Psychische Probleme in der Pandemie – Beobachtungen während der COVID-19-Krise

Abstract

We have recently observed several clusters of psychiatric symptoms in the context of COVID-19: (1) increased anxiety in psychiatric in- and outpatients with different diagnoses; (2) more cases of domestic violence often associated with increased drug- or alcohol-consumption in offenders and victims; (3) a nihilistic “apocalyptic” syndrome of elderly patients cut-off from their families; (4) visual and acoustic hallucinoses due to pneumonia and sepsis-related confusional states. Cases of chloroquine-related toxicity have been reported elsewhere, but have not been observed in our hospital so far. Mental issues related to COVID-19 reported from China and practical recommendations are briefly summarized. Many patients with serious mental disorders will suffer world-wide due to a reallocation of medical, social and financial ressources.

Im Kontext der allgemeinen Krisensituation mit Versorgungsengpässen und kollektiver Anspannung sinkt die Aufmerksamkeit für die Bedürfnisse von Patienten mit vorbestehenden psychischen Erkrankungen oder drohender Dekompensation. Wir berichten über 4 eigene Patienten und das Problem der Chloroquin-Intoxikation, um auf typische Problemkonstellationen und geeignete Interventionen hinzuweisen.

Schlüsselwörter

Apokalypse-Syndrom - Chloroquin - Halluzinose - häusliche Gewalt - Verwirrtheitszustand

Key words

apocalypse syndrome - chloroquine - hallucinosis - domestic violence - confusional state

Publication History

Article published online:
09 April 2020

• Literatur

• 1 Cheng VCC, Lau SKP, Woo PCY. et al. Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection. Clin Microbiol Rev 2007; 20: 660-694
• 2 Menachery VD, Yount BL, Debbink K. et al. A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence. Nature Med 2015; 21: 1509-1513
• 3 Schwerthöffer D, Fatke B, Förstl H. Dilemmasituation: Nächtlicher Unruhezustand beim älteren Patienten – Differenzialdiagnose und Therapie. Dtsch Med Wochenschr 2020;
• 4 Banner Health. Chloroquine Phosphate Intended for Fish: FDA Letter to Stakeholders – Do Not Use as Treatment for COVID-19 in Humans. Im Internet (Stand: 30.03.2020): http://bannerhealth.mediaroom.com/chloroquinephosphate
• 5 FDA. MedWatch. Chloroquine Phosphate Intended for Fish: FDA Letter to Stakeholders – Do Not Use as Treatment for COVID-19 in Humans. Im Internet (Stand: 30.03.2020): http://s2027422842.t.en25.com/e/es?s=2027422842&e=316918&elqTrackId=376c7bc788024cd5a73d955f2e3dcbdc&elq=6cbcee7b129849b09b0de7b8fc2bbb2b&elqaid=11841&elqat=1
• 6 Duan YJ, Liu Q, Zhao SQ. et al. The trial of chloroquine in the treatment of Corona Virus disease 2019 COVID-19 and its research progress in forensic toxicology. Fa Yi Xue Za Zhi 2020;
• 7 Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. BioScience Trends 2020;
• 8 Zhou D, Dai SM, Tong Q. COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression. J Antimicrob Chemother 2020;
• 9 Biswas PS, Sen D, Majumdar R. Psychosis following chloroquine ingestion: a 10-year comparative study from a malaria hyperendemic district of India. Gen Hosp Psychiatry 2014; 36: 181-186
• 10 Cortegiani A, Ingoglia G, Ippolito M. et al. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care 2020;
• 11 Schwerthöffer D, Fatke B, Förstl H. Antipsychotische Pharmakotherapie bei deliranten Symptomen – nur zeitlich begrenzt, symptomorientiert und unter Beobachtung der QTc-Zeit. MMW-Fortschr Med 2019;
• 12 Keller T, Schneider A, Lamprecht R. et al. Fatal chloroquine intoxication. Forens Sci Int 1998; 96: 21-28
• 13 Stokkermans TJ, Trichonas G. Chloroquine and hydrochloroquine toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2020. Im Internet: www.ncbi.nlm.nih.gov/books/NBK537086
• 14 Liu S, Yang L, Zhang C. et al. Online mental health services in China during the COVID-19 outbreak. The Lancet 2020; 7: e17
• 15 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 Environment Res Pub Health 2020; 17: 2032
• 16 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 Environment Res Pub Health 2020; 17: 1729
• 17 Lai J, Ma S, Wang Y. et al. Factors associated with mental health outcomes among health care workers exposed to Coronavirus disease 2019. JAMA Network Open 2020;
• 18 Cheng Q, Liang M, Li Y. et al. Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet 2020; 7: e15
• 19 Yang Y, Li W, Zhang Q. et al. Mental health services for older adults in China during the COVID-19 outbreak. The Lancet 2020; 7: e19
• 20 Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry 2020; 7: e21