Psychiatric Services and Teaching during the Covid-19 Pandemic in Romania

Abstract

The Covid-19 pandemic has been declared in Romania on the 16th March 2020.The medical system reacted promptly: chronic patients had to be discharged within 48 h and further scheduled admittances were postponed, adequate epidemiological measures and circuits were organized. Anxiety, insomnia, frustration, binge eating, domestic violence were reported. The majority respected the general advises but soon, persons selected their information sources rather from social media, being victims of the infodemia and peculiar conspirationist theories. A new disorder has been described: coronaphobia. The psychiatric hospitals and outpatient settings had to reduce or innactivate their activity, switch as much as possible to TelePsychiatry. Psychiatry admittances were: onsets of psychosis, relapses of schizophrenia and alcohol, other psychoactive substances abuses, intoxications, and withdrawal states. Later, there were depressions, bipolar disorders, suicide attempts, self-harm in borderline disorder, dementia and delirium. Due to the closure of outpatient units for several months, patients visited the Emergency rooms. Personnel experienced burnout and new psychiatric pathology developed in the aftermath of Covid-19 infection. A big relief occurred with the initial vaccination of the medical staff and seniors, chronically ill persons, psychiatric patients being again left behind. Medical teaching shifted entirely to online and in 2021 the hybrid teaching system has been employed.

COVID-19-Related Disruptions Are an Opportunity for Reflection on the Role of Research Training in Psychiatric Residency Programs

“…Pandemic-related disruptions posed significant barriers to trainees' (both medical students' and residents') acquisition of knowledge, skills, and professional development support in the rapidly changing research and clinical training environment [5][6][7]. Reduced opportunities to strengthen clinical skills contributed to deficits in developing rapport with patients, performing mental status examinations, conducting diagnostic interviews, and other clinical skills that are difficult to develop solely through self-study and peerlearning.…”

“…A national survey of residents in US psychiatry programs in April 2020 found a wide range of concerns; the most prominent were mental health of fellow residents and infection risk for families [13]. Reports from other countries show that similar strains on residency programs are a global phenomenon [5,14,15]. As the pandemic has continued, the vulnerabilities of research training have emerged in an environment of unrelenting clinical demand, especially when clinicians themselves are directly affected by public health threats.…”