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Medicina
Special Issues
Mental Health Care: Pandemic and Beyond
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Mental Health Care: Pandemic and Beyond

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Psychiatry".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 8095

Special Issue Editor

Dr. Soumitra Das

E-Mail Website
Guest Editor
1. Emergency Mental Health, Sunshine Hospital, Western Health, Melbourne, Australia
2. Tutor for Master of Psychiatry Program, Department of Psychiatry, University of Melbourne, Melbourne, Australia
Interests: emergency psychiatry; youth mental health; developmental psychiatry; social psychiatry

Special Issue Information

Dear Colleagues,

In light of the significant challenges and transformations observed in the delivery of mental health services during the recent global pandemic, this Special Issue seeks to delve deep into the innovations, adaptations, and resilience of mental health service providers and systems. The aim is not just to document the changes during the pandemic but to draw valuable lessons and insights from them that can shape the future of emergency mental health service delivery.

We believe that your expertise and insights in this field would greatly benefit our readers and contribute significantly to this body of knowledge.

Key topics include (but are not limited to) the following:

  • Innovations in mental health delivery during the pandemic;
  • Challenges and barriers faced by service providers;
  • Studies showcasing adaptability and resilience;
  • Long-term implications and strategies for future preparedness;
  • Studies on the COVID-19 outbreak, preventive measures, etc.;
  • Studies related to leadership and clinical governance;
  • Special sections: youth mental health, neuropsychiatry, etc.

Dr. Soumitra Das
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • emergency mental health
  • pandemic
  • service delivery
  • precautions

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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22 pages, 1269 KiB  
Article
Pre- and Post- COVID-19 Pandemic Pneumonia Rates in Hospitalized Schizophrenia Patients
by Ana-Aliana Miron, Petru Iulian Ifteni, Alexandra-Elena Lungu, Elena-Luiza Dragomirescu, Lorena Dima and Andreea Teodorescu
Medicina 2025, 61(7), 1251; https://doi.org/10.3390/medicina61071251 - 10 Jul 2025
Viewed by 222
Abstract
Background and Objectives: Schizophrenia is a disabling psychiatric condition, affecting around 1% of people worldwide. It has been ranked among the ten most disabling conditions globally. Alongside the psychological and social burdens imposed on individuals suffering from this disease, there are also [...] Read more.
Background and Objectives: Schizophrenia is a disabling psychiatric condition, affecting around 1% of people worldwide. It has been ranked among the ten most disabling conditions globally. Alongside the psychological and social burdens imposed on individuals suffering from this disease, there are also serious complications regarding the physical health of these patients. Pneumonia is a significant cause of death in patients with schizophrenia. This group of patients also has a higher risk of developing pneumonia and all-cause mortality compared to those without schizophrenia, along with an increased overall mortality rate. A retrospective study revealed that advanced age, underweight, smoking, and the use of high-dose atypical antipsychotics increase the risk of pneumonia-related mortality in hospitalized patients. Our study aims to examine differences in factors associated with pneumonia in hospitalized patients with schizophrenia, before and after the COVID-19 pandemic, as well as to identify potential changes in clinical characteristics and outcomes. Materials and Methods: This is an observational, retrospective analysis, based on the review of medical records of psychiatric inpatients diagnosed with schizophrenia according to the DSM-5 criteria. Patients were selected according to the following criteria: both schizophrenia and pneumonia diagnoses, hospitalized in Spitalul Clinic de Psihiatrie si Neurologie Brasov during 1 March 2018–1 March 2020, and 1 March 2022–1 March 2024, respectively. Results: A total of 27 patients met the inclusion criteria; 13 patients (48%) were in the pre-pandemic group and 14 patients (52%) in the post-pandemic group. Contrary to other reports, our results showed relatively low pneumonia rates in hospitalized schizophrenia patients (1.02% pre-pandemic and 1.63% post-pandemic), and rates were higher in female patients (61.54% pre-pandemic and 71.43% post-pandemic). Post-pandemic, most cases (42.86%) were registered during summer, in a schizophrenia population with mostly urban residence and with lower smoking rates than the pre-pandemic group. Physical restraints were, however, more frequently utilized in the post-pandemic group. Conclusions: Pneumonia risk factors might register a change in the post-pandemic years. Polypharmacy and physical restraints are probably underestimated risk factors for pneumonia in schizophrenia patients, while a multidisciplinary approach and preventive measures might exert a protective role. Full article
(This article belongs to the Special Issue Mental Health Care: Pandemic and Beyond)
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14 pages, 846 KiB  
Article
From Anxiety to Hopelessness: Examining Influential Psychological Processes Affecting Mental Health Status of Spanish Nurses During the COVID-19 Pandemic
by Cecilia Peñacoba-Puente, Fernanda Gil-Almagro, Fernando José García-Hedrera and Francisco Javier Carmona-Monge
Medicina 2025, 61(2), 236; https://doi.org/10.3390/medicina61020236 - 28 Jan 2025
Viewed by 1083
Abstract
Background and Objective: to test a model aimed at delving into the psychological processes that lead to hopelessness in Spanish nurses two years after a stressful work situation. The model proposed starts with the anxiety experienced at the beginning of the COVID-19 pandemic [...] Read more.
Background and Objective: to test a model aimed at delving into the psychological processes that lead to hopelessness in Spanish nurses two years after a stressful work situation. The model proposed starts with the anxiety experienced at the beginning of the COVID-19 pandemic and includes cognitive fusion and emotional exhaustion, evaluated six months after the end of the confinement, as possible contributing factors to development of hopelessness. Design: prospective study with three data collection periods, May to June 2020 (period 1), January to April 2021 (period 2), April to July 2022 (period 3). Materials and Methods: The sample (n = 131 Spanish nurses) was selected by non-probabilistic convenience sampling. The inclusion criteria were as follows: being female, over 18 years of age, and working as a nurse in direct contact with COVID-19 patients. Results: The model proposed was statistically significant (B = 0.34, SE = 0.07, t = 5.15, p < 0.001, 95% CI = [0.21, 0.47]), contributing to the explanation of 28% of the variance of hopelessness, finding that the direct anxiety–hopelessness effect was equally significant (B = 0.19, SE = 0.08, t = 2.46, p = 0.014, 95% CI = [0.04, 0.34]). An effect of anxiety on cognitive fusion and on emotional exhaustion was observed. In turn, cognitive fusion had a significant effect on emotional exhaustion but not on hopelessness. Finally, emotional exhaustion had a significant effect on hopelessness. In this final model, years of experience had a significant effect (p = 0.004) on hopelessness. Conclusions: Cognitive fusion and emotional exhaustion are shown to be relevant psychological processes upon which to intervene to contribute to the improvement of the mental health of nurses regarding the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Mental Health Care: Pandemic and Beyond)
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18 pages, 521 KiB  
Article
A Preliminary Investigation into the Use of Cannabis Suppositories and Online Mindful Compassion for Improving Sexual Function Among Women Following Gynaecological Cancer Treatment
by Samantha Banbury, Hannah Tharmalingam, Joanne Lusher, Simon Erridge and Chris Chandler
Medicina 2024, 60(12), 2020; https://doi.org/10.3390/medicina60122020 - 7 Dec 2024
Cited by 2 | Viewed by 2970
Abstract
Background and Objectives: The impact of gynaecological cancer and its treatments on sexual intimacy can be profound on female sexuality. However, very few registered clinical trials have addressed sexual intimacy among this cohort. Materials and Methods: This preliminary randomised control trial (RCT) and [...] Read more.
Background and Objectives: The impact of gynaecological cancer and its treatments on sexual intimacy can be profound on female sexuality. However, very few registered clinical trials have addressed sexual intimacy among this cohort. Materials and Methods: This preliminary randomised control trial (RCT) and content analysis assessed the effectiveness of a brief online mindful compassion group intervention adjunct with cannabis suppositories. Eighty-three participants aged between 18 and 50+ years who were at least six months post-cancer treatment were randomly allocated to one of four groups, depending on whether they were already using cannabis suppositories. These included a cannabis-only group (CO), a mindful-compassion group (MC), a combined mindful-compassion and cannabis suppositories group (COCM) and a care-as-usual group (CAU). Measurements of sexual function, sexual self-efficacy, mindful compassion, well-being and quality of life were taken at weeks 0, 4 and 12. Results: Sexual function, including arousal, lubrication and orgasms, improved for both the MC p = 0.002 and COCM p ≤ 0.001 groups; in addition, sexual pain was reduced in the COCM p = 0.008 and CO p ≤ 0.001 groups compared to the CAU and MC groups, where p ≥ 0.05. Feedback suggested that cannabis mediated the effects of mindful compassion and supported well-being, sexual self-efficacy, and quality of life. Participants also voiced a preference for cannabis suppositories when using dilators as part of their treatment and the use of sex toys instead of dilators, suggesting that dilators had negatively impacted their sexuality. Conclusions: These preliminary and exploratory outcomes look promising and provide a foundation for future research to develop varied healthcare options to improve mental health service delivery and quality of life for this cohort. Full article
(This article belongs to the Special Issue Mental Health Care: Pandemic and Beyond)
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10 pages, 338 KiB  
Article
Psychometric Properties of the Anxiety Measure: Stress and Anxiety to Viral Epidemics-6 (SAVE-6) for Spanish Medical Students
by Aziz Sarhani-Robles, María Guillot-Valdés, Cristina Lendínez-Rodríguez, María Auxiliadora Robles-Bello, David Sánchez-Teruel and Nieves Valencia Naranjo
Medicina 2024, 60(11), 1803; https://doi.org/10.3390/medicina60111803 - 3 Nov 2024
Cited by 1 | Viewed by 1210
Abstract
Backgroud and Objective: The aim of this study was to evaluate the psychometric properties of SAVE-6 in the medical student population and assess its gender invariance. Subjects and Methods: The sample consisted of 320 medical students aged 18–23 years (153 men and 167 women) [...] Read more.
Backgroud and Objective: The aim of this study was to evaluate the psychometric properties of SAVE-6 in the medical student population and assess its gender invariance. Subjects and Methods: The sample consisted of 320 medical students aged 18–23 years (153 men and 167 women) who completed an anonymous online questionnaire. Data collection took place in June 2024. To assess the scale structure, a descriptive analysis of the items was carried out, followed by a confirmatory factor analysis (CFA). To analyze whether there were differences in the invariance of the measure by gender, a multigroup CFA was performed. Results: SAVE-6 showed high internal consistency, α = 0.89 and ω = 0.92, a minimum score of 12, a maximum score of 22, an unifactorial structure, and adequate convergent validity. Specifically, the following were found: the positive and significant relationship with HADS was 0.98 for the full scale, 0.76 for depression, and 0.91 for anxiety, and there was a negative and significant convergent validity with resilience (−0.82) and resilience to suicide attempts (−0.88). Regarding the gender invariance, relevant data is that the factor loadings between each item and the SAVE-6 factor were not the same, so women present a higher level of anxiety than men (Δχ 2 (6) = 42.53). Discussion: The results showed good internal reliability of SAVE-6 and good suitability. Data also revealed that they were not equal in relation to gender. Specifically, the scalar invariance revealed significant differences by items between men and women in anxiety. Conclusions: This scale can be applied to medical students as a reliable and valid instrument to assess the anxiety response to disease contagion in future health professionals. Full article
(This article belongs to the Special Issue Mental Health Care: Pandemic and Beyond)

Other

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28 pages, 3325 KiB  
Systematic Review
Clozapine and Pneumonia: Synthesizing the Link by Reviewing Existing Reports—A Systematic Review and Meta-Analysis
by Victor Zhao, Yiting Gong, Naveen Thomas and Soumitra Das
Medicina 2024, 60(12), 2016; https://doi.org/10.3390/medicina60122016 - 6 Dec 2024
Cited by 1 | Viewed by 1820
Abstract
Background and Objectives: Clozapine is a highly effective antipsychotic used for treating treatment-refractory psychotic and mood disorders. However, clozapine also has a serious risk of side effects leading to mortality, particularly its potentiated risk of leading to pneumonia. This review aims to overview [...] Read more.
Background and Objectives: Clozapine is a highly effective antipsychotic used for treating treatment-refractory psychotic and mood disorders. However, clozapine also has a serious risk of side effects leading to mortality, particularly its potentiated risk of leading to pneumonia. This review aims to overview the demographic and health-related risk factors leading to pneumonia to better inform risk assessment for clozapine users and to summarise current theories on the mechanisms for clozapine-associated pneumonia. This paper will highlight the need to prioritise pneumococcal vaccination in this population group. Materials and Method: We conducted a literary search of five online databases conforming to PRISMA. Our review includes all peer-reviewed papers with original data that discuss clozapine and pneumonia and excludes case reports. Baseline information of participants, pneumonia-related information and information regarding risk factors and mechanisms causing pneumonia were also extracted. Results: Clozapine was found to have an increased risk of pneumonia compared to other antipsychotic medications. Factors included comorbidities, higher clozapine dosages, and concurrent use of other antipsychotic medications. Key mechanisms for clozapine-associated pneumonia include clozapine-induced hyper sedation, sialorrhea and neutropoenia. Conclusions: While clozapine improves overall mortality for patients, our review confirms clozapine has the highest risk of pneumonia of all antipsychotics. The review also highlights the prevalent underuse of pneumococcal vaccines among clozapine users and the urgent need to increase uptake. Full article
(This article belongs to the Special Issue Mental Health Care: Pandemic and Beyond)
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