Marcelo Pio de Almeida Fleck

Background: The SARS-CoV-2 pandemic was a major stressful event that significantly affected healthcare providers. Objective: To evaluate the efficacy of a single-session intervention (SSI), with and without weekly personalised prerecorded videos, in preventing emotional distress worsening. Methods: Nationwide randomised clinical trial conducted in Brazil from 19 May 2020 to 31 December 2021. We included healthcare professionals with anxiety, depression or irritability scores below a T-score of 70, measured by the Patient-Reported Outcomes Measurement Information System. Participants were randomised to SSI or SSI plus weekly personalised prerecorded videos for 4 weeks (SSI-ET). The primary outcome was the proportion of participants with a significant escalation of symptoms (ie, T-score above 70). Findings: From 3328 assessed for eligibility, 1112 participants were randomised (SSI=549; SSI-ET=563). The cumulative proportion of incident cases at 6 months was 17.5% (95% CI: 13.1% to 21.6%) for SSI and 15% (95% CI: 10.9% to 18.8%) for SSI-ET, with no difference between groups (HR=0.81, 95% CI: 0.83 to 1.79). Both groups showed significant symptom reductions at 1 month follow-up, maintained at 3 and 6 months (Cohen’s d=0.68–1.08). Conclusions: Adding asynchronous videos to SSI provided no additional benefit. While symptom improvements occurred over time, the lack of a control group limits conclusions about intervention efficacy. Clinical implications: Given its simplicity and scalability, the synchronous component, which includes core mental health support elements, such as active listening, validation, and empathic care, may represent a feasible way to assist healthcare professionals in crisis settings, even though further research is needed to determine its specific impact. Trial registration number: NCT04632082 .

The Brazilian Journal of Psychiatry is the official publication of Brazilian Psychiatric Association (Associação Brasileira de Psiquiatria - ABP)

BACKGROUND Single session intervention (SSI) have been shown to be an effective strategy for reducing emotional distress. Enhanced psychoeducation (EP), which includes empathic listening, risk stratification, symptom monitoring, and habit modification, is particularly suitable for SSIs. OBJECTIVE This study aimed to investigate the predictors of responses to an online EP intervention among professionals from essential services during the COVID19 in Brazil with the aim of reducing emotional distress. METHODS This study analyzed data from the TELEPSI Project from April 2020 to December 2021. We included all participants who received SSIs with high levels of emotional distress (T-scores above 70 on the PROMIS for anxiety, depression, or irritability). RESULTS The final sample consisted of 460 subjects, 89.1% female and 81.1% health professionals, of which 300 subjects underwent reassessment in one month (65% retention). Participants with harmful use of social networks, spending time on social media, playing video games, smoking, drinking alcohol, using drugs, and spending time with pets showed a less pronounced decrease in symptoms. In contrast, participants who played instruments or had already received psychological treatment showed a greater magnitude of decrease in symptoms. CONCLUSIONS This study highlights the impact of lifestyle factors on SSI efficacy. These results underscore the importance of considering individual lifestyle factors when implementing SSIs, and contribute to a growing body of evidence supporting the tailored application of psychoeducational strategies in mental health interventions, particularly in high-stress environments.

The Brazilian Journal of Psychiatry is the official publication of Brazilian Psychiatric Association (Associação Brasileira de Psiquiatria - ABP)

OBJECTIVE To show the implementation process of IPT-G in primary care, including facilitating and obstructing factors, implementation strategies, and training and supervision of primary care professionals. METHODS Quantitative (cross-sectional and longitudinal) analysis of pre and post-knowledge tests; qualitative analyses of the training courses; patient recruitment; conduction of IPT-G sessions; supervision of IPT-G therapists; application of a semi-structured questionnaire to assess, investigate, and develop strategies against the identified barriers. RESULTS About 120 clinicians answered the pre-test; 84 completed the post-test. Pre- and post-test scores of IPT-G knowledge were significantly different. Twenty initially trained clinicians completed additional supervision in IPT-G. Qualitative analysis identified twelve barriers and six facilitators to IPT-G implementation in individual, organizational, and systemic contexts. CONCLUSIONS Implementation of IPT-G in primary care is a complex process with several steps. In the first step, health professionals were successfully trained in IPT-G. However, subsequent steps were more complex. Therefore, careful planning of IPT-G implementation is essential to maximize the success of this innovation.

National Health Service use the Community Mental Health Service User Questionnaire (NHS-CMH) to assess care quality. However, its reliability and internal validity is uncertain.To test the NHS-CMH ...

Per Bech was Professor of Clinical Psychiatry and Head of the Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Denmark. Working initially in psychometrics, and subsequently in clinimetrics, for more than four decades he was undoubtedly one of the most influential scientists in the field.