Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

Impact of COVID-19 pandemic on mental health in the general population: A systematic review.

Background
During the COVID-19 pandemic general medical complications have received the most attention, whereas only few studies address the potential direct effect on mental health of SARS-CoV-2 and the neurotropic potential. Furthermore, the indirect effects of the pandemic on general mental health are of increasing concern, particularly since the SARS-CoV-1 epidemic (2002–2003) was associated with psychiatric complications.

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COVID-19 pandemic and mental health consequences: Systematic review of the current evidence.

The coronavirus disease 2019 (COVID-19) pandemic has caused enormous psychological impact worldwide. We conducted a systematic review and meta-analysis on the psychological and mental impact of COVID-19 among healthcare workers, the general population, and patients with higher COVID-19 risk published between 1 Nov 2019 to 25 May 2020. We conducted literature research using Embase, PubMed, Google scholar and WHO COVID-19 databases. Among the initial search of 9207 studies, 62 studies with 162,639 participants from 17 countries were included in the review. The pooled prevalence of anxiety and depression was 33% (95% confidence interval: 28%-38%) and 28% (23%-32%), respectively. The prevalence of anxiety and depression was the highest among patients with pre-existing conditions and COVID-19 infection (56% [39%-73%] and 55% [48%-62%]), and it was similar between healthcare workers and the general public. Studies from China, Italy, Turkey, Spain and Iran reported higher-than-pooled prevalence among healthcare workers and the general public. Common risk factors included being women, being nurses, having lower socioeconomic status, having high risks of contracting COVID-19, and social isolation. Protective factors included having sufficient medical resources, up-to-date and accurate information, and taking precautionary measures. In conclusion, psychological interventions targeting high-risk populations with heavy psychological distress are in urgent need.

The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis.

Expanding the Boundaries of Cognitive Therapy Cognitive Therapy for Personality Disorders: A Schema-Focused Approach Young, Jeffrey E. Sarasota, FL: Professional Resource Exchange, Inc., 1990. (79 pp.) $11.70 (paperback). The author's primary aim for this book is to show how cognitive therapy can be adapted and expanded to address the unique challenges presented by clients with personality disorders. In the first section, a rationale for such an adaptation and expansion is provided. Young outlines seven basic assumptions associated with cognitive therapy and shows how many of these assumptions are violated when treating clients with personality disorders. More specifically, he points out that the high degree of rigidity, avoidance, and long-term interpersonal difficulties characteristic of this clinical population are significant obstacles to successful treatment when using the "short-term cognitive therapy" approaches pioneered by Beck and others. Young contends that more effective treatments require an expanded cognitive theory-one which can account for the salient themes and patterns exhibited by clients with personality disorders. The second section of the book is devoted to an outline of the conceptual underpinnings of Young's proposed expansion. Drawing upon schema theory in cognitive psychology, Young contends that any complete understanding of personality disorders must go beyond the three levels of cognitive phenomena identified with short-term cognitive therapy (automatic thoughts, cognitive distortions, and underlying assumptions) and include a focus on the "deepest level of cognition"-what he terms the Early Maladaptive Schema (EMS). According to Young, EMSs are "extremely stable and enduring themes that develop during childhood and are elaborated upon throughout an individual's lifetime. These schemas serve as templates for the processing of later experience." (p. 9) In brief relief, through the EMS construct Young presents a case for the developmental etiology of personality disorders. EMSs are characterized as unconditional and self-perpetuating beliefs about oneself and the world that are presumed to be the consequence of dysfunctional childhood experiences with parents. Young suggests that EMSs are typically activated by current environmental events related to the schema and are often associated with a high level of emotional arousal. In his most recent revised list of specific schemas (found in Appendix B of the book), Young identifies 16 distinctEMSs that are grouped into five categories (Impaired Autonomy, Disconnection, Undesirability, Restricted Self-Expression, and Insufficient Limits). A thorough understanding of the themes and issues associated with these "core" schemas is fundamental to the practice of schema-focused therapy. In the final and perhaps most significant section of the book, Young details the assessment and intervention aspects of his schema-focused model. Because the primary goal of assessment is to determine the predominant EMSs of the client, Young outlines an eight-step evaluation procedure and guides the reader through each step by way of a case example. EMS assessment is multifaceted and includes the use of questionnaire data (Lazarus' Multimodal Life History Questionnaire and Young's own Schema Questionnaire); procedures for "triggering" schemas both within and outside of sessions; ways of educating the client about schemas; techniques for identifying schema maintenance, avoidance, and compensation behaviors; and a methodology for distinguishing among primary, secondary, and associated schemas. Young presents a wealth of applied information at this juncture and does an excellent job of bringing the material to life through the case illustration and accompanying summary tables and appendices. Particularly noteworthy is the "Client's Guide to Schema-Focused Therapy" (Appendix D) which is designed to be used as a handout for orienting clients to the schemafocused approach. …

Cognitive Therapy for Personality Disorders: A Schema-Focused Approach

Background:The COVID-19 pandemic is having negative effects on societies’ mental health. Both the pandemic and the measures taken to combat it can affect individuals’ mental health.Aims:The purpose...

https://journals.sagepub.com/doi/pdf/10.1177/0020764020927051

Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender.

Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and monocyte-lymphocyte ratio (MLR) have recently been used as indicators of inflammation. Higher MLR and PLR values have been determined in the euthymic and manic periods in patients with bipolar disorder compared to a control group. High NLR values were determined in the only study investigating this ratio in schizophrenia patients. The purpose of this study was to compare NLR, PLR and MLR values and complete blood count elements in patients receiving treatment and hospitalized due to schizophrenic psychotic episode and bipolar disorder manic episode. All patients meeting the inclusion criteria among subjects receiving treatment and hospitalized due to schizophrenia-psychotic episode and bipolar affective disorder-manic episode at the Ondokuz Mayis University Medical Faculty Psychiatry Department, Turkey, in 2012-2016 were included in our study. A total of 157 healthy donors were included as a control group. White blood cell (WBC), neutrophil, lymphocyte, platelet and monocyte numbers were noted retrospectively from complete blood counts at time of admission, and NLR, PLR and MLR were calculated from these. NLR, PLR and MLR values and platelet numbers in this study were higher and lymphocyte numbers were lower in bipolar disorder patients compared to the controls. Elevation in NLR, MLR and PLR values and neutrophil numbers and lower lymphocyte numbers were determined in schizophrenia patients compared to the controls. Higher NLR and MLR values were found in schizophrenia patients compared to bipolar disorder. Findings of our study supported the inflammation hypothesis for schizophrenia and bipolar disorder.

A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review.

The inflammation hypothesis is frequently mentioned in the pathogenesis of schizophrenia. The objective of this study was to compare inflammation markers during relapse and remission periods in patients with schizophrenia. Complete blood count (CBC) of 105 patients diagnosed with schizophrenia who were hospitalized due to psychotic relapse at Ondokuz Mayis University Medical Faculty Psychiatry Service between 2012 and 2016 and 105 healthy control subjects were retrospectively analyzed. Relapse CBC was also compared with remission CBC of the same patients and with the control group. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) of the patients during relapse period were found to be significantly higher when compared with the control group. MLR and PLR were found to be significantly higher in the remission period when compared with the control group. NLR, PLR and MLR values were significantly increased in the relapse period when compared with the remission period of the same patients. The findings of our study support the inflammation hypothesis of schizophrenia. As a result of our study, we believe MLR and PLR are important markers. There is a decrease in inflammatory response in schizophrenia following treatment.

Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in different stages of schizophrenia

Evaluation of Depression and Anxiety Levels and Related Factors Among Operating Theater Workers During the Novel Coronavirus (COVID-19) Pandemic.

The number of studies investigating inflammatory biomarkers in bipolar disorder has increased significantly in recent years. The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (...

Selçuk Özdin

Papers

Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender.

A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review.

Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in different stages of schizophrenia

Evaluation of Depression and Anxiety Levels and Related Factors Among Operating Theater Workers During the Novel Coronavirus (COVID-19) Pandemic.

A comparison of inflammatory markers in manic and euthymic states of bipolar disorder.