scholarly journals COVID 19 and Psychiatric Morbidity

Author(s):  
Sujit Sarkhel

The COVID 19 virus was first identified in Wuhan in China in 2019. It spread to the entire world subsequently and gave rise to a global pandemic. Although the virus is primarily known to cause respiratory symptoms, there are instances of gastrointestinal symptoms as well as neurological sequelae. The main route of neurotropism is ACE2 receptors expressed in neurons and neuroglia. The SARS-CoV-2, similarly to other respiratory viruses, could gain access to CNS through several routes, for example by migrating through axons of the olfactory nerve.[1]The virus infects and damages the brainstem where respiratory center is located. The inflammatory response, so commonly described in COVID 19 infections, also damages the blood brain barrier causing further destruction to central nervous system through inflammatory chemicals. These massive changes to the brain milieu may be responsible for various neuropsychiatric sequelae like delirium, dementia, stroke as well as form the organic basis of psychiatric conditions like major depressive disorder, anxiety disorder and reactive psychosis. Similarly, massive psychosocial upheavals caused by the overwhelming global pandemic including change in lifestyle and socialization, being forced to stay indoors for weeks together due to lockdowns, financial consequences of unemployment and downslide of economy have all lead to increase in anxiety, depression and even suicidality. This is bound to increase further as time passes and economy takes a further beating. Prolonged stay in intensive care units, fear of imminent death, loss of loved ones all of a sudden- all these have caused increased incidences of post traumatic stress disorder. Overall, the COVID 19 is poised to increase the burden of neuropsychiatric conditions manifold. Longitudinal studies must be undertaken to gain clarity and further understanding on the neuropsychiatric sequelae of COVID 19 and their mechanism.

Author(s):  
Lisa Berg ◽  
Edith de Montgomery ◽  
Monica Brendler-Lindquist ◽  
Ellenor Mittendorfer-Rutz ◽  
Anders Hjern

AbstractParental psychiatric morbidity related to experiences of war and trauma has been associated with adverse psychological outcomes for children. The aim of this study was to investigate parental post-traumatic stress in relation to psychiatric care utilization among children of refugees with particular attention on the child’s own refugee status, sex of both child and parents, and specific psychiatric diagnoses. This was a register study in a population of 16 143 adolescents from refugee families in Stockholm County born 1995–2000 and followed between 2011 and 2017 (11–18 years old). Parental post-traumatic stress, identified in three levels of care, was analysed in relation to child and adolescent psychiatric care use. Cox regression analysis was used to estimate hazard ratios (HR) and 95% confidence intervals (CI), adjusted for duration of residence and demographic and socioeconomic variables. Having a mother with post-traumatic stress was associated with higher psychiatric care utilization, with adjusted HR 2.44 (95% CI 1.90–3.14) among foreign-born refugee children and HR 1.77 (1.33–2.36) among Swedish-born children with refugee parents, with particularly high risks for children with less than five years of residence (HR 4.03; 2.29–7.10) and for diagnoses of anxiety and depression (HR 2.71; 2.11–3.48). Having a father with post-traumatic stress was not associated with increased HRs of psychiatric care utilization. Similar results were seen for boys and girls. Treatment for post-traumatic stress should be made available in refugee reception programmes. These programmes should use a family approach that targets both parents and children.


1987 ◽  
Vol 150 (2) ◽  
pp. 252-255 ◽  
Author(s):  
Jonathan Davidson ◽  
J. Ingram Walker ◽  
Clinton Kilts

In recent years, there has been renewed appreciation of the morbidity which can result from unusual or overwhelming stress and while many situations can give rise to post-traumatic disorder, the most frequently studied of these is probably military combat. Psychiatric disorder pursuant to combat experience can not only become chronic, but may intensify with advancing age, decades after the original trauma (Archibald & Tuddenbaum, 1965; Wilmer, 1982). Moreover, a high percentage of combat veterans are believed ultimately to develop chronic psychiatric morbidity (Walker & Cavenar, 1982). The drug treatment of such post-traumatic states remains an important question, largely over looked until the last 2 years but recent case reports suggest that doxepin and imipramine (White, 1983; Burstein, 1984) are beneficial in treating post traumatic stress disorder (PTSD), which may be either combat or non-combat related. Hogben & Cornfield (1981) described five veterans whose PTSD improved when treated with phenelzine, while Van der Kolk (1983) has described beneficial results with antidepressants, lithium, benzodiazepines, beta blockers, and neuroleptics in uncontrolled studies of PTSD.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046996
Author(s):  
Kirsty Clark ◽  
John Pachankis ◽  
Kaveh Khoshnood ◽  
Richard Bränström ◽  
David Seal ◽  
...  

BackgroundDisplaced Syrians face psychiatric morbidity often resulting from displacement-related stressors (eg, resource scarcity). Both men who have sex with men (MSM) and transgender women among the displaced Syrians are particularly vulnerable to mental health challenges given that they also often face stigma-related stressors (eg, discrimination).MethodsBetween January and December 2019 in greater Beirut, 258 Lebanese-born MSM and transgender women and 230 displaced Syrian MSM and transgender women were recruited via respondent-driven sampling to complete an in-person survey assessing displacement-related stressors, stigma-related stressors, depression, anxiety and post-traumatic stress disorder. In the total sample, we first documented the prevalence of psychiatric morbidity among the displaced Syrians; we then assessed associations among displacement-related and stigma-related stressors and each psychiatric outcome.ResultsSixty-three per cent of Syrian participants met criteria for depression compared with 43.8% of Lebanese participants (p<0.001); 21.3% of Syrians met criteria for severe anxiety compared with 13.1% of Lebanese participants (p<0.05) and 33.0% of Syrians met criteria for post-traumatic stress disorder compared with 18.4% of Lebanese participants (p<0.001). Among Syrian MSM and transgender women, sociodemographic characteristics, displacement-related stressors and stigma-related stressors were uniquely associated with psychiatric morbidity.ConclusionDisplaced Syrian MSM and transgender women experience higher levels of psychiatric comorbidities than Lebanese MSM and transgender women in part due to compounding exposure to displacement-related stressors and stigma-related stressors. Informed by tenets of minority stress theory and intersectionality theory, we discuss mental health intervention implications and future directions.


1992 ◽  
Vol 22 (3) ◽  
pp. 685-693 ◽  
Author(s):  
Nigel Fisher ◽  
Robin Jacoby

SynopsisIn a prospective study 22 bus crews who were victims of physical assault were assessed using standardized psychiatric instruments, followed up for 18 months and compared to a non-assaulted control group drawn from the same bus garage. At initial assessment the assaulted group, compared to the controls showed a significant increase in psychiatric impairment and distress (as measured by the GHQ-30 and IES respectively), with 23% of assault victims developing post-traumatic stress disorder as defined by DSM-III-R. At follow-up, while high levels of both psychiatric impairment and distress persisted there was evidence that they may be separate phenomena.


2003 ◽  
Vol 183 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Jeremy Coid ◽  
Ann Petruckevitch ◽  
Wai-Shan Chung ◽  
Jo Richardson ◽  
Stirling Moorey ◽  
...  

BackgroundAbusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.AimsTo measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.MethodA cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.ResultsChildhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.ConclusionsAbuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.


Author(s):  
Nayoon Lee ◽  
Hyun-Ju Lee

COVID-19 is a respiratory disease caused by a novel coronavirus that quickly spread worldwide, resulting in a global pandemic. Healthcare professionals coming into close contact with COVID-19 patients experience mental health issues, including stress, depression, anxiety, post-traumatic stress disorder, and burnout. This study aimed to explore the experiences of COVID-19-designated hospital nurses in South Korea who provided care for patients based on their lived experiences. Eighteen nurses working in a COVID-19-designated hospital completed in-depth individual telephone interviews between July and September 2020, and the data were analyzed using Giorgi’s phenomenological methodology. The essential structure of the phenomenon was growth after the frontline battle against an infectious disease pandemic. Nine themes were identified: Pushed onto the Battlefield Without Any Preparation, Struggling on the Frontline, Altered Daily Life, Low Morale, Unexpectedly Long War, Ambivalence Toward Patients, Forces that Keep Me Going, Giving Meaning to My Work, and Taking Another Step in One’s Growth. The nurses who cared for patients with COVID-19 had both negative and positive experiences, including post-traumatic growth. These findings could be used as basic data for establishing hospital systems and policies to support frontline nurses coping with infectious disease control to increase their adaption and positive experiences.


2003 ◽  
Vol 43 (2) ◽  
pp. 98-104 ◽  
Author(s):  
Rajan Nathan ◽  
Harry Wood ◽  
Keith Rix ◽  
Eric Wright ◽  

The physical effects of CS spray are well documented. However, less is known about the impact of its use by the police on the psychological health of those exposed. In this study we explored the psychiatric morbidity of a group of 30 individuals who experienced the same trauma, a significant part of which was exposure to CS spray. Just over a quarter suffered post-traumatic stress disorder. It is proposed that more attention needs to be paid to the psychological effects of the use of CS spray by the police. Consistent with other studies, a past psychiatric history and a more external locus of control was associated with post-traumatic morbidity. The latter finding may have implications for psychological interventions after exposure to trauma.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Gul ◽  
R. Faruqui

Background:The South Asian Earthquake of 2005 had a devastating impact on family lives; almost 76,400 people lost their lives, and thousands more sustained disabling injuries.Study design:An epidemiological study, to study psychiatric morbidity amongst parents of deceased children, was carried out at Balakot, Pakistan. The area was chosen due to much lesser migration of the original inhabitant to other part of the country. The study was carried out in April-May 2006, six months after the earthquake.Method:80% of the eligible population participated in the study. The psychiatric instruments that were used in the study included, Pakistan Anxiety & Depression Questionnaire, Hopkins Symptoms Check list- 25 (Urdu-Version) and Rater administered DSM-IV, PTSD questionnaire (Urdu) for diagnosis of Post Traumatic Stress Disorder. The assessment schedules were administered by medical students, trained to administer above instruments and questionnaires.Results:133 subjects participated in the study. Participants mean age was 39 years. Amongst the participants, 20% lost their spouse in the earthquake. There was statistically significant difference in the prevalence of probable diagnosis of depression or anxiety disorder between the male and female population as assessed by PADQ (P< 0.01). Mean HSCL-25 anxiety and depression sub-scale scores also showed a statistically significant gender difference (P< 0.01). 49% met the DSM-IV criteria for diagnoses of PTSD. A higher proportion of female population suffered from PTSD (P< 0.01).Conclusion:The recognition of gender difference in psychiatric morbidity in disaster affected areas has important implications for emergency serviced delivery and long term planning of service provision.


2016 ◽  
Vol 55 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Alberto Firenze ◽  
Nicola Aleo ◽  
Clara Ferrara ◽  
Marianna Maranto ◽  
Caterina La Cascia ◽  
...  

Abstract Introduction Italy is the main recipient of asylum seekers in the European region, and Sicily is their first point of arrival. This geographical position creates a large job for Health Authorities to identify and deal with the health of immigrants. This study evaluates the prevalence of disease among asylum seekers, assessing which are associated factors. Methods A cross-sectional study was conducted to analyse demographic and clinical data in an Acceptance Centres for Asylum Seekers from February 2012 to May 2013. All variables that were found to be significant on unvariable analysis for the most frequent pathologies were included in a multivariable logistic regression model. Results Post-traumatic stress disorders with 17.4% and major depression with 7.3% were the most frequent diseases. The factors associated with post-traumatic stress disorders among asylum seekers were: major depression diagnosis (OR=2.91, p=0.004), Pakistan as a country of origin (OR=3.88, p <0.001), the largest number of medical visits (OR=1.02, p=0.033) and refugee status (OR=1.97, p=0.036). The variables linked with the diagnosis of major depression from the multivariable analysis were: suffering from post-traumatic stress disorders (OR=3.83, p <0.001), Pakistan as a country of origin (OR=3.45, p=0.004) and the highest number of visits to psychologist (OR=1.15, p <0.001). Conclusions The mental wellbeing of asylum seekers needs special attention, and interventions should be done to prevent the consolidation of psychiatric morbidity. A short psychological screening after the arrival might prove helpful here. Moreover, carefully designed longitudinal studies should be carried out when political recommendations try to change the organization of psychological and healthcare services.


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