Abstract
The COVID-19 pandemic is a major health issue, which leads to psychological and behavioural changes. In particular, among various negative feelings, fear seems to be one of the main emotional reactions that can be as contagious as the virus itself. The actual pandemic is likely to function as an important stressor, especially in terms of chronic anxiety and lack of control over the succession of unforeseeable environmental events. In this direction, the psychological impact of previous quarantine measures showed important negative psychological effects, including post-traumatic stress symptoms (PTTS) with long-lasting effects. The presence of psychological discomfort and disturbances due to negative contextual factors can be studied using the nocebo phenomenon as a possible theoretical explanatory framework. Although in the absence of studies linking nocebo to Covid-19 and data-driven evidence, the context of the actual pandemic may be seen as a fertile ground for amplified discomfort and anxiety. The media provide dramatic and negative descriptions and often present conflicting sources of information, which can lead to physical and mental health problems, diminishing response to treatment. This can be worse when supported by conspiracy theories or misinformation. The aim of this perspective review is to propose a new theoretical framework for the COVID-19 pandemic, which should be supported by future empirical studies. In particular, the negative contextual factors, which can predispose individuals to psychological distress and the onset of the nocebo phenomena will be presented here, in order to suggest possible guidelines to mitigate the devastating effects of COVID-19.
Highlights
The COVID-19 pandemic includes a perfect storm in which powerful nocebo effects may be flourishing
Previous coronavirus epidemics caused an increase in stress levels and neuropsychiatric implications, − i.e., mental disorders that are the sequelae of brain damage or disease, in patients admitted to hospital for Severe acute respiratory syndrome due to coronavirus (SARS-CoV) or Middle East respiratory syndrome (MERS-CoV; Rogers et al, 2020) – as reported by WHO (2020) for the actual pandemic
Regarding the individual factors that can predispose individuals to psychological distress, and the onset of the nocebo phenomena, two aspects should be highlighted: (1) the importance of maintaining the functional aspects of anxiety, as healthy and natural response to stressful circumstances, as useful to comply with the rules of conduct to reduce the risk of SARS-COV2 infection and (2) in contrast, high levels of anxiety about the risk of contagion, which can lead to a stress reaction causing post-traumatic stress symptoms (PTTS), should be contrasted, for instance, by avoiding update on alarming news
Summary
The COVID-19 pandemic includes a perfect storm in which powerful nocebo effects may be flourishing. Stress associated with negative expectations, which can be a fertile substrate for the onset of a nocebo effect, can produce significant physiological changes in the human body, including sleep disorders, respiratory complications, circulatory stress, digestive disorders, muscle tension, and pain (Liu et al, 2020). These symptoms are likely to further aggravate the prognosis of individuals with COVID-19. Possible guidelines to mitigate the devastating effects of COVID-19 will be suggested
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