Background and aims
Long COVID is the collective term to denote persistence of symptoms in those who have recovered from SARS-CoV-2 infection.
Methods
WE searched the pubmed and scopus databases for original articles and reviews. Based on the search result, in this review article we are analyzing various aspects of Long COVID.
Results
Fatigue, cough, chest tightness, breathlessness, palpitations, myalgia and difficulty to focus are symptoms reported in long COVID. It could be related to organ damage, post viral syndrome, post-critical care syndrome and others. Clinical evaluation should focus on identifying the pathophysiology, followed by appropriate remedial measures. In people with symptoms suggestive of long COVID but without known history of previous SARS-CoV-2 infection, serology may help confirm the diagnosis.
Conclusions
This review will helps the clinicians to manage various aspects of Long COVID.
Four research diagnostic schemes are compared in one community sample. The prevalence of psychiatric disorder ranged from 8.7 per cent (ID-Catego, threshold and definite) through 13.7 per cent (RDC, probable and definite) to 20.3 per cent (Bedford, borderline and definite). The main comparison made is between the PSE/ID/Catego and SADS/RDC systems. Sixty-one per cent of cases are identified as such by both these schemes. There is poor agreement about labelling; only 56 per cent of cases of depression and 16.7 per cent of cases of anxiety are so diagnosed by both systems. A post hoc check list was used to identify Bedford cases; all bar one were found to fulfil RDC and PSE case criteria. The results are compared with those from other centres which have used the same diagnostic criteria in community studies.
AimsTo examine the extent and nature of coercive practices in mental healthcare and to consider the ethical, human rights challenges facing the current clinical practices in this area. We consider the epidemiology of coercion in mental health and appraise the efficacy of attempts to reduce coercion and make specific recommendations for making mental healthcare less coercive and more consensual.MethodsWe identified references through searches of MEDLINE, EMBASE, PsycINFO and CINAHL Plus. Search was limited to articles published from January 1980 to May 2018. Searches were carried out using the terms mental health (admission or detain* or detention or coercion) and treatment (forcible or involuntary or seclusion or restraint). Articles published during this period were further identified through searches in the authors' personal files and Google Scholar. Articles resulting from searches and relevant references cited in those articles were reviewed. Articles and reviews of non-psychiatric population, children under 16 years, and those pertaining exclusively to people with dementia were excluded.ResultsCoercion in its various guises is embedded in mental healthcare. There is very little research in this area and the absence of systematic and routinely collected data is a major barrier to research as well as understanding the nature of coercion and attempts to address this problem. Examples of good practice in this area are limited and there is hardly any evidence pertaining to the generalisability or sustainability of individual programmes. Based on the review, we make specific recommendations to reduce coercive care. Our contention is that this will require more than legislative tinkering and will necessitate a fundamental change in the culture of psychiatry. In particular, we must ensure that clinical practice never compromises people's human rights. It is ethically, clinically and legally necessary to address the problem of coercion and make mental healthcare more consensual.ConclusionAll forms of coercive practices are inconsistent with human rights-based mental healthcare. This is global challenge that requires urgent action.
The implications of these findings are discussed. The potential of early intervention programmes and home treatment services to address the ethnic differentials identified in this study merit consideration.
The prevalence of psychiatric disorder was determined according to alternative diagnostic criteria in a random sample of 576 women from an Edinburgh community. Whichever diagnostic system was applied, significantly higher rates of disorder were found among the working class, the unemployed and women who were divorced, widowed, separated or cohabiting; in the subgroup of women who met all these conditions, up to half were found to satisfy the diagnostic criteria. The observed prevalence estimates can be explained as the effects of each demographic factor acting independently, no interaction effects being needed. Our results are discussed in relation to the findings of others, and in terms of the statistical issues involved.
One hypothesis concerning the nature of the link between negative self-appraisal and certain psychological disorders is that low self-esteem may be a consequence of both early and current experiences, and may predispose to breakdown. An alternative view is that the negative self-concept is only to be found in the presence of illness, which is the primary cause. Results are reported from a community survey, confirming the influence of certain biographical factors on self-esteem in the absence of illness, whereas other factors appear to operate only after the onset of illness. Anxiety as well as depression, has effects on self-esteem.
GP recognition of psychological problems varies according to patient ethnicity but can be substantially masked by both the physical and social circumstances of patients at consultation.
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