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      The impact of the COVID-19 pandemic on suicide ideation and suicide attempts in a sample of psychiatric inpatients

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          Abstract

          There has been little research reported regarding both suicide ideation and suicide attempts during the COVID-19 pandemic and government lockdown restrictions in Italy, one of the countries most affected by the pandemic. We investigated whether the frequency of suicide ideation and suicide attempts differed between psychiatric patients admitted to a psychiatric unit before and during the COVID-19 pandemic and government lockdown restrictions. We also assessed psychiatric diagnosis, length of hospitalization, and types of admission. We collected data on 632 psychiatric patients admitted to a public psychiatric clinic. Patients were divided into two different groups according to their admission before or during the COVID-19 pandemic. Our results showed that only suicide attempts, but not suicide ideation, were more frequent in psychiatric patients admitted during the COVID-19 pandemic than before. Furthermore, mood disorder diagnoses were more frequent during the COVID-19 pandemic than before the pandemic. The types of admission and the mean length of hospitalization did not differ between the two groups. In conclusion the present study results adds consistent knowledge on the phenomenon of suicide during the challenging time of the pandemic, pointing to continuing effort in suicide prevention measures.

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          The psychological impact of quarantine and how to reduce it: rapid review of the evidence

          Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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            Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

            Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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              Patients with mental health disorders in the COVID-19 epidemic

              More than 60 000 infections have been confirmed worldwide in the coronavirus disease 2019 (COVID-19) epidemic, with most of these cases in China. Global attention has largely been focused on the infected patients and the frontline responders, with some marginalised populations in society having been overlooked. Here, we write to express our concerns with regards to the effect of the epidemic on people with mental health disorders. Ignorance of the differential impact of the epidemic on these patients will not only hinder any aims to prevent further spread of COVID-19, but will also augment already existing health inequalities. In China, 173 million people are living with mental health disorders, 1 and neglect and stigma regarding these conditions still prevail in society. 2 When epidemics arise, people with mental health disorders are generally more susceptible to infections for several reasons. First, mental health disorders can increase the risk of infections, including pneumonia. 3 One report released on Feb 9, 2020, discussing a cluster of 50 cases of COVID-19 among inpatients in one psychiatric hospital in Wuhan, China, has raised concerns over the role of mental disorders in coronavirus transmission. 4 Possible explanations include cognitive impairment, little awareness of risk, and diminished efforts regarding personal protection in patients, as well as confined conditions in psychiatric wards. Second, once infected with severe acute respiratory syndrome coronavirus 2—which results in COVID-19—people with mental disorders can be exposed to more barriers in accessing timely health services, because of discrimination associated with mental ill-health in health-care settings. Additionally, mental health disorder comorbidities to COVID-19 will make the treatment more challenging and potentially less effective. 5 Third, the COVID-19 epidemic has caused a parallel epidemic of fear, anxiety, and depression. People with mental health conditions could be more substantially influenced by the emotional responses brought on by the COVID-19 epidemic, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population. Finally, many people with mental health disorders attend regular outpatient visits for evaluations and prescriptions. However, nationwide regulations on travel and quarantine have resulted in these regular visits becoming more difficult and impractical to attend. Few voices of this large but vulnerable population of people with mental health disorders have been heard during this epidemic. Epidemics never affect all populations equally and inequalities can always drive the spread of infections. As mental health and public health professionals, we call for adequate and necessary attention to people with mental health disorders in the COVID-19 epidemic.
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                Author and article information

                Journal
                Psychiatry Res
                Psychiatry Res
                Psychiatry Research
                Published by Elsevier B.V.
                0165-1781
                1872-7123
                24 June 2021
                September 2021
                24 June 2021
                : 303
                : 114072
                Affiliations
                [a ]Department of Neurosciences, Mental Health, and Sensory Organs, Faculty of Medicine and Psychology, Suicide Prevention Centre, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
                [b ]Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
                [c ]Department of Psychology, Sapienza University of Rome, Rome, Italy
                [d ]Psychiatry Residency Training Program, Faculty of Medicine and Psychology, Sapienza University of Rome, Psychiatry Unit, Sant'Andrea Hospital, Rome, Italy
                [e ]Department of Human Sciences, European University of Rome, 00163 Rome, Italy
                [f ]Stockton University, New Jersey, USA
                Author notes
                [* ]Corresponding author.
                Article
                S0165-1781(21)00369-3 114072
                10.1016/j.psychres.2021.114072
                8543059
                34256349
                6f556b12-1fea-4a35-b090-96b0f595559a
                © 2021 Published by Elsevier B.V.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 10 April 2021
                : 17 June 2021
                : 19 June 2021
                Categories
                Article

                Clinical Psychology & Psychiatry
                covid-19 pandemic,suicide attempts,suicide ideation,depression

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