Psychiatric illness with COVID-19.
Psychiatric
illness with COVID-19.
ألا بِذكرِ اللهِ تطمئنُ القلُوب
Many physicians treating
COVID-19 ptns may develop moderate/severe
psychiatric illness that include:
v Anxiety: 12-20 % of clinicians
v Depression: 15-25 %
v Insomnia: 8 %
v Distress: 35-49 %
One report suggests
that about 50 % of health care workers
need psychological support. Ptns
with acute COVID-19 illness seem to
be at the risk for developing neuropsychiatric Sms & associated disorders. Among ptns
hospitalized for previous coronavirus epidemics, anxiety,
confusion, depressed mood, and insomnia,
as well as impaired attention, concentration, & memory, each observed in almost 20-40 % of ptns. Minimally, some of these Sms are
consistent with delirium in ptns with medical
illness. Furthermore, COVID-19
pandemic may
be accompanied with Sms of anxiety, depression, distress,
& post-traumatic stress disorder (PTSD)
in the general population.
COVID-19 pandemic ptns may
be complicated by a new onset or exacerbation of sub-syndromal
psychiatric Sms in addition to full-blown
psychiatric disorders, including anxiety
disorders, depressive disorders,
PTSD, or substance
use disorders. Within periods of viral epidemic, psychiatric Sms
& disorders are more likely to involve
health care staffs who’re at a higher
risk of exposure as compared to other workers who’re at low risk. Moreover, acute infection &
hospitalization during previous coronavirus (non-COVID-19)
epidemic was complicated with a wide scale of neuropsychiatric Sms. Many ptns hospitalized with COVID-19 infection and then recover will
manifest persistent
psychiatric illness that may include anxiety
disorder, depressive disorder,
& PTSD that is consistent with
outcome from a previous coronavirus epidemic.
Furthermore, the psychological impact of
COVID-19 pandemic may be adversely compromising
many ptns with pre-existing
mental disorder, to the extent that almost 20-25 % may think that
they’re getting poor or even deteriorating.
For subjects presenting
with Sms of anxiety, depressive illness, insomnia, or PTSD,
scheduled care programs may be an efficacious & cost-effective
technique; surveillance of mental health disorders is crucial. Ptns with low
grade Sms may be provided with self-help material
and are amenable to contact with a mental
health professional if they experience persistent
manner. Subjects with moderate/severe Sms may be managed by their primary care worker
or may need a mental health specialist.
If available, psychiatric care should be administered by telehealth
rather than face-to-face contact, despite
that some cases may in need for face-to-face
care. Mental health providers working with subjects experiencing psychiatric disorders
related to COVID-19 should address potential sources of
anxiety & distress that may include an access to personal
protective measures, risk of self-exposure & infection, risk of infection transmission, increased & taxing
work overload, moral dilemma, and ptn
death.
The adverse psychological impact of quarantine can be alleviated by making steps e.g.
explanation of the real purpose of quarantine and how to apply
it, in addition to clarification of the altruistic
benefits of quarantine
in keeping the safety of others. Ptns who’re hospitalized with psychiatric illnesses
are at a higher risk for COVID-19
infection as they’re usually residing in isolated
quarters. In-ptn psychiatric program that is following general
procedure of infection control in
health care settings is suggested (e.g., screening ALL ptns & health care staff before
entry), in addition to other procedures directed to in-ptns psychiatric facilities
if possible. The hardships induced by COVID-19 pandemic may be complicated by suicidal tendency. Subjects with moderate/severe
distress, anxiety, or depression should be surveyed for suicidal ideas &
behavior. Ptns with COVID-19 disease and ptns with psychiatric disorders
pre-dating the start of pandemic should be encouraged to maintain social support and to maintain therapeutic progress via telehealth or
in-person.
REFERENCES
1.
World
Health Organization. Director-General's remarks at the media briefing on
2019-nCoV on 11 February 2020. http://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
(Accessed on February 12, 2020).
9.
Potloc
and Canadian Public Health Association. Perception of Canadian health workers
around the COVID-19 outbreak.
https://potloc.com/blog/en/potloc-study-canadian-health-workers-insights-front-lines-covid-19-pandemic/
(Accessed on July 05, 2020).
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