Patients with mental health disorders in the COVID-19 epidemic

Yao, Hao; Chen, Jianhua; Xu, Yifeng

doi:10.1016/s2215-0366(20)30090-0

Cited by 1,264 publications

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“…The risk of infection, the situation of confinement and the absence of preparation to face this epidemic wave are three constraints that weigh even more heavily on psychiatric care than on other medical disciplines. Amongst the hundreds of articles on mental health and the pandemic, we have identified two letters to the editor about patients hospitalized in psychiatry in China (8,9). The Chinese colleagues warn about the fate of populations with psychiatric disorders and share their experience, deploring the lack of interest towards them among the authorities and the scientific community.…”

Section: The Vulnerability Of Psychiatric Patients Towards Covid-19mentioning

confidence: 99%

“… Psychosocial vulnerability: Patients' socio-economic living conditions can aggravate the prognosis in settings of confinement: severe social isolation, precarious housing, restricted solidarity networks for the informal monitoring of these patients' health status. In addition, Chinese colleagues reported that in case of severe forms of COVID-19, stigmatization delays these patients' access to care and alters its quality (8). This phenomenon has been observed for every severe psychiatric disorder in every country (16,17).…”

Section: Individual Vulnerability Of Psychiatric Patients To Coronavirusmentioning

confidence: 99%

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Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review

et al. 2020

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Objective: The lack of resources and coordination to face the coronavirus epidemic raises concerns for the health of patients with mental disorders in a country where we still have memories of the dramatic experience of famine in psychiatric hospitals during the Second World War. This article aims to propose guidance to ensure mental health care during the SARS-CoV epidemic in France. Methods: The authors performed a narrative review identifying relevant results in the scientific and medical literature and in local initiatives in France. Results : We identified four types of major vulnerabilities among patients with mental disorders during this pandemic: 1) medical comorbidities that are more frequently found among patients with mental disorders (cardiovascular and pulmonary pathologies, diabetes, obesity, etc.) which are risk factors for severe covid-19 infection; 2) age (the elderly form the population most vulnerable to the coronavirus); 3) cognitive and behavioural disorders, which can hamper compliance with confinement and hygiene measures and finally and 4) psychosocial vulnerability as a result of stigmatization and/or socio-economic difficulties. Furthermore, the mental health healthcare system is more vulnerable than other healthcare systems. Current government plans are poorly suited to psychiatric establishments in a context of major shortages of organizational, material and human resources. In addition, a certain number of structural aspects make the psychiatric institution particularly vulnerable: many beds have been closed, wards have high densities of patients, mental health community facilities are closed, and medical teams are understaffed and poorly trained to face infectious diseases. There are also major issues when referring patients with acute mental disorders to intensive care units. To maintain the continuity of psychiatric care in this pandemic situation, several directions can be considered, in particular with the creation of "COVID+ units". These units are under the dual supervision of a psychiatrist and an internist / infectious disease specialist; all new entrants are placed in quarantine for 14 days; the nursing staff receives specific training, daily medical checkups and close psychological support. Family visits are prohibited and replaced by videoconference. At the end of hospitalization, in particular for the population of patients in compulsory ambulatory care situations, specific case-management are organized with the possibility of home visits, in order to support patients when they get back home and to help them cope with the experience of confinement, which is liable to induce recurrences of mental disorders. The total or partial closure of community mental health facilities is particularly disturbing for patients, but a regular follow-up is possible with telemedicine and should include the monitoring of suicide risk and psycho-education strategies;developing support platforms could also be very helpful in this context. Private practice psychiatrists also have a crucial role...

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Section: The Vulnerability Of Psychiatric Patients Towards Covid-19mentioning

confidence: 99%

Section: Individual Vulnerability Of Psychiatric Patients To Coronavirusmentioning

confidence: 99%

Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review

et al. 2020

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“…Le risque infectieux, la situation de confinement et l'absence de préparation à cette vague épidémique, sont, plus encore que pour d'autres disciplines médicales, trois contraintes qui pèsent sur les soins psychiatriques. Parmi les centaines d'articles en lien avec la santé mentale, parus autour de la pandémie, nous avons identifié deux lettres à l'éditeur portant sur les patients hospitalisés en psychiatrie en Chine (8,9). Les confrères chinois alertent sur le sort des populations souffrant de troubles psychiques et partagent leur expérience, déplorant le manque d'intérêt des autorités et de la communauté scientifique à leur égard.…”

Section: Vulnérabilité Des Patients De La Psychiatrie Au Covid-19unclassified

“…Les conditions de vie socio-économiques des patients aggravent le pronostic lié au confinement : fort isolement social des patients, logements précaires, peu de réseau de solidarité permettant une surveillance informelle de l'état de santé de ces personnes. Par ailleurs, les confrères chinois ont rapporté qu'en cas de forme sévère du COVID-19, la stigmatisation retardait leur accès aux soins et altéraient leur qualité (8). Ce phénomène a été décrit pour tous les troubles psychiatriques sévères dans tous les pays (16,17).…”

Section: Vulnérabilité Individuelle Des Patients De La Psychiatrie Auunclassified

Assurer les soins aux patients souffrant de troubles psychiques en France pendant l’épidémie à SARS-CoV-2

et al. 2020

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§les auteurs ont contribué à part égale à cet article Résumé Objectif: L'absence de préparation du système de soins psychiatriques à l'épidémie de virus SARS-CoV-2 fait redouter fait redouter un scénario pessimiste pour la santé physique et mentale des patients suivis en psychiatrie. L'objectif de cet article est de proposer des éléments de guidance pour réorganiser les soins psychiatriques dans le contexte de pandémie COVID-19. Méthode : Les auteurs ont réalisé une synthèse de la littérature internationale combinée au partage des expériences locales françaises. Résultats : Les patients souffrant de troubles psychiques semblent particulièrement vulnérables à ce virus et à la pandémie : vulnérabilités liées aux comorbidités médicales, à l'âge, aux troubles cognitifs qui peuvent entraver le respect des consignes de confinement, et aux complications psychosociales. Plusieurs initiatives ont été prises pour assurer la continuité des soins et contenir l'épidémie : création en psychiatrie d'unité COVID+ co-supervisée par des médecins généralistes ou internistes, restriction des consultations aux cas sévères et redéploiement des soins en téléconsultation, accompagnement de type case-management pour les sorties précoces ou Page 3 of 21 J o u r n a l P r e -p r o o f 3 management and coping strategies, prevention of addictions, etc. They should also be trained to prevent, detect and treat early warning symptoms of post-traumatic stress disorder, because their prevalence was high in the regions of China most affected by the pandemic. Discussion : French mental healthcare is now in a great and urgent need for reorganization and must also prepare in the coming days and weeks to face an epidemic of emotional disorders due to the containment of the general population.

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“…Se ha señalado que entre los sujetos que padecen una enfermedad mental el impacto podría ser todavía mayor 12,13 . En cuanto a los pacientes diagnosticados de COVID-19, se ha sugerido que pueden experimentar miedo y malestar por las consecuencias potencialmente fatales de la infección y la situación de aislamiento.…”

Section: J O U R N a L P R E -P R O O Funclassified

International Mental Health perspectives on the novel coronavirus SARS-CoV-2 pandemic

Vizoso

Alberdi-Páramo

Dı́az-Marsá

2020

Revista de Psiquiatría y Salud Mental

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Patients with mental health disorders in the COVID-19 epidemic

Cited by 1,264 publications

References 3 publications

Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review

Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review

Assurer les soins aux patients souffrant de troubles psychiques en France pendant l’épidémie à SARS-CoV-2

International Mental Health perspectives on the novel coronavirus SARS-CoV-2 pandemic

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