Abstract
To examine the psychological and social impact of the COVID-19 pandemic and its associated restrictions on a cohort of patients with severe and enduring mental illness treated with clozapine. Semi-structured interviews were conducted with 63 individuals attending a clozapine clinic within the Galway-Roscommon Mental Health Services to determine the impact of COVID-19 restrictions on anxiety and depressive symptoms, social and occupational functioning and quality of life, by utilising Likert scale data. The Beck Anxiety Inventory (BAI) and Hamilton Anxiety Rating Scale (HAM-A) were additionally utilised to measure anxiety symptoms cross-sectionally. Anxiety symptoms were low with a median BAI score of 4.0 and HAM-A score of 4.0. Likert scale measurements recorded only a modest adverse impact of COVID-19 restrictions on anxiety and depressive symptoms, quality of life and occupational and social functioning. Free-text comments from patients (n = 55), were grouped into five themes: neutral impact (n = 22), negative psychological impact (n = 13), negative social impact (n = 11), positive psychological impact (n = 5) and media coverage inducing anxiety (n = 4). Three months into the COVID-19 pandemic and its restrictions, the impact on individuals with treatment-resistant psychotic disorders attending a clozapine clinic has been modest, with preliminary evidence demonstrating minimal increases in subjective symptoms of anxiety and reduced social functioning. Reduced social engagements and supports attainable both within the community and from mental health services were noted by some participants.
Highlights
COVID-19 is the infectious disease associated with the recently discovered coronavirus, SARS-CoV-2
Research interviews were undertaken by one author (YF) with training in study procedures provided by the principal investigator (BH)
44 (69.8%) participants were male, the mean age of participants was 44.7 ± 10.6 years, 23 participants were engaged in employment prior to ‘lockdown”, with 5 having their site of employment temporarily terminated and 4 of the remaining 18 participants having their site of work moved to their own residence due to COVID-19 restrictions
Summary
COVID-19 is the infectious disease associated with the recently discovered coronavirus, SARS-CoV-2. First identified in Wuhan, China, in December 2019, COVID-19 was characterised as a pandemic by the World Health Organization (WHO) on 11 March 2020 (World Health Organisation, 2020). The COVID-19 pandemic has dominated media coverage in recent months with updates regarding spread and lethality produced and available on a minute-by-minute basis (González-Padilla & Tortolero-Blanco, 2020). The declaration of the pandemic was followed by the implementation of restrictions and ‘“lockdowns’ in many countries worldwide. In Ireland, restrictions included ‘cocooning’ of individuals over 70 years of age, a limitation on travel and the introduction of social distancing measures, which resulted in the closure of many facilities deemed as ‘non-essential’. In addition to restaurants and cafes, these facilities included centres attended by individuals with mental health disorders such as day centres and training centres where group activities and social engagement occurred. Social effects of a pandemic may include disruption of daily routine and social isolation including separation from family and friends (Taylor, 2019)
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