In 2019, intranasal esketamine gained approval as a promising therapy for those individuals grappling with treatment-resistant depression. Both clinical trials and real-world studies have underscored its efficacy in alleviating and remitting depressive symptoms, with sustained benefits observed for nearly 4.5 years. As the S-enantiomer of ketamine, esketamine’s dosing guidelines and strict medical supervision stem from prior research on ketamine’s use in depression and history as a recreational drug. Despite initial concerns, long-term clinical studies have not documented instances of abuse, misuse, addiction or withdrawal, and the same was found in case reports or subsamples of high-risk populations with comorbidities such as substance use disorder or alcohol use disorder. Esketamine has proven to be safe and well tolerated without fostering new-onset substance use in vulnerable groups. Real-world studies reinforced these observations, reporting no adverse events (AEs) related to pharmacological interactions of esketamine with any other substance, and no new-onset drug or alcohol misuse, craving, misuse or diversion of use. Reports of esketamine craving remain rare, with only one case report documented in 2022. Most drug-related AEs reported in pharmacovigilance databases are those identified in the product’s technical data sheet and with known reported frequency. More importantly, no register of illicit acquisition of esketamine or its tampering for obtaining ketamine or other altered products was found in our search. Overall, our review confirms esketamine’s safety across diverse patient populations, reassuring its responsible use and the scarcity of reports of abuse or misuse since its introduction to the market.

The SARS-CoV-2 health emergency has led to a restructuring of health care systems and the reassignment of medical specialists from their usual duties to attend COVID-19 patients. The aim of this paper is to describe the levels of insomnia, anxiety, depression, and the impact on quality of life of doctors who were on the frontline of COVID-19 during the first two waves of the pandemic. Self-report surveys were conducted on said physicians during both waves, with 83 and 61 responses in the first and second waves, respectively. The reported presence of insomnia was frequent (71.8%), although it decreased in the second survey. Anxiety was moderate, decreasing from 57.1% to 43.1% between measurements. Overall, depression rates decreased between the two surveys. Substance use was found to have an indirect correlation with personal and professional satisfaction. In the light of the unforeseeable evolution of the pandemic and the medium- to long-term repercussions on professionals, we believe the adaptation of health resources is crucial to meet the new unpredictable mental health needs of this group.

Background: Insomnia significantly impairs healthcare worker (HCW) well-being, particularly amid COVID-19 sequelae and shift work demands. We aimed to assess the prevalence of insomnia among HCWs, identify those needing clinical intervention, analyze shift work as a potential risk factor, and explore associations with COVID-19 sequelae and psychiatric comorbidities. Methods: A cross-sectional online survey was administered at the University of Salamanca University Care Complex (CAUSA) from March 2023 to January 2024. Validated scales (Insomnia Severity Index, Patient Health Questionnaire-4, Generalized Anxiety Disorder Scale-2) were used to measure insomnia, depression, and anxiety. Participants scoring ISI ≥ 7 were invited for Occupational Medicine follow-up. Descriptive and inferential analyses were performed. Results: Overall, 1121 HCWs participated (mean age 44.59 ± 11.78, 78.3% women). The mean ISI score was 10.5 ± 5.8 (subclinical insomnia), with 22.7% reporting moderate and 3% reporting severe insomnia. Depression and anxiety affected 28.4% and 33% of respondents, respectively. Shift workers had poorer sleep (mean ISI 11.3 ± 0.9 vs. 8.8 ± 0.3, p < 0.001). Individuals reporting COVID-19 sequelae were 3.1 times more likely to have insomnia than those who did not (mean ISI 13.89 ± 5.9 vs. 10.33 ± 5.7, p < 0.001). Over one-quarter reported at least the monthly use of sleep or psychiatric medications. Conclusions: Insomnia remains prevalent among HCWs, influenced by shift work, COVID-19 sequelae, and mental health factors. Targeted, multidisciplinary interventions, e.g., workplace policy changes, mental health programs, and shift schedule adjustments are urgently needed to safeguard well-being, reduce burnout, and maintain quality patient care. Ensuring adequate sleep is central to minimizing errors and preserving professional performance. Future studies should investigate the impact of coordinated workplace strategies to effectively address insomnia.

In this study, binary logistic regression and linear regression analyses were used to examine the relationship between interoceptive body awareness and suicidal orientation among Colombian university students. Additionally, the bootstrap technique was employed to resample and estimate the distribution of the data. The results support the idea that greater interoceptive awareness may protect against suicidal orientation by improving emotional regulation. An inverse relationship was found between interoceptive awareness and suicidal ideation. These findings align with previous literature emphasizing the importance of body awareness for emotional well-being. Further longitudinal research is needed to explore this relationship more deeply.

Background: Patients with schizophrenia die decades earlier than the general population. Among the factors involved in this mortality gap, evidence suggests a telomere length shortening in this clinical population, which is associated with premature ageing. Recent studies support the use of strength-based training exercise programmes to maintain, or even elongate, telomere length in healthy elderly populations. However, studies aiming at modifying telomere length in severe mental illnesses, such as schizophrenia, are still very scarce. Aims: To investigate the effect of a strength-based physical exercise programme on the telomere length of individuals with schizophrenia. Method: We propose a pragmatic, randomised controlled trial including 40 patients aged ≥18 years, with a stable diagnosis of schizophrenia, attending the Complejo de Rehabilitación Psicosocial (CRPS, Psychosocial Rehabilitation Centre) in Salamanca, Spain. These patients will be randomly assigned (1:1) to either receive the usual treatment and rehabilitation programmes offered by CRPS (treatment-as-usual group) or these plus twice weekly sessions of an evidence-based, strength-based training exercise programme for 12 weeks (intervention group). The primary outcome will be effect on telomere length. Secondary outcomes will include impact on cognitive function, frailty and quality of life. Results: We expect to show the importance of implementing strength-based physical exercise programmes for patients with schizophrenia. We could find that such programmes induce biological and genetic changes that may lengthen life expectancy and decrease physical fragility. Conclusions: We anticipate that our trial findings could contribute to parity of esteem for mental health, reducing premature ageing in patients with severe mental illnesses, such as schizophrenia.

Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, associated factors, and their relationship with mental health issues following the COVID-19 pandemic. Methods: An anonymous online survey was conducted among healthcare workers at the Salamanca University Healthcare Complex (CAUSA) from March 2023 to January 2024. Of 1121 participants, 685 provided complete responses, which were analysed. Insomnia, anxiety, and depression were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-4 (PHQ-4). Results: Of the respondents, 23.8% reported using sleep medication, with 27.8% doing so without a prescription. Additionally, 14.7% used medication for depression or anxiety, with only 0.6% without a prescription. Hypnotic medicine use was associated with older age, insomnia, anxiety, depression, psychological or psychiatric treatment, COVID-19 after-effects, and diagnosed sleep disorders. Night-shift work was associated with increased hypnotic medication use in men but not in women. The use of these medications was linked to a reduced quality of life and impaired work performance. Conclusions: The use of BZD and self-medication are prevalent among healthcare professionals, exceeding the rates observed in the general population. These findings highlight the urgent need for targeted interventions to address psychotropic medication use, promote other pharmacological and non-pharmacological alternatives for insomnia, and enhance mental health support for this vulnerable population.