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.
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