Psychisch krank in Krisenzeiten: Subjektive Belastungen durch COVID-19

Zusammenfassung

Ziel der Studie Wir untersuchen die alltagsrelevanten und klinischen Auswirkungen der aktuellen Corona-Krise auf Menschen mit vorbestehenden psychischen Erkrankungen.

Methode Neben der klinischen Untersuchung wurde den Patienten, die sich derzeit in unserer stationären oder ambulanten Behandlung befinden, ein standardisierter Fragebogen zur subjektiven Belastung und psychiatrischen Versorgung ausgehändigt.

Ergebnisse Mehr als die Hälfte der Befragten sah eine Verschlechterung der psychischen Erkrankung durch den Ausnahmezustand. Schwerer Erkrankte waren stärker belastet.

Schlussfolgerung Patienten mit psychischen Erkrankungen stellen in der gegenwärtigen Krise eine besonders vulnerable Gruppe dar. Es bedarf einer Anpassung der psychiatrischen und psychotherapeutischen Versorgung; spezifische Belastungen müssen bei Patienten mit allen Diagnosegruppen aktiv erfragt werden.

Abstract

Objective This study examines the impact of the COVID-19 pandemic and the lock-down on patients with mental illness.

Methods Patients in inpatient or outpatient psychiatric treatment received a questionnaire, examining psychological distress and psychiatric care during the COVID-19 pandemic.

Results More than half of the patients indicated that the state of emergency had a negative impact on their mental illness. Severely ill patients were more affected.

Conclusion Patients with mental illness are a particularly vulnerable group in the current crisis. Psychiatric and psychotherapeutic care needs to be adapted accordingly; the specific burden and distress needs to be examined actively in patients from all diagnostic groups.

Schlüsselwörter

COVID-19-Pandemie - Quarantäne - soziale Isolation - psychische Erkrankung - Sucht

Keywords

COVID-19 pandemic - quarantine - social isolation - mental health disorder - addiction

• Literatur

• 1 Trilla A, Trilla G, Daer C. The 1918 “Spanish Flu” in Spain. Clin Infect Dis 2008; 47: 668-673
• 2 Reynolds DL, Garay JR, Deamond SL. et al. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect 2008; 136: 997-1007
• 3 Wu P, Liu X, Fang Y. et al. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol Alcohol 2008; 43: 706-712
• 4 Wu P, Fang Y, Guan Z. et al. The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry 2009; 54: 302-311
• 5 Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses’ coping strategies during the SARS crisis: An online questionnaire survey. Int J Nurs Stud 2007; 44: 991-998
• 6 Liu X, Kakade M, Fuller CJ. et al. Depression after exposure to stressful events: Lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatry 2012; 53: 15-23
• 7 Maunder R, Hunter J, Vincent L. et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Cmaj 2003; 168: 1245-1251
• 8 Lee SH, Juang YY, Su YJ. et al. Facing SARS: Psychological impacts on SARS team nurses and psychiatric services in a Taiwan general hospital. Gen Hosp Psychiatry 2005; 27: 352-358
• 9 Hawryluck L, Gold WL, Robinson S. et al. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis 2004; 10: 1206-1212
• 10 Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. The lancet Psychiatry 2020; 7: 300-302
• 11 Li W, Yang Y, Liu Z-H. et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci 2020; 2020: 1732-1738
• 12 Qiu J, Shen B, Zhao M. et al. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry 2020; 33: 19-21
• 13 Li S, Wang Y, Xue J. et al. The Impact of COVID-19 Epidemic Declaration on Psychological Consequences: A Study on Active Weibo Users. Int J Environ Res Public Health 2020; 17: 2032
• 14 Wang C, Pan R, Wan X. et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 2020; 17: 1729
• 15 Zhou X. Psychological crisis interventions in Sichuan Province during the 2019 novel coronavirus outbreak. Psychiatry Res 2020; 286: 112895
• 16 Fatke B, Hölzle P, Frank A. et al. Psychische Probleme in der Pandemie – Beobachtungen während der COVID-19-Krise. Dtsch med Wochenschr 2020;
• 17 Bayerischer Rundfunk. Corona: Hochbetrieb beim Krisendienst Psychiatrie. (30.03.2020). Im Internet: Stand: 26.04.2020 www.br.de/nachrichten/bayern/corona-hochbetrieb-beim-krisendienst-psychiatrie,RujfcQF?UTM_Name=Web-Share&UTM_Source=Link&UTM_Medium=Link
• 18 Wind TR, Rijkeboer M, Andersson G. et al. The COVID-19 pandemic: The „black swan“ for mental health care and a turning point for e-health. Internet Interv 2020; 20: 100317
• 19 Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry (Edgmont) 2007; 4: 28
• 20 Inchausti F, Macbeth A, Hasson-ohayon I. et al. Psychological intervention and COVID-19. PsyArXiv 2020;
• 21 Katz CL, Pellegrino L, Pandya A. et al. Research on psychiatric outcomes and interventions subsequent to disasters: a review of the literature. Psychiatry Res 2002; 110: 201-217
• 22 Mitteldeutscher Rundfunk. Coronakrise: Jeder Dritte macht sich große Sorgen um finanzielle Situation. (09.04.2020). Im Internet: Stand: 26.04.2020 www.mdr.de/nachrichten/mitmachen/mdrfragt/umfrage-ergebnis-corona-virus-wirtschaft-100.html
• 23 Mernyi L, Hölzle P, Hamann J. Berufstätigkeit und Rückkehr an den Arbeitsplatz bei stationärpsychiatrisch behandelten Patienten = Psychiatric inpatient treatment and return to work. Psychiat Prax 2018; 45: 197-205
• 24 Banerjee S, Burkholder G, Drph BS. Social Isolation as a predictor for mortality : Implications for COVID-19 prognosis. MedRxiv 2020; 1-25 doi:10.1101/2020.04.15.20066548
• 25 Chou K-L, Liang K, Sareen J. The Association Between Social Isolation and DSM-IV Mood, Anxiety, and Substance Use Disorders. J Clin Psychiatry 2011; 72: 1468-1476
• 26 Fosnocht AQ, Lucerne KE, Ellis AS. et al. Adolescent social isolation increases cocaine seeking in male and female mice. Behav Brain Res 2019; 359: 589-596
• 27 Volkow ND. Collision of the COVID-19 and Addiction Epidemics. Ann Intern Med 2020; 2019: 2019-2021
• 28 Marsden J, Darke S, Hall W. et al. Mitigating and learning from the impact of COVID-19 infection on addictive disorders. Addiction 2020; n/a: 0–3
• 29 Farhoudian A, Baldacchino A, Clark N. et al. COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine ( ISAM ) Practice and Policy Interest Group position paper. BCN 2020; 98: 129-146
• 30 Frank A, Fatke B, Frank W. et al. Depression dependence and prices of the COVID-19-crisis. Brain, Behaviour and Immunity 2020;