April 27, 2020 by Sam Bazzi
As people grow restless during self-isolation as a result of stay-at-home orders (especially as shown by the growing amount of protests across the USA), I think it is important to look at psychological responses to this crisis around the world. It may seem obvious that people respond negatively to a global infectious disease and being isolated indoors, but issues of mental health and psychiatric disorders during this crisis are not reported on nearly as much as the biological and economic impact of this disease.
One study from China showed that during the early phase of the pandemic, 16.5% of responders reported moderate to severe depressive symptoms, 28.8% reported moderate to severe anxiety symptoms, and 8.1% reported moderate to severe stress symptoms (Wang, et al., 2020). Factors that were associated with greater psychological impact of the pandemic were female gender, student status, physical symptoms, and poor self-rated health status. These factors were also associated with higher levels of stress, anxiety, and depression.
Another paper published in the Lancet focused on the lack of mental health services for older adults in China. China has 241 million people over the age 60, comprising the largest aging population globally as of 2017. Unfortunately, Chinese adults over the age of 55 have a higher prevalence of depressive symptoms (23.6%), which could be exacerbated by the high mortality rate of COVID-19 in this age group (Yang, et al., 2020). Despite the advantages of telemedicine, older adults in China are less likely to have access to the internet and smartphones. Additionally, older psychiatric patients in most parts of China obtain their medications in person from outpatient clinics, which has created a large barrier for many people. This has created a situation where many older people cannot access appropriate mental health services, which is made particularly more devastating due to mass restrictions on public movement.
infectious diseases in the past have created fear, isolation, and suffering at both the individual and community level. During the H1N1 influenza pandemic in the US, individuals were more likely to take part in risky behaviors such as smoking, drinking, drug misuse, recklessness, and unsafe work practices (Pfefferbaum, et al., 2012). Perhaps the many protests occurring across the US aimed at lifting stay-at-home orders are driven more by these well-documented psychological responses to pandemic (in addition to financial vulnerability) rather than an earnest belief in the effectiveness of lifting restrictions (Mogaji, 2020). This pandemic has not only created a need to produce medications and vaccines, but also the need to rethink how leadership can better meet the needs of people suffering from mental health disorders, as well as stymie the spread of misinformation and mistrust that naturally arises during crises like this.
Written by: Sam Bazzi
Edited by: Jina Zhou and Esther Melamed
4/27/2020
References
Mogaji, E. (2020). Financial Vulnerability During a Pandemic: Insights for Coronavirus Disease (COVID-19). Mogaji, E, 57-63.
Pfefferbaum, B., Schonfeld, D., Flynn, B. W., Norwood, A. E., Dodgen, D., Kaul, R. E., … & Jacobs, G. A. (2012). The H1N1 crisis: a case study of the integration of mental and behavioral health in public health crises. Disaster medicine and public health preparedness, 6(1), 67-71.
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research and public health, 17(5), 1729.
Yang, Y., Li, W., Zhang, Q., Zhang, L., Cheung, T., & Xiang, Y. T. (2020). Mental health services for older adults in China during the COVID-19 outbreak. The Lancet Psychiatry, 7(4), e19.
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