1Department of Psychological Medicine, National University Health System, Singapore 2Department of Psychological Medicine, National University of Singapore, Singapore 3Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore Address for Correspondence: Dr Cyrus Ho Su Hui, Department of Psychological Medicine, National University Health System, Level 9, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228. Email: su_hui_ho@nuhs.edu.sg Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic

Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic

Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review.

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Mental Health Strategies to Combat the Psychological Impact of Coronavirus Disease 2019 (COVID-19) Beyond Paranoia and Panic

The COVID-19 pandemic has radically impacted the world lifestyle. Epidemics are well-known to cause mental distress, and patients with a current or past history of obesity are at increased risk for the common presence of psychological comorbidities. This study investigates the psychological impact of the current pandemic in patients participating in a bariatric surgery program. Patients were consecutively enrolled during the Italian lockdown among those waiting for bariatric surgery or attending a post-bariatric follow-up, and were asked to complete through an online platform the Depression Anxiety Stress Scales-21 and a self-assessment questionnaire of 22 items evaluating the resilience, change in eating behavior and emotional responses referring to the ongoing pandemic. 59% of the 434 enrolled subjects reported of being worried about the pandemic, and 63% specifically reported of being worried about their or their relatives’ health. 37% and 56% felt lonelier and more bored, respectively. 66% was hungrier with increased frequency of snacking (55%) and 39% reported more impulse to eat. Noteworthy, 49% felt unable to follow a recommended diet. No difference in terms of psychological profile was recorded among pre and post-bariatric subjects. Logistic regression analysis on post-bariatric patients showed a relationship between snacking, hunger, eating impulsivity, and anxiety, stress, and/or depression symptoms. The pandemic led to increased psychological distress in patients with a current or past history of obesity, reducing quality of life and affecting dietary compliance. Targeted psychological support is warranted in times of increased stress for fragile subjects such as pre- and post-bariatric patients. Level V: cross-sectional descriptive study.

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The psychological impact of COVID-19 pandemic on patients included in a bariatric surgery program.

The prevalence of COVID-19 disease continues to be a significant psychosocial status among health care workers (HCWs) and the general population worldwide. This cross sectional study aimed to compare the psychosocial status between healthcare workers and general population during the prevalence of COVID-19 disease in southeast Iran. Totally 415 health care workers of a medical service center for COVID-19 patients and 1023 people of general population participated in the study. An online socio-demographic characteristics questionnaire, General Health Questionnaire (GHQ -28), and Generalized Anxiety Disorder 7-item (GAD-7) were utilized to evaluate psychosocial status. According to GHQ, the psychological disorders of the HCWs were significantly higher than that of the general population (P < 0.001). According to GAD-7, no significant difference was found between general population and HCWs. Multivariate logistic analysis showed no difference between general population and HCWs in the psychological disorder. Although HCWs suffered from psychological disorders more than general population, nearly one third to half of the participants in both groups had psychosocial disorders.

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Psychosocial status during the prevalence of COVID-19 disease: the comparison between healthcare workers and general population.

Emil Kraepelin, the founder of modern psychiatric classification, and the Nobel laureate Julius Wagner von Jauregg highlighted the role of infections and the immune system in psychiatric disorders. It is well known that infections can trigger various psychiatric syndromes and influence the course of psychiatric disorders. Psychiatric symptoms during virulent infections, often presenting as encephalitis or meningitis, normally are diagnosed as mental disorders due to a general medical condition. On the other hand, an expanding research field underpins the view that infections and activation of the immune system may play a causative role in major psychiatric disorders such as schizophrenia or major depression. Also in other psychiatric syndromes, such as Tourette's syndrome, inflammation - partially based on infections - is involved. For this mild smoldering inflammatory process, the ‘mild (chronic) encephalitis' concept was developed. In this chapter, findings related to immune activation and inflammation in schizophrenia, major depression and Tourette's syndromes as examples for this concept are described. Moreover, encouraging results from randomized clinical trials in schizophrenia and major depression showing a benefit of anti-inflammatory therapy in these psychiatric disorders are discussed as examples for immunomodulating treatment approaches in psychiatric disorders. Further immunotherapies used in Tourette's syndrome or pediatric autoimmune disorders associated with streptococci are highlighted as further examples for such a therapeutic approach.

Norbert Müller

Papers

Infectious Diseases and Mental Health