Bhugra Dinesh, Molodynski Andrew, Gnanapragasam Sam Nishanth
Department of Mental Health and Cultural Diversity, Institute of Psychiatry, Psychology and Neuroscience, Kings College, London, England.
Department of Psychiatry, Oxford University, Oxford, England.
Ind Psychiatry J. 2021 Oct;30(Suppl 1):S5-S9. doi: 10.4103/0972-6748.328862. Epub 2021 Oct 22.
The unprecedented SARS-2 COVID-19 pandemic has had a profound impact on individuals, families, and societies worldwide. The impact of the illness does not only directly relate to poor health on infection but also social and political determinants of health. As such, the secondary effects of the pandemic have been profound. Mental health and well-being have been one such area of concern, with the causal links thought to occur in three ways. First: the impact on general population, particularly vulnerable groups such as BAME individuals; Second: the impact on people with pre-existing psychiatric disorders; Third: mental health of COVID patients and those who have recovered and their careers. There are lessons to be learnt from previous pandemics and the impact on mental health. There are high levels of anxiety, depression, substance use (particularly alcohol), posttraumatic stress symptoms, and survivor guilt. Within this context, there is a need to consider the differential impact on underprivileged populations. Vulnerable groups include women, children, elderly, minority racial and ethnic groups, LGBT + individuals and the poor. It is noted that these classifications are met with challenges related to definition, and there is significant heterogeneity within the groups and the focus on race, gender, and poverty must be seen through an intersectional lens.
前所未有的严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)引发的新型冠状病毒肺炎(COVID-19)大流行对全球个人、家庭和社会产生了深远影响。该疾病的影响不仅直接关系到感染后的健康不佳,还涉及健康的社会和政治决定因素。因此,大流行的次生影响极为深远。心理健康和幸福感就是一个备受关注的领域,其因果联系被认为通过三种方式产生。第一:对普通人群的影响,特别是对如少数族裔和其他易受影响群体(BAME);第二:对已有精神疾病患者的影响;第三:COVID患者及其康复者的心理健康以及他们的职业发展。以往的大流行及其对心理健康的影响能给我们带来一些经验教训。存在高度的焦虑、抑郁、物质使用(尤其是酒精)、创伤后应激症状和幸存者内疚感。在此背景下,有必要考虑对弱势群体的不同影响。弱势群体包括妇女、儿童、老年人、少数种族和族裔群体、 LGBT+个体以及贫困人口。需要注意的是,这些分类在定义上存在挑战,而且群体内部存在显著的异质性,对种族、性别和贫困的关注必须通过交叉视角来看待。