Puangsri Pavarud, Jinanarong Vinn, Wattanapisit Apichai
School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, Thailand.
Walailak University Hospital, Thasala, Nakhon Si Thammarat, Thailand.
Clin Pract Epidemiol Ment Health. 2021 Jul 12;17:52-60. doi: 10.2174/1745017902117010052. eCollection 2021.
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.
2019年12月冠状病毒病(COVID-19)的爆发导致了生活方式、经济和健康方面的巨大变化。COVID-19大流行对精神科患者产生了广泛影响,加剧了精神病、抑郁和自杀意念等症状。因此,我们旨在综述COVID-19对精神科患者和精神卫生保健人员的心理影响,并为医务人员和相关部门提供实用指导。本综述的主要发现包括COVID-19对精神科患者和精神卫生专业人员的影响以及精神卫生保健的转变。由于缺乏自我护理能力、神经认知障碍和免疫功能受损,应更加关注精神病和抑郁症患者的护理。抑郁症状可能会因经济危机、社会隔离和身体活动受限等多种因素而加剧。失业和经济问题可能导致自杀率上升。因此,精神卫生保健工作者的工作量可能会增加,这可能导致职业倦怠以及失眠、抑郁和焦虑等心理症状。在大流行期间需要对精神科护理进行转变。在维持急诊护理的同时,门诊护理应加以限制以减少病毒传播。将护理转向远程医疗和社区精神病学可能会有所帮助。住院服务应通过收紧入院标准、缩短住院时间、暂停一些团体活动、限制访客以及必要时做好隔离准备来进行调整。可以通过电信、合理的工作班次、替代住宿以及团队领导与工作人员之间的良好沟通来支持精神卫生保健工作者。