Background: The current COVID-19 pandemic is affecting mental health of global population and, particularly, of people suffering from preexisting mental disorders. Aims: This study aims to report on findings from a phone-based clinical follow-up conducted in two large catchment areas in Italy and Paraguay, during the COVID-19 lockdown, in order to provide psychiatric assessments and measure the level of stress related to the quarantine in a large sample of psychiatric outpatients. Methods: A clinical phone-based follow-up has been conducted in two large catchment areas in the province of Chieti (Vasto, Italy) and City of Asunción (Paraguay), during the COVID-19 national lockdown. The following rating scales have been employed: Hamilton Anxiety Rating Scale (HAM-A); Hamilton Depression Rating Scale (HAM-D); 18-items Brief Psychiatric Rating Scale (BPRS-18). The psychological distress related to the outbreak has been assessed employing the Impact of Event Scale – Revised (IES-R). Results: A total of 110 outpatients were consecutively included and followed among those reporting a stable phase of illness before the COVID-19 lockdown. Findings confirmed a significant increase of general psychopathology, anxiety and fear as well as mild levels of stress related to the quarantine. Also, significant weight gain during the lockdown was detected among patients. Conclusions: This study confirmed the impact of COVID-19 lockdown on mental health of people suffering from psychiatric disorders and may also add evidence on the employment of digital psychiatry in the current pandemic.

Purpose: Treatment-resistant depression (TRD) is a common phenomenon and a considerable clinical challenge; recently, esketamine in conjunction with an oral antidepressant (AD) has emerged as a potential treatment for TRD. Several studies have shown the efficacy of esketamine in improving depressive symptoms. This prospective study aims to explore the long-term effects of esketamine therapy on subjective quality of life (QoL) and general status of adults with TRD. Methods: The study was an observational, prospective and multicenter study comprising a total of 18 TRD patients treated with Esketamine-Nasal Spray ESK-NS. Anamnestic data and psychometric assessments were collected at baseline (T0) and at follow-ups at 1 month (T1), 3 months (T2), and 6 months (T3). Results: Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF), Sheehan Disability Scale (SDS), and Personal and Social Performance Scale (PSP) showed a statistically significant amelioration in QoL and functioning for all 3 scales, with progressive improvements at 1, 3, and 6 months. Montgomery-Asberg Depression Rating Scale (MADRS) scores decreased from a baseline score of 39.2 to 28.7 on T1, 20.9 on T2, and 15.9 on T3, respectively. Correlation analyses showed statistical significance between changes at 6 months between MADRS and QLES and between MADRS and SDS, but not between MADRS and PSP. Conclusions: Significant improvement in QoL was observed among patients with TRD treated with ESK-NS; ESK-NS in combination with an oral AD appears to offer meaningful benefit as a treatment option for patients with TRD who generally have substantial QoL and functioning limitations as a result of their depressive illness