Abstract
The outbreak of coronavirus disease (COVID-19) in December 2019 has led to massive lifestyle, economic, and health changes. The COVID-19 pandemic has had broad impacts on psychiatric patients, exacerbating symptoms such as psychosis, depression, and suicidal ideation. Therefore, we aimed to review the psychological impacts of COVID-19 on psychiatric patients and mental healthcare staff and provide practical guidance for medical staff and authorities.The main findings of this review included the impacts of COVID-19 on psychiatric patients and mental health professionals as well as the transformation of mental health care. Greater consideration should be given to the care of patients with psychosis and depression because of their lack of self-care ability, neurocognitive impairment, and impaired immune function. Depressive symptoms can be exacerbated due to several factors, such as economic crises, social isolation, and limited physical activity. Unemployment and financial problems can lead to an increased suicide rate. Consequently, mental healthcare workers’ workload can increase, which could lead to burnout and psychological symptoms such as insomnia, depression, and anxiety.A transformation of psychiatric care is needed during the time of the pandemic. While emergency care should be maintained, outpatient care should be limited to decrease viral spread. Shifting care to telemedicine and community-based psychiatry can be helpful. Inpatient services should be adapted by tightening admission criteria, shortening the length of hospital stays, suspending some group activities, limiting visitors, and preparing for quarantine if necessary. Mental healthcare workers can be supported with telecommunication, appropriate work shifts, alternative accommodations, and good communication between the team leader and staff.
Highlights
Prior experiences with coronavirus outbreaks such as MERS-CoV and SARS-CoV contributed to mental health consequences among patients, health care providers, and the general population
This article aims to present perspectives on the care of psychiatric patients during the outbreak of COVID-19 based on public health concerns and recent literature
The immune reactivity can cause psychotic symptoms related to inflammatory tissue damage as confirmed by autopsy studies. Neurological sequelae such as neuroinflammatory signs, reactive gliosis, astrocytosis, and microglia activation were found in patients with COVID-19 [22, 23]. These findings suggest that neuropsychiatric manifestations can be a direct impact of human coronavirus exposure
Summary
Prior experiences with coronavirus outbreaks such as MERS-CoV and SARS-CoV contributed to mental health consequences among patients, health care providers, and the general population Mental problems such as psychophysical stress, posttraumatic stress disorder (PTSD) symptoms, anxiety, depression, and insomnia were common [1 - 7]. Healthcare professionals are Psychiatric patients are more vulnerable to crises than general populations [13, 14] These patients may be at risk of worsening depression, anxiety, and psychotic symptoms during a crisis [15]. Psychiatric patients’ higher risk of the inappropriate use of self-medications, nonprescribed medications, and substances e.g., alcohol, illegal drugs must be recognized Such inappropriate use can worsen symptoms and cause a vicious cycle of illness [16 - 18]. Psychiatric inpatient settings, which have unique characteristics of patient care, involve a high likelihood of transmission due to patientpatient and patient-provider contact [21]
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