The risk of developing a mental health disorder is increased when the environment around is more hostile, such as poverty and homelessness, and other comorbid physical conditions may arise. As such, people with mental disorders are at increased risk of infections in general (and thereby potentially at increased risk of COVID-19), and are more likely to develop severe organ dysfunction and to die in ICUs than people without mental disorders

Higher risk of SARS-CoV-2 infection

Physical distancing can be challenging certain institutions, such as nursing homes, learning disability nursing or prisons. For institutions such as nursing homes and learning disability nursings, the nature of patients' conditions makes it difficult to manage, while prisons may experience difficulty because of overcrowding.

Difficulty in following safety measures 

Particular circumstances that appeared due to the pandemic can have negative impacts on the symptoms of those who had previous mental health problems, such as increased symptoms, relapse, suicidal behavior, lack of access to medical care, and social isolation. Such circumstances include: 
- early discharge from psychiatric units, 
- disruption of face-to-face psychiatric care, 
- lockdown and quarantine, 
- disruption of daily routines,
- Physical distancing: Physical distancing, in particular, can reduce the availability of many families, social, and psychiatric supports. 

Increased symptoms, relapse, and poorer access to services and supports

- Depression
- Obsessive-Compulsive Disorder
- Hoarding Disorder
- Post-traumatic Stress Disorder
- Anxiety/ Panic Disorders
- Social Anxiety Disorder
- Body dysmorphic disorder
- Schizophrenia 
- Borderline Personality Disorder

Mental Disorders Affected By The Covid-19 Pandemic

- higher risk of SARS-CoV-2 infection for those with pre-existing mental health disorders
- Difficulty in following safety measures due to entenuating circumstances
- increased symptoms, relapse, and poorer access to services and supports

Smith College

- Children

- Domestic caregivers

- Old age

- Marginalized community

- General public

- People who have or had COVID-19

- People with pre-existing mental health disorders

- Health-care workers

Psychological Effects of COVID-19 on different sections of society

Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C., Byrne, L., Carr, S., Chen, E., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., Phillips, M., Uchida, H., Vieta, E., Vita, A. and Arango, C., 2020. How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet Psychiatry. DOI:https://doi.org/10.1016/S2215-0366(20)30307-2

How mental health care should change as a consequence of the COVID-19 pandemic

Developmental psychology researchers largely founded that learned experiences through environmental factors during early childhood engender the fundamentals for lifetime behavior and success as it is a crucial phase for cognitive, emotional and psychosocial skill development.  Closing of schools, parks, and playgrounds will disrupt children’s usual lifestyle and can potentially promote distress and confusion. Children are likely to become more demanding, having to cope up with these changes, and may exhibit impatience, annoyance and hostility, which in turn may cause them suffering from physical and mental violence by overly pressurized parents

Children

 older adults and people with serious comorbidities are particularly vulnerable to worse outcomes from COVID-19 can create considerable fear amongst the elderly.   Older adults with cognitive decline may become much more anxious, agitated, and socially withdrawn, thus their specific needs demand specific attention

Old Age

 Members at home may feel it emotionally difficult if they cannot visit their sick relatives in the hospital due to strict lockdown situations. On the other hand, family members coming to hospitals for their critically ill relatives/significant others who require emergency care and admission may have feelings of helplessness and vulnerability in fear of violating the social restriction rules, setting an example of “learned helplessness”

Domestic Caregivers

Majority of international migrant workers in the public health structures are already overstretched and live in areas with high incidence of Covid-19.  These people are more likely to be discriminated against.  Furthermore, immigrants and refugees may even have to bear with the stigma of remaining as a speculated source of outbreak in a community where home-quarantine has been implemented. Considering the lethal communicability of this disease, migrants, refugees and slum-dwellers are at heightened risk of contracting and spreading the infection

Marginalized community- migrants, prisoners, slum dwellers and daily wagers

Potential consequences of COVID-19 for mental health for people with pre-existing mental health disorders

- Clinically stable people discharged from hospital after recovering from COVID-19 have reported high rates of post-traumatic symptoms 
- Mental disorders such as PTSD, depression and anxiety were prevalent in people who survived severe coronavirus infections 
- People who have had COVID-19 can experience post-intensive-care syndrome, and those who have been admitted into ICUs may experience dysexecutive syndrome 
- There have been reports of a post-viral syndrome that resembles depression

Potential consequences of COVID-19 for mental health for people who have or had COVID-19

Potential consequences of COVID-19 for mental health for the General Public

The stress of exposure and fear of infecting themselves or their loved ones associated with working as a health-care worker is related to adverse mental health effects such as depression, anxiety, insomnia, distress. Common risk factors included a lack of social support and communication, maladaptive coping strategies, and a lack of (usually disaster) training. Moral injury is also a subject of concern in health-care workers, especially those who had worked in the over-stressed ICUs where they had to make tough decisions about how to prioritize scant or inadequate resources, potentially resulting in deaths that might be avoidable under normal circumstances

Health-care workers


Since COVID-19’s inception in December 2019, healthcare workers (HCW) have been the primary persons involved in the screening and treatment of the disease. However, HCW are not immune to its psychological effects. Various reasons exist for these adverse outcomes which include: high infection rates among HCW, excessive workload, inadequate PPE, an oversaturated media presence, and the feeling of insufficient support. Reasons specific to the disease itself include its rapid spread, mode of transmission, an undefined protocol of treatment, and lack of vaccine. Compared to doctors, nurses have higher rates of depressive and anxiety symptoms. Thus, it is important to consider mental health evaluation in the regular screening of HCW, followed with implementation of mental health teams.

Psychological Effects of COVID-19 on Healthcare Workers

- People with IDD had higher prevalence of specific co-morbidities associated with poorer COVID-19 outcomes such as hypertension, heart disease, respiratory disease, and diabetes
- Overall case-fatality rates similar for those with IDD (5.1%) and those without
- Within 18–74 years age range, case-fatality rate higher for IDD population(4.5%) compared to those without IDD (2.7%), and also in the 0–17 years age group, but not among those 75 years and older
- Not enough data on people with IDD even though they have higher risk of identified co-morbidities 
- Case-fatality rates in this study were similar for people with and without IDD when not accounting for age, but considerably different when accounting for age

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