Psychiatry in the age of COVID-19

Fonte: World Psychiatry 19:2 – June 2020

Authors: J. Unützer, R.J. Kimmel, M. Snowden

Within a few months, COVID-19 has sickened millions, killed more than 200,000, disrupted the lives of virtually everyone, and caused tremendous anxiety, trauma and grief. As psychiatrists, we are used to helping people who have suffered trauma and loss. Some of us have cared for survivors of disasters, but few have experienced a global pandemic that threatens all of our lives. None of us was prepared for this crisis, and we acknowledge that the observations and adaptations we are writing about here may not stand the test of time.
What do we know about the effects of pandemics on mental health and what can psychiatrists do to help? Studies from earlier outbreaks suggest high rates of acute stress and anxiety among the public, patients and health care workers. A recent study of health care personnel in China found high rates of depression and anxiety, especially among those on the front lines. In our own experience, we have seen increased stress in individuals with preexisting mental health or substance use disorders, who may be socially isolated and have reduced access to their usual treatment programs or support systems.
We have also noted new psychiatric symptoms in individuals experiencing stress, anxiety or grief as a result of the pandemic. Some are experiencing losses under traumatic circumstances, such as not being able to say goodbye to dying loved ones or the inability to offer proper burials. Physical distancing can help slow the spread of the virus, but we know the risks associated with so-cial isolation. This can be particularly challenging for those who are elderly, poor, or without access to telephones or the Internet. Along with isolation, we may experience a loss of structure, in-creased time for anxious rumination, and limited opportunities for active coping. […]

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