|
1
|
Vivalya BMN, Vagheni MM, Piripiri AL, Mbeva JBK. Religion and mental health seeking behaviors in war-tone zones of the Democratic Republic of the Congo. Int J Psychiatry Med 2025:912174251316784. [PMID: 39849836 DOI: 10.1177/00912174251316784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2025]
Abstract
OBJECTIVE Although religious leaders play an important role in providing informal mental health care to individuals struggling to seek religious and spiritual care, existing studies have not explored the magnitude of psychiatric symptoms and motivators to seek mental health services from religious leaders in religious listening centers and mental hospitals. This paper presents preliminary data from a survey aimed at assessing psychiatric symptoms and factors associated with access to spiritual services among 151 individuals at a religious listening center, as well as to determine the pathways of care among 150 patients attending a mental health clinic in conflict zones of the Eastern Democratic Republic of the Congo. METHOD Three hundred and one participants were screened for psychiatric symptoms and factors motivating access to religious leaders using a semi-structured questionnaire. Descriptive analyses were performed to determine information on psychiatric symptoms and factors affecting access to spiritual and mental health services. RESULTS Nearly 6 in 10 individuals seeking spiritual help in the religious center had psychiatric symptoms. Furthermore, 7 in 10 patients seek help for mental health needs from religious leaders and healers before seeking conventional mental health services; among such individuals, there was a high prevalence of bipolar disorder and schizophrenia spectrum disorder, recurrent admissions, and poor adherence to psychotropic medication. CONCLUSION These results highlight the need for greater integration of mental health services with care provided by religious organizations within conflict zones such as the Congo. They also emphasize the need for greater promotion of person-centered care that considers and integrates patients' religious beliefs in their treatment.
Collapse
Affiliation(s)
| | - Martial Mumbere Vagheni
- Mental Health School, Université pour La Conservation de La Nature et le Development de Kasugho, Goma, Democratic Republic of Congo
- Department of Psychiatry, Centre Neuro-Psycho-Pathologique, University of Kinshasa, Lemba, Kinshasa, Democratic Republic of Congo
- Mental health Unit, Department of Internal Medicine, Katwa General Referral Hospital, Butembo, Democratic Republic of Congo
| | - Astride Lina Piripiri
- Kinshasa School of Public Health, Faculty of Medicine University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Bosco Kahindo Mbeva
- Department of Public Health, Official University of Ruwenzori, Goma, North-Kivu Democratic Republic of the Congo
| |
Collapse
|
|
2
|
Bokhari SA, Karaman MJ, Thalitaya MD. Transient Psychotic Relapse Following COVID-19 in a Stable Schizophrenia Patient on Paliperidone Palmitate: A Case Report. Cureus 2024; 16:e74661. [PMID: 39735104 PMCID: PMC11681963 DOI: 10.7759/cureus.74661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2024] [Indexed: 12/31/2024] Open
Abstract
Schizophrenia is a chronic psychiatric disorder marked by severe disturbances in thought, perception, and behavior. Long-acting injectable (LAI) antipsychotics, such as paliperidone, are widely used to promote sustained remission and ensure medication adherence, especially in patients prone to relapse. However, the COVID-19 pandemic has introduced unique challenges, with studies indicating that infections like COVID-19 may exacerbate psychiatric symptoms through neuroinflammatory pathways. This report presents the case of Ms. X, a 48-year-old Emirati female patient with chronic schizophrenia, who achieved long-term stability on paliperidone LAI at 150 mg monthly. For almost two years, she remained stable with notable improvements in delusional and paranoid symptoms, supported by structured therapeutic care, supportive psychotherapy, occupational therapy, and family involvement. However, in August 2024, Ms. X contracted COVID-19, which triggered a sudden relapse marked by acute persecutory delusions, heightened suspicion, and avoidance behavior, despite ongoing adherence to her LAI regimen. Following her recovery from COVID-19, Ms. X's psychotic symptoms remitted without changes to her antipsychotic treatment, and she returned to her baseline functioning. This case highlights the sensitivity of chronic schizophrenia to physiological stressors such as viral infections, underscoring the importance of vigilant monitoring and comprehensive care during periods of illness. It also contributes to the growing body of evidence suggesting that infections can induce transient yet significant psychiatric relapses in otherwise stable schizophrenia patients, emphasizing the intricate interplay between physical and mental health. This case underscores the complex interplay between physical and mental health in schizophrenia and highlights the need for further research into infection-induced psychiatric exacerbations.
Collapse
Affiliation(s)
- Syed Ali Bokhari
- Psychiatry, Al Amal Psychiatric Hospital, Emirates Health Services, Dubai, ARE
| | - Mariam J Karaman
- Psychiatry, Maudsley Health, Al Amal Psychiatric Hospital, Dubai, ARE
| | - Madhusudan Deepak Thalitaya
- Psychiatry, Maudsley Health, Al Amal Psychiatric Hospital, Dubai, ARE
- Psychiatry, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| |
Collapse
|
|
3
|
Arinda A, Kalani K, Mpamizo E, Sebuliba R, Akinyange V, Lofgren S. Challenges and adaptations of mental health services during the COVID-19 Pandemic in Uganda. Pan Afr Med J 2024; 48:84. [PMID: 39465193 PMCID: PMC11512146 DOI: 10.11604/pamj.2024.48.84.43031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/07/2024] [Indexed: 10/29/2024] Open
Abstract
Introduction Coronavirus disease (COVID-19) significantly impacted mental health and mental health services worldwide. We sought to explore the challenges faced by mental health services from the perspectives of service users, providers, and policymakers during the COVID-19 pandemic in Uganda and the strategies put in place to ensure the continuity of these services. Methods qualitative data were collected using semi-structured interviews with eight mental health service users, four mental health workers, four hospital administrators, four district mental health focal persons, and two policymakers. The data were analyzed using thematic analysis. Results the challenges reported by participants included human resource shortages, loss of space for service provision, low funding, drug shortages, changes in patient load, and lack of access to services due to restrictive measures. The adaptations included the use of innovative means like mobile phone technology, reorientation of health facility functioning to COVID-19 restrictions, using different methods to deliver medications, integration of mental health in general health services, and alternative financing for mental health services. Conclusion the COVID-19 pandemic posed significant challenges to mental health service provision. Nevertheless, the health system responded by implementing various measures to ensure continuity of care. Further research is needed to evaluate the effectiveness and scalability of these innovations in the long term.
Collapse
Affiliation(s)
- Anita Arinda
- Department of Psychiatry, College of Health Sciences, Makerere University Kampala, Uganda
| | | | | | - Raymond Sebuliba
- Infectious Disease Institute, Makerere University, Kampala, Uganda
| | | | - Sarah Lofgren
- Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
|
4
|
Kaya H, Civan Kahve A, Darben Azarsız Y, Ayaz Naycı N, İleri Akdoğan T, Goka E. Management of psychiatric treatments of patients diagnosed with bipolar disorder in the COVID-19 pandemic: A one-year evaluation in the pandemic. Chronic Illn 2024; 20:49-63. [PMID: 36775889 PMCID: PMC9925865 DOI: 10.1177/17423953231156783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/25/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVE The course of bipolar disorder (BD) is sensitive to factors that may disrupt biological and social rhythms. It is important for patients diagnosed with BD to continue their follow-up and treatment during the pandemic due to personal and social effects. This study aimed to evaluate the disease course and treatment compliance of individuals diagnosed with BD during the pandemic. METHODS A total of 267 patients with BD were included in the study. The scales were applied by phone calls. A sociodemographic data form was filled out during the phone interviews. Diagnostic criteria for hypomanic, manic, and depressive episodes in DSM-5 were questioned and recorded through the created form. RESULTS During the first of the pandemic, a total of 72 (27.0%) patients had a mood episode, of which 56 (21.0%) were manic/hypomanic episodes and 16 (6.0%) depressive episodes. Also, 54.7% of the patients were able to obtain their medications thanks to the extended medication reports. Being unable to use their medications regularly, having a seasonal pattern of disease, and using an increased number of psychotropics were significant predictors of a new episode. While 74.5% of the patients wanted to talk to their psychiatrists online, only 1.1% could reach the psychiatrist online. DISCUSSION The effects of the COVID-19 pandemic are particularly evident in patients with a seasonal pattern. Telepsychiatry practices should be actively included in clinical practice, and government policies developed for treatment compliance seem important.
Collapse
Affiliation(s)
- Hasan Kaya
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Aybeniz Civan Kahve
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Yagmur Darben Azarsız
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Nagihan Ayaz Naycı
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Turceun İleri Akdoğan
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Erol Goka
- Department of Psychiatry, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
|
5
|
Dindar RE, Yıldızhan E, Tomruk NB. Symptom Exacerbations of Patients Attending a Community Mental Health Center During the COVID-19 Pandemic. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:34-45. [PMID: 38556935 PMCID: PMC11003372 DOI: 10.5080/u27175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/11/2022] [Indexed: 04/02/2024]
Abstract
OBJECTIVE The aim of this study was to examine the effect of the COVID-19 pandemic on the clinical conditions of the patients with bipolar disorder (BD) and schizophrenia spectrum disorders (SSD) in a community mental health center (CMHC). METHOD Symptom exacerbations, emergency service admissions, drug dose increases, additional medication prescriptions, and psychiatric hospitalizations of patients with BD and SSD in the CMHC were evaluated retrospectively. The data from the 1-year prior, 6-months prior, 6-months after the onset and 1-year after the onset of the pandemic were compared. Hospital and CMHC medical records were used for outcomes. Personal and Social Performance (PSP) Scale was used to assess the level of functioning. RESULTS 107 patients with the diagnosis of BD and 121 patients with the diagnosis of SSD were recruited. In the BD group, there was increase in the frequency of symptom exacerbations (p=0.001) and additional medication prescriptions or increased dose (p=0.007), with decrease in emergency service admissions (p=0.039) during the pandemic. In the patients with SSD, the number of patients with exacerbation of symptoms (p=0.001) and with increased dose or additional medication prescriptions (p=0.004) were higher during the pandemic. There was no increase in the rate of hospitalized patients in the period of first 6 months and first one year. Symptom exacerbations were more frequent in the SSD group with Covid (+) in family (p=0.016). CONCLUSION The fact that the hospitalization rates remained the same despite an increase in the acute exacerbations provides info on the role of CMHCs and how mental health system functioned during the pandemic.
Collapse
Affiliation(s)
- Remzi Erşah Dindar
- Psychiatrist, Bakırköy Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Disorders, Department of Psychiatry
| | - Eren Yıldızhan
- Assoc. Prof., Bakırköy Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Disorders, Department of Psychiatry, Bağcılar Community Mental Health Center, İstanbul, Turkey
| | - Nesrin Buket Tomruk
- Psychiatrist, Bakırköy Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Disorders, Department of Psychiatry
| |
Collapse
|
|
6
|
van Reekum EA, Woo JJ, Petropoulos J, Samaan Z, Mbuagbaw L. Association between the COVID-19 pandemic and psychiatric symptoms in people with preexisting obsessive-compulsive, eating, anxiety, and mood disorders: a systematic review and meta-analysis of before-after studies. Psychiatry Clin Neurosci 2023; 77:583-591. [PMID: 37565691 PMCID: PMC11488625 DOI: 10.1111/pcn.13582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/18/2023] [Accepted: 08/02/2023] [Indexed: 08/12/2023]
Abstract
AIM To determine whether the coronavirus disease 2019 (COVID-19) pandemic was associated with a change in psychiatric symptoms in people with preexisting obsessive-compulsive, eating, anxiety, and mood disorders compared to their prepandemic levels. METHODS We searched MEDLINE, CINAHL, PsycINFO, and Embase from inception until February 16, 2022. Studies were included if they reported prepandemic and during-pandemic psychiatric symptoms, using validated scales, in people with preexisting mood, anxiety, eating, or obsessive-compulsive disorders. Two reviewers independently screened studies, extracted data, and assessed evidence certainty. Random-effects meta-analyses were conducted. Effect sizes were reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs). RESULTS Eighteen studies from 10 countries were included. Of the 4465 included participants, 68% were female and the average age was 43 years. Mood and obsessive-compulsive disorders were the most studied disorders. During-pandemic psychiatric measurements were usually collected during nationwide lockdown. Obsessive-compulsive symptoms worsened among people with obsessive-compulsive and related disorders, with a moderate effect size (N = 474 [six studies], SMD = -0.45 [95% CI, -0.82 to -0.08], I2 = 83%; very low certainty). We found a small association between the COVID-19 pandemic and reduced anxiety symptoms in people with mood, anxiety, obsessive-compulsive, and eating disorders (N = 3738 [six studies], SMD = 0.11 [95% CI, 0.02-0.19], I2 = 63%; very low certainty). No change in loneliness, depressive, or problematic eating symptoms was found. CONCLUSION People with obsessive-compulsive and related disorders may benefit from additional monitoring during the COVID-19 pandemic and possibly future pandemics. Other psychiatric symptoms were stable in people with the specific disorders studied. Overall, evidence certainty was very low.
Collapse
Affiliation(s)
- Emma A van Reekum
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Population Health Research InstituteMcMaster University and Hamilton Health SciencesHamiltonOntarioCanada
| | - Julia J Woo
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Jo‐Anne Petropoulos
- Health Sciences Library, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Zainab Samaan
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| |
Collapse
|
|
7
|
Kassam A, Beder M, Sediqzadah S, Levy M, Ritts M, Maher J, Kirwan N, Law S. Impact of COVID-19 on the lives of people with severe mental illness-front-line community psychiatry workers observation from a provincial survey of assertive community treatment teams in Ontario, Canada. Int J Ment Health Syst 2023; 17:18. [PMID: 37328776 DOI: 10.1186/s13033-023-00585-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/23/2023] [Indexed: 06/18/2023] Open
Abstract
Using an online survey distributed to members of the provincial organization that represents the 88 Assertive Community Treatment (ACT) and Flexible ACT teams in Ontario, Canada, this descriptive study relied on the unique vantage points and observations of the front-line community psychiatry workers who maintained contact with patients through outreach and telecommunication during the height of COVID-19. The patients who suffer from serious mental illness (SMI) were uniquely affected by COVID-19 due to the changes, reduction or shut down of many essential clinical and community support services. Thematic and quantitative analyses of the workers' observations highlighted 6 main areas of note, including significant social isolation and loneliness, clinical course deterioration and life disruption, increased hospital and ER use, police and legal contacts, and substance abuse and related deaths. There were also encouraging signs of positive adaptations in terms of independence and resilience. Reflections of these impacts and potential ameliorating approaches are further discussed.
Collapse
Affiliation(s)
- Aly Kassam
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Michaela Beder
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Saadia Sediqzadah
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Matthew Levy
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Madeleine Ritts
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - John Maher
- Canadian Mental Health Association, Barrie and Ontario Association of ACT and FACT, Barrie, ON, Canada
| | - Nicole Kirwan
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada
| | - Samuel Law
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Psychiatry, Unity Health Toronto, St. Michael's Hospital, Toronto, ON, Canada.
| |
Collapse
|
|
8
|
Ross CA, Kara S, Ferrer GF. COVID-19 and Psychiatric Admissions: A Comparative Study of Pre-pandemic and Post-pandemic Psychosis Admissions in a South Florida Emergency Department. Cureus 2023; 15:e40989. [PMID: 37503505 PMCID: PMC10370826 DOI: 10.7759/cureus.40989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/29/2023] Open
Abstract
We noticed a subjective increase in psychosis admissions within our emergency department (ED) with the onset of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to identify trends concerning admissions due to psychosis in the ED before and after the beginning of the COVID-19 pandemic. We analyzed 508 psychiatric admissions through the ED from October 2019 to October 2020, of which 367 cases of psychosis were identified. Statistical analysis was performed using T-tests and Pearson's correlation coefficient. T-testing showed mean psychosis admissions during the pandemic (March 2020 to July 2020) to be greater than admissions occurring during the pre-pandemic period (October 2019 to February 2020) (p = 0.04). Pearson's correlation coefficient identified the relationships between COVID-19 admissions and psychosis admissions during this time as positive (r = 0.5) but did not reach statistical significance (p = 0.06). Therefore, within our time frame, we did see a noted increase in psychosis by 22.9% during the pandemic compared to pre-pandemic times. Current research remains conflicted concerning psychiatric ED admissions during COVID-19, with some stating an increase and others finding a decrease. Our data showed a significant statistical increase in the mean number of psychosis cases when comparing pre-pandemic and pandemic admissions. These findings help add pertinent data to understand how psychosis admissions trended before and during the beginning of the COVID-19 pandemic, specifically in South Miami, Florida. It also provides a foundation for future studies by providing data points concerning mental illness within the vulnerable population of patients served in our community.
Collapse
Affiliation(s)
| | - Sam Kara
- Neurology, Larkin Community Hospital, Miami, USA
| | | |
Collapse
|
|
9
|
Barlattani T, D'Amelio C, Capelli F, Mantenuto S, Rossi R, Socci V, Stratta P, Di Stefano R, Rossi A, Pacitti F. Suicide and COVID-19: a rapid scoping review. Ann Gen Psychiatry 2023; 22:10. [PMID: 36932453 PMCID: PMC10020759 DOI: 10.1186/s12991-023-00441-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023] Open
Abstract
There is considerable interest in exploring effects of coronavirus disease 2019 (COVID-19) pandemic on mental health. Suicide is one of the leading causes of mortality worldwide and changes in daily life brought by the pandemic may be additional risk factors in people with pre-existing mental disorders. This rapid PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) scoping review aims to identify and analyze current evidence about the relation between COVID-19 pandemic outbreak, along with COVID-19 disease and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection, and suicide in individuals with previously diagnosed mental disorders. First, we conducted a comprehensive review of the literature, then proceeded to discuss findings in a narrative way. Tables were constructed and articles sorted according to the studies' methodologies. 53 papers were eventually identified as eligible, among which 33 are cross-sectional studies, 9 are longitudinal studies, and 11 studies using other methodologies. Despite suffering from a mental disorder is a risk factor for suicidal behavior per se, the advent of COVID-19 pandemic may exacerbate this relation. Nevertheless, data addressing a clear correlation between suicidal behavior and the pandemic outbreak are still controversial. Longitudinal analysis using validated suicide scales and multicenter studies could provide deeper insight and knowledge about this topic.
Collapse
Affiliation(s)
- Tommaso Barlattani
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy.
| | - Chiara D'Amelio
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Francesco Capelli
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Simonetta Mantenuto
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
| | - Valentina Socci
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Paolo Stratta
- Department of Mental Health Sulmona-Avezzano-L'Aquila, ASL 1, Abruzzo, Italy
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Alessandro Rossi
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, 67100, Coppito, L'Aquila, Italy
| |
Collapse
|
|
10
|
Nooraeen S, Bazargan-Hejazi S, Naserbakht M, Vahidi C, Shojaerad F, Mousavi SS, Malakouti SK. Impact of COVID-19 pandemic on relapse of individuals with severe mental illness and their caregiver's burden. Front Public Health 2023; 11:1086905. [PMID: 36817882 PMCID: PMC9929280 DOI: 10.3389/fpubh.2023.1086905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Abstract
Background The implementation of quarantine and social distancing measures to control the COVID-19 pandemic led to restrictions at the community level and most of in-person psychiatric services were discontinued. This situation could affect the psychopathology of the patients and the burden of their caregivers. The aim of this study was to investigate the effects of COVID-19 pandemic on people with severe mental illnesses (SMIs) and their caregivers' burden. Method The study sample consisted of 86 patients with severe mental illness and 86 caregivers. The mental status, relapse rate, and rehospitalization rate of the patients and the general health status and burden of caregivers were investigated in three waves, including before and 3 and 6 months after the COVID-19 pandemic. Results The relapse rate of the patients was 14%, 33.7%, and 43% (p = 0.000) and the rehospitalization rate was 4.7%, 7%, and 10.5% in waves 0, 1, and 2, respectively (p = 0.000). Most of the psychopathological scales increased in three waves (p = 0.000). The caregivers' burden and health condition worsened during the nine months of the study as well (p = 0.000). Conclusion The COVID-19 pandemic led to the exacerbation of symptoms and increased the relapse rate in people with SMIs. It also worsened the caregivers' condition. People with severe mental illnesses (SMIs) and their caregivers are one of the most vulnerable groups on which the COVID-19 pandemic had a marked negative effect.
Collapse
Affiliation(s)
- Sara Nooraeen
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Morteza Naserbakht
- Mental Health Research Center, Psychosocial Health Research Institute, Tehran, Iran
| | - Camelia Vahidi
- Andisheh-Salamat-Ravan Mental Rehabilitation Center, Tehran, Iran
| | | | | | - Seyed Kazem Malakouti
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
|
11
|
Mastelić T, Borovina Marasović T, Rakušić M, Martinović D, Lasić D, Uglešić B, Glavina T. Rehospitalization Rates Among Patients with Psychotic Disorders During Covid-19 Pandemic: Oral Versus Long-Acting Injectable Antipsychotics. CLINICAL NEUROPSYCHIATRY 2022; 19:365-369. [PMID: 36627948 PMCID: PMC9807113 DOI: 10.36131/cnfioritieditore20220603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective The superiority of long-acting injectable antipsychotics (LAIs) versus oral antipsychotics is often emphasized, even in terms of adherence and rehospitaliza-tion rates. As such, LAIs are particularly recommended during the COVID-19 pandemic. The goal of our research was to determine whether there are differences in the number of rehospitalizations in patients treated for schizophrenia, schizophrenia-like disorders, and delusional states (psychotic disorders) with LAI antispychotics versus oral antispychotics. Method Subjects with schizophrenia, schizophrenia-like disorders and delusional states participated in our retrospective study. 124 subjects were treated with oral anti-psychotics, while 72 received LAIs along with oral antipsychotics. We collected their sociodemographic data and psychiatric history data. Our main outcome measure was the number of rehospitalizations. Results Statistical analysis showed that the studied groups did not differ according to sociodemographic parameters, except that in the group of patients with LAIs there was a significantly higher percentage of men (65 (52.4) vs 50 (69.4), p=0.029)). Also, the groups do not differ according to the psychiatric history data. There is no difference in the duration of the current hospitalization nor in the composition of the patients, considering the order of the current hospitalization. The difference in the number of rehospitalizations is not significant neither in the first year of follow-up (p=0.144), nor in the second (p=0.142), nor after two years of follow-up (p=0.083). Conclusions Our research has shown that there is no difference in the number of rehospitalizations in patients with schizophrenia, schizophrenia-like disorders and delusional states, considering whether they take oral antipsychotics or they also take LAIs along with them. We can therefore conclude that it is particularly important to work on improving patient adherence. We must make psychiatrists aware that the pandemic, like other threats, can be our ally in improving adherence ("perceived threat as a health belief").
Collapse
Affiliation(s)
- Tonći Mastelić
- Clinic for Psychiatry, Clinical Hospital Centre Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Tonka Borovina Marasović
- Clinic for Psychiatry, Clinical Hospital Centre Split, Spinčićeva 1, 21 000 Split, Croatia,Corresponding author Tonka Borovina Marasović MD Clinic for Psychiatry University Hospital Centre Split, Croatia Spinčićeva 1, 21 000 Split, Croatia Tel.:+38521556132 E-mail:
| | - Mihaela Rakušić
- Clinic for Psychiatry, Clinical Hospital Centre Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Dinko Martinović
- Department of Pathophysiology, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
| | - Davor Lasić
- Clinic for Psychiatry, Clinical Hospital Centre Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Boran Uglešić
- Clinic for Psychiatry, Clinical Hospital Centre Split, Spinčićeva 1, 21 000 Split, Croatia
| | - Trpimir Glavina
- Clinic for Psychiatry, Clinical Hospital Centre Split, Spinčićeva 1, 21 000 Split, Croatia
| |
Collapse
|
|
12
|
Sato A, Watanabe N, Maruo K, Moriyama T, Furukawa TA. Psychotic relapse in people with schizophrenia within 12 months of discharge from acute inpatient care: protocol for development and validation of a prediction model based on a retrospective cohort study in three psychiatric hospitals in Japan. Diagn Progn Res 2022; 6:20. [PMID: 36324165 PMCID: PMC9629881 DOI: 10.1186/s41512-022-00134-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 08/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Schizophrenia is a severe mental illness characterized by recurrent psychoses that typically waxes and wanes through its prodromal, acute, and chronic phases. A large amount of research on individual prognostic factors for relapse in people with schizophrenia has been published, and a few logistic models exist to predict psychotic prognosis for people in the prodromal phase or after the first episode of psychosis. However, research on prediction models for people with schizophrenia, including those in the chronic phase and after multiple recurrences, is scarce. We aim to develop and validate a prediction model for this population. METHODS This is a retrospective cohort study to be undertaken in Japan. We will include participants aged 18 years or above, diagnosed with schizophrenia or related disorders, and discharged between January 2014 and December 2018 from one of the acute inpatient care wards of three geographically distinct psychiatric hospitals. We will collect pre-specified nine predictors at the time of recruitment, follow up the participants for 12 months after discharge, and observe whether our primary outcome of a relapse occurs. Relapse will be considered to have occurred in one of the following circumstances: (1) hospitalization; (2) psychiatrist's judgment that the person needs hospitalization; (3) increasing doses of antipsychotics; or (4) suicidal or homicidal ideation or behavior resulting from such ideation. We will develop a Cox regression model and avoid overfitting by penalizing coefficients using the elastic net. The model will be validated both internally and externally by bootstrapping and "leave-one-hospital-out" cross-validation, respectively. We will evaluate the model's performance in terms of discrimination and calibration. Decision curve analysis will be presented to aid decision-making. We will present a web application to visualize the model for ease of use in daily practice. DISCUSSION This will be the first prediction modeling study of relapse after discharge among people with both first and multiple episodes of schizophrenia using routinely collected data. TRIAL REGISTRATION This study was registered in the UMIN-CTR (UMIN000043345) on February 20, 2021.
Collapse
Affiliation(s)
- Akira Sato
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida-konoecho, Sakyo-ku, Kyoto, 606-8501, Japan.
| | - Norio Watanabe
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | | | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida-konoecho, Sakyo-ku, Kyoto, 606-8501, Japan
| |
Collapse
|
|
13
|
Forster SE, Gancz NN, Gaither ML, Haas GL, Starver KD, Steinhauer SR. Barriers to Long-acting Injectable Antipsychotic Adherence During the COVID-19 Pandemic: Observations From One Site. J Psychiatr Pract 2022; 28:497-504. [PMID: 36355590 PMCID: PMC9645453 DOI: 10.1097/pra.0000000000000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Long-acting injectable antipsychotics (LAI-As) are a crucial treatment option for individuals with serious mental illness. However, due to the necessity of in-person administration of LAI-As, pandemics pose unique challenges for continuity of care in the population prescribed these medications. This project investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on LAI-A adherence at a Veterans Health Administration medical facility in the United States, as well as changes in LAI-A prescribing and administration practices during this period. METHODS Electronic health records were evaluated for 101 patients prescribed LAI-As. A subset of 13 patients also participated in an interview and rated subjective concerns about pandemic-related barriers to medication adherence. RESULTS Pandemic-related barriers to LAI-A adherence and/or changes to LAI-A medications were documented in 33% of the patients. Within-subjects comparison of an adherence metric computed from electronic health record data further suggested a somewhat higher incidence of missed or delayed LAI-A doses during the pandemic compared with before the pandemic. In contrast, only 2 of the 13 patients interviewed anticipated that pandemic-related concerns would interfere with medication adherence. CONCLUSIONS The results of this study suggest that LAI-A access and adherence can be disrupted by pandemics and other public health emergencies but this finding may not generalize to other sites. As patients may not foresee the potential for disruption, psychiatric service providers may need to assist in proactively problem-solving barriers to access. Improved preparedness and additional safeguards against pandemic-related disruptions to LAI-A access and adherence may help mitigate adverse outcomes in the future. Identifying patients at elevated risk for such disruptions may help support these efforts.
Collapse
|
|
14
|
Levaj S, Medved S, Grubišin J, Tomašić L, Brozić K, Shields-Zeeman L, Bolinski F, Rojnic Kuzman M. The impact of the COVID-19 pandemic and earthquake on mental health of persons with severe mental illness: A survey study among people receiving community mental health care versus treatment as usual in Croatia. Int J Soc Psychiatry 2022; 69:653-663. [PMID: 36317586 PMCID: PMC9629027 DOI: 10.1177/00207640221130966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The COVID-19 pandemic led to the disruption of mental health services in most countries. Croatia has been developing and strengthening its mental health system, including the introduction of community mental health teams (CMHT) for persons with severe mental illness (SMI), whose implementation was ongoing during the pandemic through the RECOVER-E project. AIMS The aim of this study was to assess the differences in mental health outcomes, perceived social support and healthcare utilization in the group of participants receiving treatment as usual (TAU group) compared to the group receiving TAU and additional care by the CMHT (CMHT group) during the COVID-19 pandemic and two earthquakes. METHOD This is a cross-sectional survey administered among 90 participants with SMI at two time points: in May/June 2020 (first COVID-19 wave, earthquake) and in December 2020/January 2021 (second COVID-19 wave, earthquake). RESULTS A significantly larger proportion of participants from the CMHT group visited the general practitioners in both waves of COVID-19 (first wave: CMHT 72.1%, TAU 44.2%, p = .009; second wave: CMHT 91.1%, TAU 64.1%, p = .003), as well as psychiatric services in the second wave (CMHT 95.3%, TAU 79.5%, p = .028). The use of long-acting injectables was also more frequent in the CMHT group (p = .039). Furthermore, analysis of the first wave showed higher perceived support of significant others (p = .004) in the CMHT group. We did not identify any differences in mental health outcomes between groups in either wave. CONCLUSIONS While mental health outcomes did not differ between TAU and CMHT group, people in CMHT used services and treatments more frequently than those in TAU during the pandemic, which may indicate that CMHT services enable the continuity and accessibility of care for people with SMI under the circumstances where standard care is interruped (for example pandemic, disaster conditions).
Collapse
Affiliation(s)
- Sarah Levaj
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Sara Medved
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Jasmina Grubišin
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Lea Tomašić
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
| | - Kristina Brozić
- Department of Emergency Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Laura Shields-Zeeman
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Felix Bolinski
- Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
| | - Martina Rojnic Kuzman
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
|
15
|
The effect of the COVID-19 pandemic on health behavior and psychopathology in patients with psychotic disorders. Psychiatry Res 2022; 317:114845. [PMID: 36155276 PMCID: PMC9472751 DOI: 10.1016/j.psychres.2022.114845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/04/2022] [Accepted: 09/10/2022] [Indexed: 01/04/2023]
Abstract
In our study we aimed to investigate the effect of the pandemic period on disease severity, medication adherence, suicidal behavior, physical health and health behavior in patients with psychotic disorders. 255 patients with any of the diagnoses of Schizophrenia, Schizoaffective Disorder, Delusional Disorder, Bipolar Disorder with psychotic features and Major Depressive Disorder with psychotic features were included, 200 were assessed by telephone and 55 face-to-face. The patient's sociodemographic status, cigarette-alcohol use, physical diseases, body weight, suicidal behaviors, and the effects of the pandemic period on general health were assessed. Clinical global impression scale(CGI) and modified medication adherence scale(MMS) were also administered. We showed that the MMS scores of the patients significantly decreased compared to the pre-pandemic period. In our study, suicidal behavior and decrease in medication adherence during the pandemic period were found to be correlated with higher scores of CGI- Severity and Improvement Scale. Our study is one of the few studies that addresses the effects of the pandemic period on patients with psychotic disorders. The results show that the pandemic period is associated with an increase in negative health behavior and clinical worsening in patients with psychotic disorders. In order to confirm these findings, more research is needed in this area.
Collapse
|
|
16
|
Pedruzo B, Catalan A, Aymerich C, Bordenave M, Estevez O, Gómez DA, Herrero J, Laborda M, Mancebo G, Martínez A, Pacho M, Paniagua A, Pérez JL, González-Torres MÁ. Psychological impact of COVID-19 lockdown on a population with serious mental illness. A prospective cohort study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 16:59-67. [PMID: 35755489 PMCID: PMC9212956 DOI: 10.1016/j.rpsm.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022]
Abstract
Introduction COVID-19 has spread worldwide since its appearance at the end of 2019. In Spain, 99-day long home confinement was set from March 15th 2020. Previous studies about events requiring situations of isolation suggested that mental health problems may occur among the general population and, more specifically, vulnerable groups such as individuals with serious mental illness (SMI). This study aims to assess the psychological effect of confinement in patients with mental illness admitted to an inpatient psychiatric unit. Method In this longitudinal study, IDER (State-Trait Depression Inventory) and STAI (State-Trait Anxiety Inventory) questionnaires were used at two different times (at the beginning and after the lockdown) of the pandemic to evaluate the depression and anxiety symptoms, respectively, in a population of patients who had been previously admitted to the Psychiatry Unit of the Basurto University Hospital. Results 95 participants completed the IDER questionnaire in the first measurement, with a mean score of 24.56 (SD = 8.18) for state and 23.57 (SD = 8.14) for trait. In the case of STAI, the mean score was 27.86 (SD = 15.19) for the state and 30.49 (SD = 14.71) for the trait. No differences between the first and the second time were found in anxiety and depression levels. People with personality disorders presented high levels of anxiety. Conclusions Individuals with a personality disorder showed the highest scores in anxiety and depression. Nevertheless, strict confinement did not affect this population, despite the literature that evidences that the pandemic has worsened people's mental health with SMI.
Collapse
Affiliation(s)
- Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neuroscience Department, University of the Basque Country, UPV/EHU, Leioa, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Olatz Estevez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | | | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - María Laborda
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Gonzalo Mancebo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ania Martínez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Malein Pacho
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ana Paniagua
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - José Luis Pérez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neuroscience Department, University of the Basque Country, UPV/EHU, Leioa, Spain
| |
Collapse
|
|
17
|
Psychotic disorders amid the COVID-19 pandemic: a consideration of risks and impacts. Curr Opin Psychiatry 2022; 35:140-145. [PMID: 35125397 DOI: 10.1097/yco.0000000000000784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has had a severe and widespread global impact but particularly for those with psychosis. This review summarizes recent evidence on the relationship between the COVID-19 pandemic and psychotic disorders, highlighting the risks faced by these individuals including the negative impacts on treatment services, complications from contracting COVID-19, and the acceptability of digital interventions. RECENT FINDINGS Mortality, morbidity, and infection outcomes are among the worst for individuals with psychotic disorders. Presentation rates for psychotic disorders are elevated at emergency departments compared with before the COVID-19 pandemic; demand for inpatient services has increased, and there have been complications in access because of pandemic restrictions. COVID-19 related stressors have led to the exacerbation and incidence of psychotic symptoms among individuals with and without preexisting psychotic diagnoses. Digital interventions may be an acceptable method for maintaining patient contact and treatment during extended isolation. SUMMARY More data is needed on the longitudinal trajectory for psychotic symptoms post-COVID-19 infection and pandemic restrictions to better support individuals with psychotic disorders. Development of a long-term pandemic management plan is needed to monitor and support psychiatric health across the population.
Collapse
|
|
18
|
Haghshomar M, Shobeiri P, Brand S, Rossell SL, Akhavan Malayeri A, Rezaei N. Changes of symptoms of eating disorders (ED) and their related psychological health issues during the COVID-19 pandemic: a systematic review and meta-analysis. J Eat Disord 2022; 10:51. [PMID: 35418108 PMCID: PMC9006500 DOI: 10.1186/s40337-022-00550-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/02/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and its related social restrictions have profoundly affected people's mental health. It can be assumed that symptomatic behaviors and mental health of individuals with eating disorders (ED) deteriorated during this time. To get a thorough overview, we conducted a systematic review and meta-analysis with the following aims: First, to provide a comprehensive overview of symptoms of ED during the COVID-19-related confinement; second, to identify psychological mechanisms which impacted the emergence and maintenance of ED symptoms; third, to describe changes of daily routine and changes of access to healthcare in individuals with ED during confinement. METHODS We searched Embase, PubMed, and Scopus databases for observational studies published between January 1st, 2020, to July 1st, 2021, which investigated the symptomatology of ED during the COVID-19 pandemic. RESULTS After the screening, 13 studies with 7848 participants were included in the present systematic review and meta-analysis. The overall pooled prevalence of exacerbation of binge eating, food restriction, purging behaviors, and concerns about food intake in the pooled sample of 7848 was 59.65% (95% CI: 49.30%; 69.60%), and the overall prevalence of improved symptoms of ED in the pooled sample of 741 individuals was 9.37% (95% CI: 3.92%; 16.57%). Furthermore, COVID-19-related social restrictions negatively impacted the psychological health, daily routines, and physical activity of individuals with ED. More specifically, symptoms of anxiety and depression related to ED were increased significantly over time. However, there were also positive aspects to the COVID-19 pandemic. The main positive consequences included more emotional support from the family, less pressure to engage in social activities, and more flexible meal planning. Individuals with ED reported having difficulties getting access to healthcare centers and using telemedicine. They also found a hard time communicating via online sessions. CONCLUSIONS According to our interpretation, based on the data included in the systematic review and meta-analysis, the COVID-19 pandemic and its related social restrictions detrimentally impacted the mental health of majority of individuals with ED. Limited and impaired access to healthcare interventions appeared to have further exacerbated mental health issues of individuals with ED. Given this background, it seems that individuals with ED demand more attention during the COVID-19 crisis, and it is necessary to ensure that their course of treatment remains uninterrupted.
Collapse
Affiliation(s)
- Maryam Haghshomar
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Serge Brand
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052, Basel, Switzerland
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
- Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | | | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Dr. Gharib St, Keshavarz Blvd, Tehran, Iran.
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
19
|
Zolotareva A. Cyberchondria, but not preventive behavior, mediates the relationship between fear of COVID-19 and somatic burden: Evidence from Russia. Front Psychiatry 2022; 13:1018659. [PMID: 36226097 PMCID: PMC9549408 DOI: 10.3389/fpsyt.2022.1018659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 09/08/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There is extensive available research on the relationship between fear of COVID-19 pandemic and physical symptoms. This study was the first to examine the cyberchondria and COVID-19 preventive behavior as mediators of this relationship. METHODS A cross-sectional study was conducted from October to December 2021, during the fourth wave of the COVID-19 pandemic in Russia. The participants were 2,011 Russian-speaking volunteers aged 18 years and older. They completed questionnaires on somatic burden, cyberchondria, COVID-19 preventive behavior, and fear of COVID-19 pandemic. Mediation analysis was used to explore the mediating roles of cyberchondria and preventive behavior in the relationship between fear of COVID-19 and somatic burden. RESULTS Fear of COVID-19 positively predicted somatic burden, cyberchondria, and COVID-19 preventive behavior. Mediation analysis showed that the relationship between fear of COVID-19 pandemic and somatic burden was mediated by cyberchondria (effect = 0.08, bootstrapping SE = 0.01, bootstrapping 95% CI [0.08, 0.12]), but not COVID-19 preventive behavior (effect = 0.02, bootstrapping SE = 0.01, bootstrapping 95% CI [0.00, 0.05]). CONCLUSION The findings suggest that cyberchondria had negative effects on somatic burden during the COVID-19 pandemic. The knowledge of the mediating role of cyberchondria may be used by health care workers when consulting persons with physical health complaints and psychosomatic disorders.
Collapse
|
|
20
|
Fleischmann E, Dalkner N, Fellendorf FT, Reininghaus EZ. Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature. World J Psychiatry 2021; 11:1387-1406. [PMID: 35070784 PMCID: PMC8717042 DOI: 10.5498/wjp.v11.i12.1387] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/27/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is having a great impact on individuals from all over the world, particularly on individuals with mental disorders. Several studies found more pronounced psychiatric symptoms, notably symptoms of depression and anxiety.
AIM To assess the situation of patients with serious mental illness (SMI: Affective disorders and schizophrenia) regarding their mental health outcome during the pandemic.
METHODS A systematic search using the databases PubMed and MEDLINE was conducted, employing the key words “COVID-19”, “SARS-CoV-2”, “psychiatric/mental disorder/illness”, “affective/mood disorder”, “bipolar disorder”, “(major) depression”, “schizoaffective disorder”, and “schizophrenia”. Studies that had been published up until January 9, 2021 were included. Information of studies in languages other than English and German was mostly taken from their English abstracts.
RESULTS The literature search concluded in the finding of 36 studies containing relevant clinical data. A general impairment of the mental health of individuals with SMI could be detected, particularly in individuals with affective disorders, as compared to those with schizophrenia. Compared to healthy controls, symptoms of anxiety, depression, and stress were more pronounced in individuals with SMI. Relevant factors found that impacted their mental health were age, resilience, and socioeconomic environment, especially the shortage of mental health services, lack of social support, and inadequate information about COVID-19.
CONCLUSION In light of these results, mental health services should be reinforced, notably the use of telemental health services. Furthermore, supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is important. When researching the impact of the COVID-19 pandemic on individuals with SMI, standardization as well as follow-up studies are needed to enable better comparability and understanding.
Collapse
Affiliation(s)
- Eva Fleischmann
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| |
Collapse
|