Human disasters come in all shapes and sizes including wars, terrorist violence, natural events, economic recessions and depressions as well as infection. As a species more fragile than we often allow, humans would be expected to adversely react to these types of disasters in terms of mental ill health and possibly suicidal behaviour leading to increased demands on the Mental Health services. This narrative historical paper examines relevant studies into how previous disasters affected mental health and suicidal behaviour. The characteristics of what is known of the current Covid-19 disease are analysed and compared to other types of disasters with a view to gaining some insight into what we might expect. Of all the types of disasters, economic recession appears most toxic. Mitigating the worst effects of recession appears to be protective. Particularly vulnerable groups are identified in whom we might expect an increase in suicidal behaviour.
A 58-year-old man presented to the emergency department with recent-onset palpitations and progressive exertional dyspnoea. ECG demonstrated new-onset atrial fibrillation. Transthoracic echocardiogram showed global impairment in left ventricular systolic function with left ventricular ejection fraction of 20%. Cardiac MRI (CMRI) demonstrated generalised severe myocarditis. A SARS-CoV-2 PCR was positive for SARS-CoV-2 RNA. As such, we diagnosed our patient with COVID-19-associated myocarditis based on CMRI appearances and positive SARS-CoV-2 swab. This case highlights that COVID-19-associated myocarditis can present as new atrial fibrillation and heart failure without the classic COVID-19-associated symptoms.
Activity of security personnel in psychiatric hospitals may not be role appropriate, compliant with legislation or conducive to treatment. Best practice guidelines should be developed in consultation with multiple stakeholders.
(2015). Quality of life and functioning one year after experiencing accumulated coercive events during psychiatric admission. Psychiatric Services, 66, 883-7.
Corresponding AuthorStephen Shannon stshanno@gmail.com
Abstract ObjectivesTo determine: the number of accumulated coercive events during admission and associations, functioning and quality of life one year after discharge and associations and whether accumulated coercive events were related to these outcomes.
MethodsA prospective cohort study at three community services and an independent hospital was undertaken in Ireland. The accumulated coercive events score was based on legal status, perceived coercion and episodes of physical restraint, seclusion or forced medication.
Results
110(68%) of all 162 participants experienced at least one coercive event. Lower functioning predicted more coercive events. One year after discharge, subjective quality of life was 63% of the highest possible score, objective quality of life improved for 15% and functioning improved for 70% of individuals. Accumulated coercive events did not predict these outcomes.
ConclusionsCoercive events are common during psychiatric admission and appear unrelated to functioning and quality of life one year after discharge.
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