White River Junction Veterans Affairs Medical Center, White River Junction, VT 05009, USA.
Department of Psychiatry and Dartmouth Institute, Geisel School of Medicine at Dartmouth College, Hanover, NH 03755, USA.
Mil Med. 2021 Aug 28;186(9-10):e956-e961. doi: 10.1093/milmed/usaa559.
There is emerging evidence to support that the COVID-19 pandemic and related public health measures may be associated with negative mental health sequelae. Rural populations in particular may fair worse because they share many unique characteristics that may put them at higher risk for adverse outcomes with the pandemic. Yet, rural populations may also be more resilient due to increased sense of community. Little is known about the impact of the pandemic on the mental health and well-being of a rural population pre- and post-pandemic, especially those with serious mental illness.
We conducted a longitudinal, mixed-methods study with assessments preceding the pandemic (between October 2019 and March 2020) and during the stay-at-home orders (between April 23, 2020, and May 4, 2020). Changes in hopelessness, suicidal ideation, connectedness, and treatment engagement were assessed using a repeated-measures ANOVA or Friedman test.
Among 17 eligible participants, 11 people were interviewed. Overall, there were no notable changes in any symptom scale in the first 3-5 months before the pandemic or during the stay-at-home orders. The few patients who reported worse symptoms were significantly older (mean age: 71.7 years, SD: 4.0). Most patients denied disruptions to treatment, and some perceived telepsychiatry as beneficial.
Rural patients with serious mental illness may be fairly resilient in the face of the COVID-19 pandemic when they have access to treatment and supports. Longer-term outcomes are needed in rural patients with serious mental illness to better understand the impact of the pandemic on this population.
有越来越多的证据表明，COVID-19 大流行及相关公共卫生措施可能与负面的心理健康后果有关。农村人口可能情况更糟，因为他们有许多独特的特征，使他们在大流行期间面临更高的不良后果风险。然而，由于社区意识的增强，农村人口也可能更有弹性。对于大流行前和大流行期间农村人口的心理健康和幸福感，特别是那些患有严重精神疾病的人群，人们知之甚少。
我们进行了一项纵向混合方法研究，在大流行前（2019 年 10 月至 2020 年 3 月）和居家令期间（2020 年 4 月 23 日至 2020 年 5 月 4 日）进行评估。使用重复测量方差分析或 Friedman 检验评估绝望感、自杀意念、联系感和治疗参与度的变化。
在 17 名符合条件的参与者中，有 11 人接受了采访。总体而言，在大流行前的 3-5 个月或居家令期间，任何症状量表都没有明显变化。少数报告症状恶化的患者年龄明显较大（平均年龄：71.7 岁，标准差：4.0）。大多数患者否认治疗中断，一些人认为远程精神病学有益。
当农村严重精神疾病患者能够获得治疗和支持时，他们在 COVID-19 大流行面前可能具有相当的弹性。需要对农村严重精神疾病患者进行更长期的结果评估，以更好地了解大流行对这一人群的影响。
