Depression, Dependence and Prices of the COVID-19-Crisis

Abstract

Dear Editor, The threat from the COVID-19 pandemic dawned on Western Europe early in March 2020 when the medical systems began to prepare for the care of large numbers of acutely ill patients with severe pulmonary problems. Hospital infrastructure and outpatient care was acutely reorganized and the consequences were immediately felt by staff who had to be trained (Shi et al., 2020), and with a short delay also by patients, who had to be discharged early, were not admitted for elective interventions or who were no longer invited for face to face consultations. This situation is particularly difficult for individuals with serious mental disorders (Fatke et al., 2020, Shao et al., 2020). Therefore we carried out a cross-sectional evaluation on a convenience sample of patients who were treated in our departments during the second and third week of April 2020. A short standardized interview was employed for patient examination which included the Clinical Global Impression (CGI) Scale. Diagnoses were made according to the ICD-10. 196 (of 207) patients (54% female) were able and willing to participate. Their mean age was 47 years, ranging from 18 to 85 (SD 15.8 yrs.). None of the patients had contracted COVID-19; one had been quarantined for a few days until an infection could be ruled out. Main psychiatric diagnoses were affective disorders in 121 patients (ICD-10 F3), schizophrenia and related disorders in 41 (F2), addictive disorders in 21, and others in 13. The CGI-scores were evenly distributed between the groups with a mean of 4.6 (SD 1.7) and so were most symptoms described. More than half of the patients from all groups felt that they now had to endure much more mental distress due to the pandemic. A quarter of the patients with affective disorders reported increased difficulties sleeping. What stood out in comparison with the other diagnoses was, that half or more of the patients with addictions complained that their daily routines were badly affected, they were afraid of the future, had financial worries, suffered from isolation (also on open wards) and experienced increased irritability (Pearson Chi-square < 0.01). Among the explanations offered spontaneously by the patients was that the crisis had sent prices of illegal substances sky high. The pandemic appears to burden patients with mental disorders from all diagnostic groups, disrupting their daily routines, cutting their social ties, increasing their financial worries and fears of the future. The early impact of dynamic markets not usually monitored by medical personnel was a surprise to us and may need increased attention in times of crisis. Disclosure Statement: The authors declare no conflict of interest.