Analysis of the Consequences of the COVID-19 Pandemic on People with Severe Mental Disorders.

Antonio José Sánchez-Guarnido,Inmaculada Esteban,Silvia Mondón,Carlos Herruzo,Nuria Hidalgo,Jorge Arenas De La Cruz

doi:10.3390/ijerph18168549

Abstract

For people with severe mental disorders (SMDs) the COVID-19 pandemic may pose a number of risks. These include the loss of needed care, a higher probability of infection, and the worsening of their mental health. To analyze the pandemic’s impact on care received, relapses, loss of employment, and adherence to preventive guidelines in SMD sufferers, a multicenter retrospective cohort study was carried out comparing 185 patients diagnosed with SMD and 85 with common disorders. The results showed that during lockdown, there was a significant reduction in face-to-face psychotherapeutic, nursing, and occupational therapy interventions. In the same period, telematic interventions were introduced which, although subsequently reduced, now continue to be used to a greater extent than before the pandemic. Employment decreased significantly (13% vs. 9.2%; 𝜒2 = 126.228 p < 0.001). The percentage of people with SMD following preventive guidelines was significantly lower for both hand washing (56.2% vs. 75.3%; 𝜒2 = 9.360, p = 0.002) and social distancing (47% vs. 63.5; 𝜒2 = 6.423 p = 0.011). In conclusion, the COVID-19 pandemic has led to a reduction in the interventions that are needed for the recovery of people with SMDs, together with a significant loss of employment and an increased risk of contagion due to less adherence to preventive guidelines. In the future, appropriate attention to these people’s needs must be guaranteed.

Highlights

The scientific literature has recorded how different pandemics have affected the mental health of the world’s population [1], but countries have been caught unprepared to manage such repercussions at this level [2] and the COVID-19 pandemic has posed a great challenge for effective severe mental disorders (SMDs) therapy [3]
We began by comparing the percentages of patients with SMDs who received faceto-face or telemedicine psychotherapy before, during, and after lockdown
Patients receiving psychotherapy telematically increased from 4.4% in the pre-lockdown period to 64.8% during lockdown, and to 30% after lockdown

Summary

Introduction

The scientific literature has recorded how different pandemics have affected the mental health of the world’s population [1], but countries have been caught unprepared to manage such repercussions at this level [2] and the COVID-19 pandemic has posed a great challenge for effective SMD therapy [3]. A recent meta-analysis has provided concrete figures on the prevalence of mental disorders during the pandemic. The study indicates that the prevalence of depression in COVID-19-affected populations is more than three times higher (15.97%) than in the general population (4.4%); while it is four times higher for anxiety (15.15% vs 3.6%); and five times higher for post-traumatic stress disorder (21.94% vs 4%) [4]. Another study has noted that, in patients with no previous psychiatric history, a diagnosis of COVID-19 was associated with a higher incidence of a first psychiatric diagnosis in the following 14 to 90 days [5]. At the same time during the pandemic, face-to-face interven-

Objectives

Results

Discussion

Conclusion