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Markiewicz-Gospodarek A, Górska A, Markiewicz R, Chilimoniuk Z, Czeczelewski M, Baj J, Maciejewski R, Masiak J. The Relationship between Mental Disorders and the COVID-19 Pandemic—Course, Risk Factors, and Potential Consequences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159573. [PMID: 35954930 PMCID: PMC9368061 DOI: 10.3390/ijerph19159573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023]
Abstract
In this review the authors discuss that COVID-19 has already had a direct impact on the physical health of many people and that it appears to have put at risk the mental health of large populations. In this review, we also discuss the relationship between mental disorders and the SARS-CoV-2 infection. We convey the disorders’ risk factors and the more serious mental disorder consequences of COVID-19. People with mental health disorders could be more susceptible to the emotional responses brought on by the COVID-19 epidemic. The COVID-19 pandemic may adversely influence the mental health of patients with already diagnosed mental disorders. For the aim of dealing better with the psychological problems of people afflicted by the COVID-19 pandemic, new psychological procedures are required.
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Affiliation(s)
| | - Aleksandra Górska
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Renata Markiewicz
- Department of Psychiatric Nursing, Medical University of Lublin, 18 Szkolna St., 20-124 Lublin, Poland
| | - Zuzanna Chilimoniuk
- Student Scientific Group, Department of Family Medicine, Medical University of Lublin, 6a (SPSK1) Langiewicza St., 20-032 Lublin, Poland
| | - Marcin Czeczelewski
- Department of Forensic Medicine, Medical University of Lublin, 8b Jaczewskiego St., 20-090 Lublin, Poland
| | - Jacek Baj
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Ryszard Maciejewski
- Department of Human Anatomy, Medical University of Lublin, 4 Jaczewskiego St., 20-090 Lublin, Poland
| | - Jolanta Masiak
- II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, 1 Głuska (SPSK Nr 1) St., 20-059 Lublin, Poland
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2
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Scendoni R, Fedeli P, Cingolani M. The Network of Services for COVID-19 Vaccination in Persons With Mental Disorders: The Italian Social Health System, Its Organization, and Bioethical Issues. Front Public Health 2022; 10:870386. [PMID: 35795707 PMCID: PMC9252269 DOI: 10.3389/fpubh.2022.870386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
The adoption of restrictive measures aimed at curtailing the spread of SARS-CoV2 has had a harmful impact on socio-affective relationships, while limiting the scope of interventions and activities to promote social inclusion, with considerable negative repercussions for patients with mental disorders. Vaccination has been and will continue to be a valid tool to overcome the barriers of social isolation and to protect the health of this category of patients. In this paper we present an overview of the Italian network of social and healthcare services for COVID-19 vaccination among patients with mental disorders. Some aspects of medical ethics are discussed in order to share good practices for improving the health of this vulnerable group of people. We then consider the measures implemented by the health system in Italy to deal with the phenomenon of vaccine hesitancy before addressing the issue of autonomy and restricted access to vaccination points. Finally, we illustrate some of the perspectives already adopted by the Italian system, which may be useful to the global scientific community.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
- *Correspondence: Roberto Scendoni
| | | | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
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Nguyen KH, Chen S, Morris K, Chui K, Allen JD. Mental health symptoms and association with COVID-19 vaccination receipt and intention to vaccinate among adults, United States. Prev Med 2022; 154:106905. [PMID: 34863815 PMCID: PMC8634733 DOI: 10.1016/j.ypmed.2021.106905] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/22/2021] [Accepted: 11/28/2021] [Indexed: 01/05/2023]
Abstract
Early studies suggest that adults with mental health conditions are at greater risk for COVID-19 infection, severe complications, and higher mortality, yet face barriers in accessing timely health services. Data from the Census Bureau's Household Pulse Survey, a large, nationally representative survey fielded from March 17-29, 2021 (n = 77,104) were analyzed to examine COVID-19 vaccination and intention among adults with mental health symptoms. Separate multivariable regression models were conducted to examine associations between symptoms of anxiety, depression, and anxiety or depression on vaccine receipt (≥ 1 dose) and intention to be vaccinated. Reasons for not being vaccinated were also assessed. Approximately 35% of adults had symptoms of anxiety or depression. This population was less likely to receive COVID-19 vaccination (adjusted prevalence ratio (aPR) = 0.94, 95%CI: 0.91-0.98) but more likely to intend to get a vaccine (aPR = 1.13, 95%CI: 1.08-1.19) than those without these conditions. Females with mental health symptoms were less likely to receive a COVID-19 vaccination but more likely to intend to get vaccinated, while there were fewer significant associations between mental health symptoms and vaccination coverage and intentions to vaccinate among males. Reasons for not getting vaccinated, including concerns about possible vaccine side effects, efficacy, cost, dislike of vaccines, as well as lack of trust in the government and vaccines, were all greater among those with any symptoms of anxiety or depressive disorders than those without symptoms. Efforts are needed to increase vaccination uptake and confidence among this vulnerable population by increasing vaccine confidence and addressing concerns about the vaccine.
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Affiliation(s)
- Kimberly H Nguyen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, United States of America.
| | - Stacy Chen
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, United States of America
| | - Kathryn Morris
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, United States of America
| | - Kenneth Chui
- Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA, United States of America
| | - Jennifer D Allen
- Department of Community Health, Tufts University, Medford, MA, United States of America
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Huang H, Zhu XM, Liang PW, Fang ZM, Luo W, Ma YM, Zhong BL, Chiu HFK. COVID-19 Vaccine Uptake, Acceptance, and Hesitancy Among Persons With Mental Disorders During the Second Stage of China's Nationwide Vaccine Rollout. Front Med (Lausanne) 2021; 8:761601. [PMID: 34901076 PMCID: PMC8660117 DOI: 10.3389/fmed.2021.761601] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/21/2021] [Indexed: 01/11/2023] Open
Abstract
Persons with mental disorders (PwMDs) are a priority group for COVID-19 vaccination, but empirical data on PwMDs' vaccine uptake and attitudes toward COVID-19 vaccines are lacking. This study examined the uptake, acceptance, and hesitancy associated with COVID-19 vaccines among Chinese PwMDs during China's nationwide vaccine rollout. In total, 906 adult PwMDs were consecutively recruited from a large psychiatric hospital in Wuhan, China, and administered a self-report questionnaire, which comprised standardized questions regarding sociodemographics, COVID-19 vaccination status, attitudes toward COVID-19 vaccines, and psychopathology. Vaccine-recipients were additionally asked to report adverse events that occurred following vaccination. PwMDs had a much lower rate of vaccination than Wuhan residents (10.8 vs. 40.0%). The rates of vaccine acceptance and hesitancy were 58.1 and 31.1%, respectively. Factors associated with vaccine uptake included having other mental disorders [odds ratio (OR) = 3.63], believing that ≥50% of vaccine-recipients would be immune to COVID-19 (OR = 3.27), being not worried about the side effects (OR = 2.59), and being an outpatient (OR = 2.24). Factors associated with vaccine acceptance included perceiving a good preventive effect of vaccines (OR = 12.92), believing that vaccines are safe (OR = 4.08), believing that ≥50% of vaccine-recipients would be immune to COVID-19 (OR = 2.20), and good insight into the mental illness (OR = 1.71). Adverse events occurred in 21.4% of vaccine-recipients and exacerbated pre-existing psychiatric symptoms in 2.0% of vaccine-recipients. Nevertheless, 95.2% of vaccine-recipients rated adverse events as acceptable. Compared to the 58.1% vaccine acceptance rate and the 40.0% vaccination rate in the general population, the 10.8% vaccine coverage rate suggested a large unmet need for COVID-19 vaccination in Chinese PwMDs. Strategies to increase vaccination coverage among PwMDs may include provision of reliable sources of information on vaccines, health education to foster positive attitudes toward vaccines, a practical guideline to facilitate clinical decision-making for vaccination, and the involvement of psychiatrists in vaccine consultation and post-vaccination follow-up services.
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Affiliation(s)
- Hui Huang
- Affliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Min Zhu
- Department of Psychiatry, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Peng-Wei Liang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Zhong-Ming Fang
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Wei Luo
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Yi-Ming Ma
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Bao-Liang Zhong
- Affliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.,Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Helen Fung-Kum Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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Tzur Bitan D, Kridin K, Cohen AD, Weinstein O. COVID-19 hospitalisation, mortality, vaccination, and postvaccination trends among people with schizophrenia in Israel: a longitudinal cohort study. Lancet Psychiatry 2021; 8:901-908. [PMID: 34364406 PMCID: PMC8342316 DOI: 10.1016/s2215-0366(21)00256-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Individuals with schizophrenia have an increased risk of severe COVID-19 outcomes, nonetheless, no previous study has provided a year-long account of this risk, or assessed postvaccination trends in this population. This study assessed temporal trends in COVID-19 hospitalisation and mortality among people with schizophrenia during the first year of the pandemic, the predictors for COVID-19 vaccination, postvaccination infection, admission to hospital, and mortality. METHODS In this longitudinal cohort study, people with schizophrenia (n=25 539) and controls (n=25 539) were assessed for COVID-19 outcomes before and after vaccination, up to April 30, 2021. Cox proportional hazard regression models and Kaplan-Meier analyses were done to assess longitudinal trends. The study used the databases of Clalit Health Services, the largest health-care organisation in Israel. FINDINGS The sample included 51 078 participants, of which 31 141 (61·0%) male and 19 937 (39·0%) female participants, with a mean age of 51·94 years (SD 15·62). Most of the sample was from the general Jewish population (75·9%), followed by the Arab (19·1%) and Jewish Ultraorthodox population (5·1%). Overall of 51 078 individuals, 356 (0·7%) people had been hospitalised, 133 (0·3%) had died, and a total of 27 400 (53·6%) had been vaccinated. People with schizophrenia showed a higher risk for COVID-19 hospitalisation (HR 4·81, 95% CI 3·57-6·48, p<0·0001) and mortality (HR 2·52, 95% CI 1·64-3·85, p<0·0001), and showed a sharper decline in survival as time progressed. The control group showed a sharper incline in probability to vaccinate (log-rank=309·88, p<0·0001). Medical comorbidity of diabetes, hypertension, obesity, or ischaemic heart disease played a significant role in predicting vaccination rates in the schizophrenia group (all p<0·0001), but not in the control group. Hospitalisation and mortality disparities remained higher among people with schizophrenia who had not been vaccinated in comparison to controls (incidence rate difference of 6·2 and 3·2, respectively) but substantially declined in fully vaccinated groups (incidence rate difference of 1·1 and -0·9, respectively). INTERPRETATION People with schizophrenia have higher hospitalisation and mortality risk, yet have lower rates of vaccination than in the general population. Disparities in COVID-19 severe outcomes can be substantially reduced by national vaccination plans aimed at actively reaching out to people with schizophrenia. FUNDING No funding.
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Affiliation(s)
- Dana Tzur Bitan
- Department of Behavioral Sciences, Ariel University, Ariel, Israel; Shalvata Mental Health Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; Unit of Dermatology and Skin Research Laboratory, Baruch Padeh Poria Medical Center, Poria, Israel
| | - Arnon Dov Cohen
- Department of Quality Measurements and Research, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Orly Weinstein
- Hospital Division, Clalit Health Services, Tel Aviv, Israel; Department of Health Systems Administration, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Kumar S, Pathare S, Esponda GM. COVID-19 vaccine prioritisation for individuals with psychoses. Lancet Psychiatry 2021; 8:751. [PMID: 34147156 PMCID: PMC8376235 DOI: 10.1016/s2215-0366(21)00236-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Sonali Kumar
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, Maharashtra 411004, India.
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, Maharashtra 411004, India
| | - Georgina Miguel Esponda
- Economic and Social Research Council Centre for Society and Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Jagadheesan K, Danivas V, Itrat Q, Shekaran L, Lakra V. A 6-month study on the pattern of emergency department presentations for schizophrenia and other psychotic disorders during COVID-19 lockdown. Psychiatry Res 2021; 303:114081. [PMID: 34246006 PMCID: PMC8520318 DOI: 10.1016/j.psychres.2021.114081] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/14/2021] [Accepted: 06/25/2021] [Indexed: 01/08/2023]
Abstract
This study investigated the characteristics of patients with schizophrenia and other psychotic disorders presenting to emergency departments (ED) for psychiatric treatment during the first six months of the COVID-19 lockdown in Melbourne. This cross-sectional data-base study included adult patients in the North West Area Mental Health Service's catchment area who had visited two emergency departments (EDs) during the study period (March 16-September 16, 2020) and the control period (March 16-September 16, 2019). Compared to the control period (n = 467), the lockdown period (n = 451) had a 6.8% more psychotic disorders. This increase was particularly noted for schizophrenia and acute transient psychosis. In a sub-analysis of psychotic disorder group alone, compared to the control period, more patients were discharged to the community in the lockdown period. In another sub-analysis, compared to the mood disorder group, psychotic disorder group included more patients in 26-35 and 46-55 age groups, men, emergency triage category, and hospital admissions and higher mean duration of ED stay in the lockdown period. Overall, patients with psychotic disorders had increased ED presentations and appeared to be in an emergency state when they present to ED during the lockdown.
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Affiliation(s)
- Karuppiah Jagadheesan
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia.
| | - Vijay Danivas
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Quratulain Itrat
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Lokesh Shekaran
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia
| | - Vinay Lakra
- North West Area Mental Health Services, Melbourne Health, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Australia
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