their problems in a constructive manner. The activities can be approached in several distinct groups of people, who can be qualified in different artistic professions such as: visual artist, decorator, designer, they can practice adaptive-”raw arts”. (Chirila, E 2011, PhD Thesis p 398)

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The foundations are laid for an occupational therapy workshop for adults with special needs. In these types of activities, the beneficiaries who do not have artistic skills can learn useful skills for CES persons, who, to pursue a productive goal like “Work for the disabled”. (Chirila, E 2018 p50)

E. Chirila Consultant of: NO

Many beneficiaries are stuck and find it difficult to act creatively because they are used to being in a different place than where they are at that moment:

they lose their balance and the ability to move in harmony with the forces of the environment which, in the end, will support the expression.

They expect something different from what they are doing at that moment or they think that what they are doing is inadequate; they get stuck, they get caught in negative and confused thoughts.

Even if a finished object or image is obtained, the research pursues, first of all, the way and the extent to which the creative process and execution of the artifact contributes to the improvement or healing of the studied beneficiaries. Correlative objective being the increase of their quality of life and their socio-professional integration. In assessing the motor functions of the beneficiaries, it is essential that the emphasis is placed on the outstanding and hidden motor abilities of each individual. The aim is to improve: coordination disorders, spatialization disorders, fine motor skills, sensoriality, creativity, socialization.

ORGANIZATION OF ACTIVITIES is done in three types of workshops, with different objectives and interventions,

• - Occupational therapy workshop in the category that includes art therapy.

• - Occupational therapy

• - Relaxation, play therapy

CASE STUDY: Placement center Jucu PA, sex M, 16 years old.

Diagnosis: Secular infantile encephalopathy, behavioral disorders

• - heteroaggressiveness, severe mental retardation, alalia.

• - Uses modeling for self-expression and self-fulfillment. During work, he is not aggressive and relates to people who appreciate his work.

An advanced level is observed in modeling, even compared to normal people. Spatial abstract compositions from plasticine, expressive and balanced, are made at the beginning, the evolution is observed in the modeling of the figures (he starts to model personalized human figures), which he pairs chromatically, groups them into dancing figures, or groups them affectively and vertically. He also showed changes in his behavior: he smiled while working, clapped and recognized us when we entered the workshop, wanted to be photographed and petted (although normally he can’t stand being touched). He showed interest in the camera and in the modeling works of other children from Placement center.

Work in visual arts and design therapies aims to create a product. The benefits arise from experiences based on artistic creativity: materializing ideas and solving unexpected results.

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The artistic image becomes significant in strengthening the verbal exchange between the beneficiary and the art therapist, solving problems and formulating new perceptions that in turn lead to positive changes, growth and healing.

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In certain cultures psychological suffering is expressed with more somatic symptoms. Besides, they tend to describe more often hallucinations and other forms of perception problems.

To describe and warn about the risks of misdiagnose when culture is not an element considered in the diagnosis.

Descriptive methodology based on practice and observation.

In the last year MSF has been working in more than 40 countries such as South Sudan and Chad with local and refugee populations. The teams have provided treatment to people with anxiety, trauma related and depressive disorders. However, we have also treated many people with hallucinations in the context of trauma, forced displacement. Several patients presented sudden, abrupt symptoms such as fear, insomnia, anxiety, and hallucinations. These hallucinations are often related to the potential traumatic event, to the witness of violence or displacement. When it appears accompanied by flashbacks, hypervigilance, and other PTSD symptoms it may be considered as PTSD with psychotic like symptoms. But other times these hallucinations seem to be more linked to a depressive episode or adjustment disorder. We have witness several cultures where hallucinations are very common during grief processes. The main risks of a misdiagnose of psychosis is the mistreatment.

On another note, it is known that migrant and refugee status are associated with a higher prevalence of psychosis. Using the cultural lenses, should we question these findings? Is there maybe a bias or misdiagnosis in some of these research?

Not all people with sensory perceptual alterations can be diagnosed with psychosis. A proper diagnose that is adapted to the culture of the person is essential for a good quality treatment.

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The process of successfully joining medical schools, represents an important event for each student globally. The transition from one year to another needs much effort, sacrifice and perseverance in order to obtain the final goal of being a practitioner.

To assess the strength of motivation for medical studies in foreign students.

We conducted a cross-sectional, descriptive and analytical study, carried out between July and September 2023 among foreign students at the Sfax Faculty of Medicine. Data collection was carried out using an anonymous self-questionnaire via “Google Forms shared among students via social media. We used the strength of motivation for medical school “SMMS” in its French validated version.

Seventy-two foreign medical students completed the survey. The average age was 25 ± 3.45 years. Males represented 57% of the total participants. The majority of respondents were single (77.8%). Sixty-one percent were enrolled in the third cycle of medical studies, 26.5% were enrolled in the second cycle of medical studies and 12.5% were enrolled in the first cycle of medical studies. Of those surveyed, 83.3% had chosen medical studies as their first choice. For 59.7% of students, this choice was their own. The mean score for the motivational strength questionnaire was 42.4, as for the sacrifice dimension 14.6, for the start-up readiness 13.7, and 11.02 for the perseverance dimension. The mean score for the strength of motivation for medical studies was significantly lower in students enrolled in second cycle of medical studies (p=0.043) and in those who did not have their own choice of medical studies (p=0.037). We found no statistical association between the strength of motivation and having a family member in the medical field.

Motivation is a crucial aspect of the academic life of international medical students, shaping their learning path and overall experience. These students, often driven by dreams of a medical career, face obstacles linked primarily to adapting to a new educational system. The motivating strength that drives them to embark on and pursue medical training may be fueled by the desire to acquire clinical skills that will contribute to the provision of healthcare in their home countries.

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Foreign medical students in Tunisia represent a dynamic academic community, making an essential contribution to the global medical training. Their presence creates a vibrant academic ecosystem, conducive to discovery, intercultural exchange and medical innovation.

To determine the socio-cultural and the personal profile of foreign medical students, in order to optimize their academic performance and facilitate access to a high-quality professional training.

We conducted a cross-sectional, descriptive and analytical study, from July to September 2023 among foreign students at the Sfax Faculty of Medicine via an anonymous self-questionnaire via “Google Forms” shared among students through social media. We used scale of satisfaction in studies, which is a 5-item scale, each rated on a 7-point Likert scale indicating the degree of agreement or disagreement with the statements.

Seventy-two foreign student completed the survey. The average age was 25 ± 3.45 years. Students of Moroccan origin accounted 68.1%. The socioeconomic status was average in 93.1%. The majority of respondents were single (77.8%). One-third of the students lived with a roommate. Fifty-one per cent of the students had at least one family member in the healthcare field. Of those surveyed, 61.1% were enrolled in the third cycle of medical studies, 26.5% were enrolled in the second cycle of medical studies and 12.5% were enrolled in the first cycle of medical studies. The average length of stay in Tunisia was 6.5 years. Seventy-seven percent were satisfied with the choice of Tunisia for the medical studies. Seventy-nine percent of the students were satisfied with their academic performance. Coffee was the most consumed substance (88.9%) followed by tobacco (47.2%), alcohol (36.1%) and illicit drugs (26.7%). Fifty-nine percent (N=41) practiced sports and 16.7% had an artistic leisure activity. We found a statistical association between satisfaction and the practice of a leisure activity (p=0.007) and a statistical negative association with having a family member in the healthcare field (p=0.022). We found no statistical association with the choice of Tunisia as a destination even though the mean score was higher among the students that was satisfied with their choice. The quality of the studies in Tunisia as well as the geographic localization were the main reasons for choosing Tunisia No statistically significant association was found with gender, socioeconomic status or marital status, substance consumption.

The medical field studies are still challenging for students in general due heavy learning process and training process adding to that the personnel, cultural changes that a foreign student can face. Highlighting these aspects can contribute to improving their experience, by focusing on the learning process as well as making time to practice their leisure activities in order to break the routine.

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Foreign students are confronted to the multiple obstacles along their university studies. These obstacles can be related to the nature of the medical studies, the diversity and dense quantity of the subjects, and also to the interaction of the students with their colleges, their patients and the paramedical staff during the training. Psychological distress can, also affect the process of integration in society.

To assess the factors influencing the social integration and the satisfaction of the foreign students in the faculty of medicine in Sfax-Tunisia.

We conducted a cross-sectional, descriptive and analytical study, carried out between July and September 2023 among foreign students at the Sfax Faculty of Medicine, via an anonymous self- questionnaire via “Google Forms shared via social media. Social integration was evaluated via the French version of the need to belong scale by Richer and Vallerand. The satisfaction of the medical studies was evaluated using the scale of satisfaction of studies by Vallerand and Bissonnette. Psychological distress was assessed using the “DASS-21” Depression, Anxiety and Stress Scale.

Seventy-two foreign medical students completed the survey. The average age was 25 ± 3.45 years. Males represented 57% of the total participants. The majority of the participants were north Africans 87.5% (Moroccan: 68.05%, Mauritanian: 18.05% and Algerian 1.4%). The majority of respondents were single (77.8%). Sixty-one percent were enrolled in the third cycle of medical studies, 26.5% were enrolled in the second cycle of medical studies and 12.5% were enrolled in the first cycle of medical studies. The average length of stay in Tunisia was 6.5 years. Seventy-seven percent were satisfied with the choice of Tunisia for the medical studies. The male gender was statistically associated to the feeling of a better social integration (p=0.045). In addition, social integration was statistically associated to satisfaction in medical studies (p=0.004, r=0.034) and to academic performance (p=0.008). We found no statistical association between the level of the students nor the length of the stay in Tunisia. We found no statistical association between social integration and psychological distress.

The feeling of being an integral part of the social community can help alleviate the stress of adjusting to a new environment and improve emotional well-being, which can positively influence the learning experience and satisfaction of these foreign students.

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More than any other field in medicine, psychiatry is marked by an individual’s life experiences and the cultural context surrounding them. When a patient presents a set of somatic and seemingly unrelated symptoms that can’t be explained by an underlying physical condition, the diagnosis can become challenging. However, when these symptoms are seen through the lense of their particular cultural context and their traumatic family history, these manifestations start to make sense.

This paper aims to examine the relationship between transgenerational trauma and somatic manifestations without an underlying physical condition in an adult female partient N.

In order to investigate the psychological functioning of the patient N, we conducted a semi-structured interview followed by a set of psychological tests. We administered the Draw-a-Family Picture Test, the Rorschach Test and the Thematic Apperception Test (TAT). We also analysed the patient’s diary entries.

N initially came to us with unexplained somatic symptoms and a generally depressive mood, finding it difficult to discuss certain topics like her sexual issues. The various elements we have collected through the tests and the interviews with the patient N have shed light on an event that occured within the father’s family, an incestuous rape. This event was the cause of the family’s breakdown, and we believe that the depressive symptoms, suicide attempts, as well as the incestuous atmosphere related to the patient N and her family are connected to this event and have continued to be unconsciously transmitted across generations.

This case study showed the importance of taking family history and cultural context into consideration when examining psychological functioning. Family secrets and seemingly unrelated past events can cause a transgenerational trauma affecting the descendants mental and physical health.

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As psychiatrists, we provide care to patients from diverse cultural backgrounds, whose mental health is often affected by migratory trajectories and post-migration factors in the destination country, such as exposure to adversities and inequalities in access to healthcare. Moreover, culture plays a significant role in the presentation of symptoms and influences explanatory models of illness, health objectives, resources mobilized, and treatment styles. Thus, the social determinants of health are often distinct from those of the community of origin.

The development of culturally sensitive and adapted services becomes essential to reduce healthcare inequalities. We intend to review the concept of cultural diversity and explore various models studied for intervening in mental health care in culturally diverse communities.

Narrative literature review through bibliographic research and publications in the Pubmed and Google Scholar databases, using the terms “cultural psychiatry,” “cultural competence,” and “migration.”

Some barriers to healthcare access for the migrant population include ethnolinguistic barriers, stigma, resilience and minimization of symptoms and complaints, and issues related to accessibility and service costs. On the other hand, healthcare professionals also identify bureaucratic issues and report a lack of knowledge regarding different cultural practices, showing interest in obtaining more training in the area. Some strategies to adapt mental health services to cultural diversity include health literacy, “ethnic matching” techniques, interpreter and cultural mediator training, and building cultural competence for both healthcare professionals, institutions and healthcare systems. Cultural formulation uses specific tools to gather clinical information and cultural context, showing positive preliminary results.

Cultural competence represents a comprehensive response to the needs of migrant and culturally diverse population, requiring the acquisition of knowledge and skills at both the individual and organizational levels. Investing in training and research on cultural competence will further enhance the effectiveness and accessibility of mental health care, contributing to the reduction of inequalities and better health outcomes.

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While most individuals adhere to preventive measures during pandemics, a subset engages in behaviors that may intentionally spread COVID-19, presenting unique challenges to public health efforts.

This study explores the psychological, social, and environmental factors influencing deliberate virus-spreading behavior in the Saudi Arabian population during the initial phase of the COVID-19 pandemic.

A cross-sectional online survey was conducted between April 3 and May 5, 2020, with 1,817 participants. The survey collected demographic information and variables related to virus-spreading inclinations. Descriptive statistics and Pearson’s chi-squared tests were used to analyze associations between deliberate virus-spreading behavior and various characteristics, with statistical significance set at p < 0.05.

Individuals who intentionally spread the virus (2% of the sample) were younger (mean age 22.9 vs. 29.3 years, p < 0.001), predominantly female (81.1% vs. 65.6%, p = 0.033), and more likely to have a history of mental health issues (24.3% vs. 8.5%, p < 0.001) and conspiracy beliefs (45.9% vs. 26.2%, p = 0.003) compared to those who did not engage in virus-spreading behaviors. No significant differences were found regarding marital status, education level, or traumatic life events.

This study highlights key factors associated with intentional virus-spreading behaviors, such as younger age, mental health history, and conspiracy beliefs, underscoring the need for integrated mental health support and targeted misinformation interventions. Public health strategies should include age-appropriate messaging and digital outreach to mitigate the risks posed by intentional spread behaviors and enhance pandemic response efforts. Further research with larger, more diverse samples is recommended to expand understanding and improve intervention strategies

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The advent of the Coronavirus Disease 2019 (Covid-19) pandemic in late 2019 precipitated a profound transformation in the daily lives of individuals across the world, with notable implications for global mental health. The fear of the virus became a significant source of anxiety and stress, compounded by the rapid dissemination of information, both accurate and inaccurate, through digital media. The growing reliance on digital platforms for health information during the pandemic underscored the significance of eHealth literacy, which pertains to the capacity to locate, comprehend, and utilize health data from digital sources. As reliance on digital platforms for health information increased, it became imperative to examine the potential impact of digital health literacy on fear and anxiety levels related to the novel coronavirus disease (2019-nCoV), also known as Coronavirus Disease 2019 (Covid-19).

The objective of this study is to examine the relationship between fear of the Coronavirus disease 2019 (Covid-19) pandemic and mental health, while investigating the influence of eHealth literacy on these fears.

The study was conducted on a sample of 158 individuals from the general population, representing a diverse range of demographic characteristics. The data were collected using a structured questionnaire comprising three sections: demographic information, the Fear of Coronavirus Scale (FCV-19S), and the eHealth Literacy Scale (eHeals). A statistical analysis was conducted to investigate the relationships between demographic factors, levels of fear, and eHealth literacy. Additionally, a comparative analysis was performed to assess the differences between individuals who had and had not contracted the virus.

The analysis revealed no statistically significant differences in the levels of fear regarding the novel coronavirus disease (Covid-19) or eHealth literacy between different demographic groups, including gender, age, education, and health status. Nevertheless, a statistically significant discrepancy was observed in the level of fear between individuals who had contracted the virus and those who had not. Specifically, those who had not been infected exhibited higher levels of fear compared to those who had previously contracted the virus. No significant differences were identified in eHealth literacy based on infection status.

In conclusion, the findings of this study indicate that while demographic factors do not appear to influence the level of fear or digital health literacy, personal experience with a confirmed case of infection does. Those who have not contracted the virus tend to experience greater fear, suggesting that familiarity with the disease may reduce anxiety. These findings underscore the necessity for interventions.

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The COVID-19 pandemic placed an unprecedented burden on healthcare workers worldwide, particularly those in primary care settings, who faced both physical and emotional challenges.

The study aimed to assess the levels of psychological distress and anxiety, and the coping strategies among healthcare workers after the COVID-19 pandemic. It also examined changes in professional quality of life and the broader impact on personal life during the post-pandemic period.

A cross-sectional study was conducted on a sample of 100 healthcare workers from various primary care centers in Patras, Greece. The following validated psychometric instruments were used:

• - Secondary Traumatic Stress Scale (STSS): assessing symptoms of secondary traumatic stress, reflecting the emotional impact of indirect exposure to trauma through patient care.

• - Quality of Professional Life Scale (5th edition): assessing both the positive (compassion satisfaction) and negative (burnout, secondary traumatic stress) dimensions of professional life.

• - Posttraumatic Growth Inventory (PTGI): measuring positive psychological changes and personal growth experienced as a result of coping with pandemic stressors.

• - Brief-COPE Scale: identifying coping strategies used by nurses, distinguishing between adaptive and maladaptive mechanisms.

The results of the study indicate a persistent and significant psychological distress among caregivers in the post-pandemic context of 2024. The STSS scores revealed elevated levels of secondary traumatic stress, underscoring the enduring emotional impact of the pandemic on healthcare workers. As demonstrated by the Quality of Professional Life Scale, a divergence in outcomes was observed. While a subset of nurses reported elevated levels of compassion satisfaction, a considerable proportion continued to exhibit high levels of burnout and secondary traumatic stress. This finding suggests that the adverse impact of the pandemic on professional well-being persists. The PTGI results revealed that some HCW experienced post-traumatic growth, suggesting the potential for positive psychological development despite the challenges encountered. Analysis of the Brief-COPE Scale depicted a diverse range of coping strategies, with evidence of both adaptive coping mechanisms, such as problem-focused strategies, and less adaptive responses, including avoidance behaviors.

In conclusion, the results emphasize the persistent psychological impact of the ongoing pandemic on healthcare professionals, even in the post-pandemic era. These findings underscore the necessity for the provision of sustained psychological assistance and interventions that are specifically designed to address post-pandemic stressors, with the aim of ensuring the long-term well-being of healthcare workers.

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Since the start of the pandemic, healthcare workers (HCWs) have faced a range of infectious and psychosocial risks. Contracting SARS-CoV-2 has impacted their physical, mental, and emotional well-being, with sleep also likely being affected.

Our study aims to assess the impact of SARS-CoV2 infection on sleep quality in HCWs.

We conducted a descriptive cross-sectional study among staff at Sfax University Hospital who were infected with SARS-CoV-2 between October 2020 and June 2021, during post-COVID follow-up consultations. A questionnaire was utilized, with the medical section completed by a physician to assess sociodemographic, professional, and clinical characteristics of the infection. A self-administered section evaluated the impact of the infection on sleep quality using the Insomnia Severity Index (ISI).

Our study included 200 healthcare workers with an average age of 42.97 years. Nurses comprised 53.5% of the sample, and 41% of the participants were involved in the care of patients with SARS-CoV-2. Workplace infections accounted for 39% of the cases. At the post-COVID follow-up consultation, 83% reported persistent symptoms. According to the Insomnia Severity Index (ISI), 47.5% had no sleep disturbances, 3.5% had mild insomnia, 26% had moderate insomnia, and 8% had severe insomnia. Additionally, 38% of the staff were dissatisfied with their sleep quality following their SARS-CoV-2 infection.

SARS-CoV-2 infection impacts the sleep of healthcare workers, highlighting the need for strategies to improve sleep quality. Addressing these issues is crucial for maintaining staff well-being and ensuring the quality of care provided.

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The COVID-19 pandemic has been recognized as an international public health emergency.

The aim of our study was to identify contributors to nurses’ depression.

This survey-based study was conducted in the Pomeranian Medical University Hospital no. 1 in Szczecin and involved 207 nurses. The following standardized research instruments were applied: the World Assumptions Scale, the Athens Insomnia Scale, the Impact of Event Scale - Revised, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder, the Perceived Stress Scale, and a questionnaire of our own authorship.

The study showed that 72.95% of the subjects experienced severe stress, and 40.58% sufferred from insomnia. In addition, 65.7% of the respondents had anxiety symptoms of varying degrees of severity, and 62.8% had depressive symptoms of mild to severe severity. The mean score on the IES-R scale, reflecting a psychological impact of the COVID-19 pandemic, was 34.25 points.

Table 1. Influence of insomnia by AIS, anxiety by GAD-7, stress by PSS-10, World Assumptions Scale on the prevalence of depressive symptoms among nurses according to PHQ-9 (Model 1,2,3)

b - regression coefficient, βstand. - standardized regression coefficient, CI - confidence interval, ref - AIS reference level, Athens Insomnia Scale, GAD-7, generalized anxiety disorder; IES-R, Impact of Event Scale - Revised; PSS-10, The Perceived Stress Scale; WAS, The World Assumptions Scale

The COVID-19 pandemic affected the psychological health of medical staff, particularly through increased stress and anxiety symptoms. Anxiety levels and insomnia significantly affect the prevalence of depression among nurses.

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In this study, the scale’s psychometric properties are estimated among South African high school learners during a period of the coronavirus-19 crisis. The study was a cross-sectional design. The data were collected from 1603 high school learners in four South African districts. The PHQ-4 was administered for data collection, and was anchored from 0 (not at all) to 3 (nearly every day) over a two-week period, with higher scores indicating the extent of symptom severity (Kroenke et al., 2009).

The study sought to validate the PHQ-4 among South African school learners in various South African districts, and tested a model that included the PHQ-4 to investigate the obtaned factor structure’s usefulness.

Useful questionnaires were collected from 1562 high school learners within a cross-sectional design. Grades 10 to 12 learners completed the PHQ-4 from March to May 2022.

Confirmatory Factor Analysis (CFA) was conducted to validate the factor structure of the scale. CFA results show that all PHQ-4 items load onto a single factor. The factor structure reported in this study is unique. Whilst the PHQ-4 is commonly considered to measure anxiety and depression, the results suggest that the scale measures a unidimensional, psychological distress factor among the learners. The total score of the PHQ-4, characterized as psychological distress, could be predicated by associated factors, although the coefficients obtained were statistically significant but weak. The PHQ-4 was predicted by the Perceived Vulnerability and the Germ Aversion subscales but not the Fear of COVID-19 scale in girls. But the PHQ-4 was predicted by the Fear of COVID-19 scale and not the Perceived Vulnerability and the Germ Aversion subscales among boys.

Contrary to existing studies, the PHQ-4 did not consist of 2 factors. Evidence from the current study suggests that it should be used as a unidimensional, single factor scale. The PHQ-4 total scores of girls and boys were predicted by different factors, suggesting that gender should be considered an important factor when using the PHQ-4 in reseaerch.

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The psychopathological consequences of the complex impact of the coronavirus disease COVID-19 become the basis for the deterioration of the mental state of persons with a history of mental disturbances.

To investigate the impact of the clinical and psychopathological consequences of COVID-19 on the course of mental disorders in patients with a history of mental disturbances.

95 patients with a history of mental disorders who have experienced COVID-19 were examined and made up the main group (F 32.0-32.2, 33.1, 33.2 – 31 patients, F 06.3, 06.4 – 33 patients, F 41.1, 41.2, 42.2, 45.3, 48.0 – 31 patients). The comparison group included patients with 3 or more episodes of mental disorders in the anamnesis, including the current one. Clinical-psychopathological, clinical-amnestic, psychometric (the Clinical Global Impression Scale (CGI)) and methods of statistical analysis were applied.

A comparison of the course dynamics of current mental disorders after COVID-19 and previous mental disturbances in the anamnesis of the studied patients was carried out according to the indicators of the duration and severity of mental disorders, as well as the duration of the remission that preceded them. The duration of current mental disorders after COVID-19 in the examined patients in most cases ranged from 2 weeks to 6 months (46.32% of persons); duration of remission preceding mental disorders after COVID-19 – from 6 to 12 months (47.37% of persons); the initial degree of severity of psychopathological manifestations according to the CGI-S scale – as “moderate disorder” (36.84% of persons). In comparison with the duration of remission preceding mental disorders in the anamnesis, it was found that in significantly more patients, the duration of remission preceding COVID-19 corresponds to the shortest interval from 6 to 12 months (р < 0.05). When comparing with the severity of mental disorders preceding COVID-19, it was established that a “pronounced disorder” was detected in significantly more patients after COVID-19 (p < 0.05). In comparison with the duration of mental disorders preceding COVID-19, no significantly difference was found, however, when comparing indicators of minimum duration from 2 weeks to 6 months (46.32% of cases with current and 58.18% with previous disorders), the reliability indicator was p = 0.0510.

The obtained data indirectly confirm the complex impact of the SARS-CoV-2 pandemic on the formation and exacerbation of mental disorders, indicate a tendency to increase the severity of mental disorders as a result of the coronavirus disease, and also give reason to put forward a hypothesis about an increase in the duration of mental disorders after COVID-19, which is likely will appear on samples with a larger number of observations.

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The structure of clinical manifestations in patients with a history of mental disturbances who suffered from COVID-19 and were exposed to the stressors of the SARS-CoV-2 pandemic is characterized by the predominance of affective disorders of the anxiety-depressive spectrum.

To investigate the structure of affective disorders of the depressive spectrum after COVID-19 in patients with a history of mental disturbances by nosological groups.

95 patients with a history of mental disorders who have experienced COVID-19 were examined and made up the main group (F 32.0-32.2, 33.1, 33.2 – 31 patients, F 06.3, 06.4 – 33 patients, F 41.1, 41.2, 42.2, 45.3, 48.0 – 31 patients). During the study, a thorough analysis of the anamnesis of the disease was carried out, including information about the experienced coronavirus disease COVID-19. Clinical-psychopathological, clinical-amnestic, psychometric (the Montgomery-Asberg Depression Rating Scale (MADRS)) and methods of statistical analysis were applied.

According to the results of the psychodiagnostic study, the features of affective disorders of the depressive spectrum of various degrees of severity were established, which had certain differences according to nosological groups. Patients with depressive disorders have depressive disturbances in the form of sleep impairment (4.48 points, p = 0.0001), manifestations of sadness (4.27 points, p ≤ 0.021), internal tension (3.95 points, p = 0.01), difficulties in experiencing feelings (3.87 points, p ≤ 0.019), concentration difficulties (3.85 points, p = 0.031), appetite disturbances (3.11 points, p ≤ 0.012), manifestations of fatigue (3.06 points, p = 0.027), pessimistic (2.78 points, p ≤ 0.026) and suicidal thoughts (1.67 points, p = 0.038). Patients with mental disorders of organic genesis are characterized by depressive disturbances in the form of a feeling of fatigue (4.18 points, p ≤ 0.021), significant concentration difficulties (4.16 points, p = 0.024), sleep deterioration (3.87 points, p = 0.018), feeling and expressing sadness (3.16 points and 3.49 points, respectively), difficulties in experiencing feelings (2.43 points, p = 0.035). Patients with neurotic, stress-related and somatoform disorders are characterized by depressive manifestations in the form of expression of sadness (4.78 points, p = 0.034), feeling of internal tension (3.67 points, p = 0.027), concentration difficulties ((2 .68 ± 0.29) points).

The results of the study of the structure of affective disorders of the depressive spectrum after COVID-19 in patients with a history of mental disturbances should be used as targets for effective therapeutic influence.

None Declared

Stressful events are important causes of numerous psychiatric disorders, including anxiety disorders, depression and other psychiatric disorders.

The COVID-19 pandemic affects individuals and then all segments of society, and has threatened both physical and mental health.

We have noticed increasing number of the new patients seeking psychiatric help in period after COVID - 19 infections.

Also, tremendously increasing number of sick days.

In this case study, we described a 52-year-old female patient. She is a psychologist, an employee in High school in Podgorica working with students. She has achieved 25 years of work experience.She is divorced, has one child. She has never asked for psychiatric help before Sars Covid-19 infection.

She faced first symptoms in terms of bad mood, withdrawal from social contacts, fear, insomnia, problems with attention and concentration. Those symptoms appeared after COVID -19 infections. The patient was hospitalized at the Psychiatry Clinic due to persistent symptoms Admission was due to organic personality changes of the anxious-depressive type, which occasionally reach the level of psychosis. She was absent from the work more than a year.

Case study

During hospitalization, the patient was treated with anxiolytics, antidepressants and small dosses of antipsychotics medicine.

Her general condition improved after month spent in hospital. She received supportive psychotherapeutic support on a daily basis. She participated in occupational therapy.

A CT scan of the endocranium was normal.

The patient still taking prescribed therapy and regularly attends psychiatrics checks - ups.

She went back to a work after two months.

Based on our daily work with patients, we came to the conclusion that sars covid-19 infection has led to a significant increase in mental health symptoms among the population in Montenegro. This problem must not be ignored”You don’t need to fear anything in life, you just need to understand each other.” Now is the time to understand more so that we would fear less” – Marie Currie

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Despite healthcare workers (HCWs) facing mental health challenges during COVID-19, their use of psychological support is limited. Understanding these dynamics is crucial for identifying mental health needs and vulnerable groups within Spanish healthcare services.

This study analyzes psychological support use among Spanish HCWs post-pandemic onset over 2 years, and its link to workplace and COVID-19 factors from 2020 data.

Longitudinal research involved Spanish HCWs. Data from online surveys covered demographics (age and gender), depressive symptoms (PHQ-9), workplace-and COVID-19-related factors (type of job, direct exposure to COVID-19 patients, adequate access to personal protective equipment, social stigma for working with COVID-19 patients, decision making on patient prioritization, and perceived social network support at work), and psychological support use across 2020, 2021, and 2022. We received responses from 296, 294, and 251 participants at time points 1, 2, and 3, respectively.

Predominantly female participants (n=242, 82%) and with a median age of 43 years. Psychological support seeking increased from 15% in 2020 to 23% in 2022. Notably, one in four HCWs not seeking help showed major depressive disorder symptoms. Predictors for seeking support included patient prioritization decision-making (OR 5.59, 95% CI 2.47-12.63) and probable depression (wave 2: OR 1.12, 95% CI 1.06-1.19; wave 3: OR 1.10, 95% CI 1.04-1.16). Table 1 shows the association between workplace- and COVID-19-related variables at baseline and use of psychological support at follow-up.

A significant portion of HCWs may seek psychological support post-pandemic, regardless of prior workplace or COVID-19 stressors. Targeted mental health initiatives are crucial, emphasizing health promotion, primary prevention, and support for individuals, including those with depressive symptoms.

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The COVID-19 pandemic has placed immense psychological pressure on healthcare workers (HCWs) worldwide. In addition to the physical risks of infection, HCWs have faced high levels of anxiety due to their proximity to the virus, overwork, and the challenges of providing care in an ever-evolving environment. These psychological effects are expected to persist well beyond the initial phase of the pandemic.

This study explores the long-term impact of COVID-19 on both anxiety and depression among HCWs and identifies the main contributing factors.

This cross-sectional study was conducted among HCWs infected with SARS Cov-2 between January and August 2022. Sociodemographic and professional data were extracted from participants’ medical records. Anxiety and depression were evaluated using the GAD-7 (Generalized Anxiety Disorder) and PHQ-9 (Patient Health Questionnaire) scales, respectively, through phone interviews conducted at least one year after their last COVID-19 infection

This study included a total of 184 healthcare workers (HCWs). The mean age of the participants was 41.93 years (± 8.6), with 95.1% being over 30 years old. Women comprised 81.4% of the cohort, and the majority of participants were nurses (45.7%), followed by administrative staff (20.1%). The median occupational seniority was 16 years. Notably, 28.3% of HCWs were employed in COVID-19 wards. Anxiety symptoms were reported by 92.9% of participants, with 17.3% experiencing mild anxiety, and 38.5% severe anxiety. Depression was prevalent in 69.1% of HCWs, with 27.2% presenting mild symptoms, and 24.5% experiencing moderate to severe depression. Female HCWs and those aged over 40 were significantly more likely to report symptoms of anxiety and depression (p < 0.001). Furthermore, HCWs with pre-existing conditions, such as diabetes, as well as those directly exposed to COVID-19 patients, exhibited significantly higher anxiety and depression scores. Nurses demonstrated particularly elevated levels of psychological distress, especially those working in COVID-19 wards.

The COVID-19 pandemic has had a profound and lasting psychological impact on healthcare workers, with anxiety and depression levels remaining elevated long after the acute phase of the crisis. This study emphasizes the need for targeted psychological support interventions. Addressing the mental health needs of HCWs is crucial not only for their well-being but also for ensuring the ongoing efficacy and resilience of the healthcare workforce in times of crisis. Further research is warranted to explore long-term impacts and effective strategies for mental health support in this population.

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Healthcare providers are at a high risk of occupational stress, psychological distress, and mental health problems due to unique job demands. The unprecedented negative impact of the COVID-19 pandemic on healthcare further intensified the risk.

To find out the prevalence of anxiety, depression, and post-traumatic stress disorder (PTSD) in healthcare providers during the COVID-19 pandemic, and explore various associated factors.

We conducted a cross-sectional survey among clinicians across tertiary care hospitals in Lahore, Pakistan through online forms/ paper-based questionnaires, using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) Scale, and The Impact of Events Scale-Revised (IES-R) from July-November 2021. Physicians aged 20-60 years working at the public-sector hospitals of Lahore were included through non-probability convenient sampling. The non-parametric Mann-Whitney U, Kruskal-Wallis, and Chi-square test of independence were applied for inferential data analysis in SPSS version 26 at α=0.05.

Of 302 participants, the majority were males (54.6%), from medicine and allied departments (76.9%), junior staff (72%), and frontline workers (75%). 9.5% had a history of psychiatric illness. The prevalence of depression was 25%, anxiety 31.9%, PTSD 15.8%, severe depression 13.8%, and severe anxiety 7.2%. The total median (IQR) scores of depression, anxiety, and PTSD were 5(2-9.5), 4(0-7), and 10(1-23) respectively. Females and junior staff had comparatively severe symptoms of anxiety and depression. Psychiatric history was linked to severe depression (p=0.003) and PTSD (p=0.001) but not anxiety (p=0.136). There were no statistically significant differences in the anxiety and PTSD severity across genders, departments, and frontline/second-line work.

We found high levels of depression, anxiety, and PTSD in our physician sample even during the 4th COVID-19 wave. This has implications for emphasizing the significance of the mental well-being of healthcare providers and identifying effective interventions to prioritize it even after the pandemic.

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