Why psychiatric treatment must not be neglected during the COVID-19 pandemic

Psychiatric and non-psychiatric population vulnerabilities in time of a crisis: the unsuspected aggression factor

OBJECTIVES

In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis.

METHODS

We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations.

RESULTS

Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group.

CONCLUSION

New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.

A Study of the Association between the Stringency of Covid-19 Government Measures and Depression in Older Adults across Europe and Israel

Background: The COVID-19 pandemic is having major adverse consequences for the mental health of individuals worldwide. Alongside the direct impact of the virus on individuals, government responses to tackling its spread, such as quarantine, lockdown, and physical distancing measures, have been found to have a profound impact on mental health. This is manifested in an increased prevalence of anxiety, depression, and sleep disturbances. As older adults are more vulnerable and severely affected by the pandemic, they may be at increased psychological risk when seeking to protect themselves from COVID-19. Methods: Our study aims to quantify the association between the stringency of measures and increased feelings of sadness/depression in a sample of 31,819 Europeans and Israelis aged 65 and above. We hypothesize that more stringent measures make it more likely that individuals will report increased feelings of sadness or depression. Conclusions: We found that more stringent measures across countries in Europe and Israel affect the mental health of older individuals. The prevalence of increased feelings of sadness/depression was higher in Southern European countries, where the measures were more stringent. We therefore recommend paying particular attention to the possible effects of pandemic control measures on the mental health of older people.

Mental Health and the City in the Post-COVID-19 Era

The article describes the risks for the mental health and wellbeing of urban-dwellers in relation to changes in the spatial structure of a city that could be caused by the COVID-19 pandemic. A year of lockdown has changed the way of life in the city and negated its principal function as a place of various meetings and social interactions. The danger of long-term isolation and being cut-off from an urban lifestyle is not only a challenge facing individuals, but it also creates threats on various collective levels. Hindered interpersonal relations, stress, and the fear of another person lower the quality of life and may contribute to the development of mental diseases. Out of fear against coronavirus, part of the society has sought safety by moving out of the densely populated city centres. The dangerous results of these phenomena are shown by research based on the newest literature regarding the influence of COVID-19 and the lockdown on mental health, urban planning, and the long-term spatial effects of the pandemic such as the urban sprawl. The breakdown of the spatial structure, the loosening of the urban tissue, and urban sprawl are going to increase anthropopressure, inhibit access to mental health treatment, and will even further contribute to the isolation of part of the society. In addition, research has shown that urban structure loosening as a kind of distancing is not an effective method in the fight against the SARS-COV pandemic. Creating dense and effective cities through the appropriate management of development during and after the pandemic may be a key element that will facilitate the prevention of mental health deterioration and wellbeing. It is also the only possibility to achieve the selected Sustainable Development Goals, which as of today are under threat.

The Management of Psychiatric Emergencies in Situations of Public Calamity

The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them may be impaired if they have not been planned for. Although there are several models for addressing psychiatric emergencies, the general rules are the same, especially when it comes to making these services easily available to the affected population. In this article, we seek to review and present recommendations for the management of psychiatric emergencies in situations of public calamity, including disasters, physical and medical catastrophes, epidemics, and pandemics.

Worsening of Preexisting Psychiatric Conditions During the COVID-19 Pandemic

Objectives: To ascertain factors associated with worsening of psychiatric conditions during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This study anonymously examined 2,734 psychiatric patients worldwide for worsening of their preexisting psychiatric conditions during the COVID-19 pandemic. An independent clinical investigation of 318 psychiatric patients from United States was used for verification. Results: Valid responses mainly from 12 featured countries indicated self-reported worsening of psychiatric conditions in two-thirds of the patients assessed that was through their significantly higher scores on scales for general psychological disturbance, posttraumatic stress disorder, and depression. Female gender, feeling no control of the situation, reporting dissatisfaction with the response of the state during the COVID-19 pandemic, and reduced interaction with family and friends increased the worsening of preexisting psychiatric conditions, whereas optimism, ability to share concerns with family and friends, and using social media like usual were associated with less worsening. An independent clinical investigation from the United States confirmed worsening of psychiatric conditions during the COVID-19 pandemic based on identification of new symptoms that necessitated clinical interventions such as dose adjustment or starting new medications in more than half of the patients. Conclusions: More than half of the patients are experiencing worsening of their psychiatric conditions during the COVID-19 pandemic.

Lifestyle behaviors changes during the COVID-19 pandemic quarantine among 6,881 Brazilian adults with depression and 35,143 without depression

Our aim was to analyze the association between previously diagnosed lifetime depression and changes in physical activity (PA), TV-viewing, consumption of fruits and vegetables as well as frequency of ultra-processed food (UPF) consumption. Data of 41,923 Brazilian adults (6,881 with depression and 35,042 without depression) were used. Participants reported PA (≥ 150 min/week), TV-viewing (≥ 4 h/day), frequency of eating fruits or vegetables (≤ 4 days/week) and UPF (≥ 5 days/week). For incidence indicators, we only considered participants without the risk behavior before the quarantine. People without and with depression presented, respectively, incidence of physical inactivity [70.1% (95%CI: 67.4-72.8) vs 76.3 (70.3-81.5)], high TV-viewing [31.2 (29.6-32.8) vs 33.9 (30.5-37.4)], low frequency of fruit or vegetable consumption [28.3 (25.8-31.0) vs 31.5 (26.1-37.5)] and elevated frequency of UPF consumption [9.7 (8.9-10.7) vs 15.2 (13.0-17.7)]. Participants with depression were more likely to present elevated frequency of UPF consumption incidence [OR:1.49 (95%CI:1.21-1.83)]. Thus, participants with previous diagnosis of depression were at risk for incidence of unhealthy diet behaviors.