Zusammenfassung Hintergrund Der Ausbruch der COVID-19-Erkrankung und die rasche Ausbreitung des sie verursachenden Coronavirus SARS-CoV‑2 bedroht weltweit nicht nur die physische, sondern auch die psychische Gesundheit der Bevölkerung. Seine Auswirkungen auf Neuerkrankungen und die Entwicklung bestehender Erkrankungen im ambulanten psychiatrischen Bereich in Deutschland ist noch nicht untersucht. Methoden Die Dokumentation in den Akten von 682 behandelten psychisch erkrankten Personen wurde retrospektiv bezüglich ihrer subjektiv erlebten Belastung durch die Pandemie und der klinischen Relevanz hin untersucht. Ergebnisse Bei 60,5 % (n = 378) bestand eine psychische Belastung durch diese Pandemie. 14,5 % (n = 99) der Betroffenen litten unter Angst vor dem Virus SARS-CoV‑2 und einer möglichen Infektion, 25,5 % (n = 174) unter den getroffenen Schutzmaßnahmen (Lockdown) und 4,3 % (n = 29) unter beidem; hierbei bestanden signifikante diagnoseabhängige Unterschiede. Angsterkrankte waren signifikant stärker belastet und hatten mehr Angst vor der Erkrankung, Psychoseerkrankte waren signifikant weniger belastet. Bei 43,7 % aller dieser Belasteten (n = 132) wurde eine akute therapeutische Intervention erforderlich, 6,0 % (n = 18) mussten stationär eingewiesen werden. Diskussion Psychisch Vorerkrankte gehören zu den durch die Belastungen der COVID-19-Pandemie besonders gefährdeten Bevölkerungsgruppen. Langfristigere Untersuchungen zum Verlauf der psychischen Belastungen unter Pandemiemaßnahmen sowie Studien zur Förderung von Resilienz in dieser Bevölkerungsgruppe und die Implementierung solcher Maßnahmen sind erforderlich.

The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.

These results elucidate the need for better information about psychotherapy and the development of intercultural consulting services for migrants in Germany.

Clinical diagnostics of mental disorders especially among refugees and asylum seekers come with unique difficulties: language barriers, different forms of expression and concepts of the understanding of mental illness as well as a different cultural background. Therefore professional interpreters are needed but associated with a higher effort related to costs and time. We conducted a retrospective analysis of costs, which incurred by the use of professional interpreters in our outpatient clinic in Berlin, Germany, in the first quarter 2016 for the treatment of refugees and asylum seekers. The sample consisted of 110 refugees and asylum seekers; the highest costs in the use of interpreters incurred among Neurotic, stress-related and somatoform disorders (53.04%), especially Posttraumatic Stress Disorder (39.04%), as well as affective disorders (38.47%), especially major depressive episodes (25.23%). Our data point out the crucial need of a regulation of costs with regard to the service of professional interpreters in Germany.