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The COVID-19 pandemic has created an unprecedented natural experiment in drug policy, treatment delivery, and harm reduction strategies by exposing wide variation in public health infrastructures and social safety nets around the world. Using qualitative data including ethnographic methods, questionnaires, and semi-structured interviews with people who use drugs (PWUD) and Delphi-method with experts from field sites spanning 13 different countries, this paper compares national responses to substance use during the first wave of the COVID-19 pandemic. Field data was collected by the Substance Use x COVID-19 (SU x COVID) Data Collaborative, an international network of social scientists, public health scientists, and community health practitioners convened to identify and contextualise health service delivery models and social protections that influence the health and wellbeing of PWUD during COVID-19. Findings suggest that countries with stronger social welfare systems pre-COVID introduced durable interventions targeting structural drivers of health. Countries with fragmented social service infrastructures implemented temporary initiatives for PWUD led by non-governmental organisations. The paper summarises the most successful early pandemic responses seen across countries and ends by calling for greater systemic investments in social protections for PWUD, diversion away from criminal-legal systems toward health interventions, and integrated harm reduction, treatment and recovery supports for PWUD.

Background: Problematic internet use has been identified in the last decade as a rising problem due to growing availability and impact of Internet use through social media, mobiles, and laptops are now a must in life, adolescents are most vulnerable for the misuse and its impacts. Aim: To assess the prevalence of problematic internet use, Facebook, and gaming addiction among Egyptian adolescents and its impact. Methods: The study assessed 700 adolescents aged from 14 to 18 years, both sexes, using Young internet addiction test, Internet gaming disorder scale, the Bergen Facebook addiction scale, the MINI international neuropsychiatry interview for children and adolescents and the socioeconomic status scale. Results: A total of 584 students continued the study to the end with response rate more than 75%, the mean age was 16.1 = 1.2, 65.6% were having internet addiction, 61.3% were gaming addicts, and 92.8% Facebook addicts. Depression, dysthymia, suicide, social anxiety panic, and phobias were common comorbidities in addicted adolescents. Conclusion: This study shows that a significant percentage of adolescents are having different patterns of problematic internet use which is negatively impacting their mental health. [ABSTRACT FROM AUTHOR]

Background: World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19) as a pandemic in March 2020. Such widespread outbreaks are associated with adverse mental health consequences. Aims: To evaluate mental health outcomes among Egyptian healthcare workers (HCW) treating patients with confirmed or suspected Coronavirus Disease 2019 (COVID-19) to direct the promotion of mental wellbeing, by screening for symptoms of anxiety, insomnia, depression and stress, and analyzing potential risk factors. Methods: This cross-sectional, hospital-based survey study collected demographic data and mental health measurements from 502 HCW dealing with COVID-19. HCW were surveyed in 20 hospitals (Fever, Chest, and Quarantine hospitals) in different parts of Egypt, in April and May 2020. Results: Among the 502 HCW surveyed; 60.0% were physicians, 16.1% were specialized nurses, and 23.9% were non-specialized nurses. About 35.3% worked in chest hospitals, 17.5% in fever hospitals, and 47.2% in quarantine hospitals. A considerable proportion of HCW had symptoms of anxiety, insomnia, depression, and stress. Females were at higher risk of experiencing symptoms of severe anxiety (odds ratio [OR], 1.85; 95% CI, 1.12–3.05; p =.016), severe depression (OR, 2.013; 95% CI, 1.17–3.4; p =.011), and severe stress (OR, 2.68; 95% CI, 1.5–4.6; p <.001). Fever hospital workers were at higher risk of severe depression (OR, 1.52; 95% CI, 1.11–2.09; p <.01), compared to Quarantine hospital workers. Conclusion: Ensuring proper mental health support for HCW is an important component of public health measures for addressing the COVID-19 epidemic and safeguarding the continuity of appropriate medical service. [ABSTRACT FROM AUTHOR]

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Background: Poor adherence to treatment is one of the main challenges to symptom control and preventing recurrence in bipolar disorder (BD). Numerous studies have established an association between patients' poor adherence and an increased risk of recurrence, relapse of the symptoms and admission to hospital. Aim: To study the socio-demographic and clinical factors associated with medication nonadherence in patients with BD who were admitted to the hospital. Setting: The study was conducted at the Institute of Psychiatry, Ain Shams University. Methods: A 1-year longitudinal prospective study of 110 patients, aged 18-60 years, with BD-I. Young Mania Rating Scale, Clinical Global Impression, Global Assessment of Functioning, Sheehan Disability Scale and Insight and Treatment Attitude Questionnaire were applied before and 6 months after discharge. Adherence was measured using the Morisky 8-Item Medication Adherence Scale. Sociodemographic data and level of functioning were studied in relation to adherence. Results: Higher adherence was noticed in female, married and older patients and those with a higher level of education. However, low adherence was more common in male, nonmarried and less educated patients. Follow-up after 6 months revealed that the high adherence group scored the lowest in terms of disability. Meanwhile, the low adherence group scored the highest scores in disability. Conclusion: Several socio-demographic and clinical variables were found to be associated with a low adherence rate to the prescribed medication in patients with BD-I. Age and impaired insight were found to be significant predictive factors for non-adherence. [ABSTRACT FROM AUTHOR]

Objective: To study the effect of a culturally adapted, structured family intervention on symptom severity, medication attitudes and knowledge, social functioning and quality of life in patients with schizophrenia. Methods: Thirty subjects with schizophrenia were selected to receive 14 sessions of a culturally adapted behavioural family psychoeducational programme (BFPEP). Another 30 subjects received standard treatment as usual (STU) for 6 months. Pre- and post-intervention outcomes were assessed using the Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory 10-item scale (DAI-10), Quality of Life Scale (QLS) and Social Functioning Questionnaire (SFQ). Results: There was a no significant difference between BFPEP and STU at baseline on all measures. There was a significant difference (p<.05) between pre- and post-treatment scores for BFPEP on all measures, a significant difference (p<.05) between pre- and post-treatment scores for STU on all measures (favouring pre-treatment scores) and a significant difference (p<.05) favouring BFPEP over STU on all measures post-treatment. Conclusions: These results demonstrate the feasibility and effectiveness of implementing family therapy psychoeducational interventions in different cultural settings, with relatively minor modifications. This may have implications for mental health policy makers to make available such programmes for patients and mental health professionals. [ABSTRACT FROM AUTHOR]