Introduction:The concept of social isolation is currently understood as a measure of epidemiological containment that aims to reduce the speed of spread of the disease, enabling health services to prepare their resources to cope with the likely increase in demand, while also seeking to provide additional protection to groups considered to be at higher risk. Objective: The present narrative review aims to compile and synthesize the literature related to social isolation produced during the COVID-19 pandemic in 2020. Method: This study is a narrative review of the literature on social isolation in the context of the COVID-19 pandemic. Results: 73 publications were included for full-text reading and were classified into the following categories: levels of social isolation, economic effects, family relationships, health system, mental health of the population, and use of technology. Conclusions: It is necessary to plan an escalation of responses to the consequences of the pandemic, especially in view of the increased demand on the health sector and social services. The negative effects of social isolation can be prevented by public policies that offer a response to the economic recession, maintenance of social work, encouragement of quality care in mental health services, and community support for vulnerable families.
Background: The SARS-CoV-2 pandemic first reached Brazil in late February 2020. Since then, it is one of the most affected countries globally. The rise of mental health problems in the population directly or indirectly affected is now a major concern. In the present study, we show the results of the first wave of the COVIDPsiq cohort study, which started early on (April 2020). The aim of this study was to investigate and compare independent predictors of symptoms of stress, anxiety, depression, and post-traumatic stress disorder (PTSD) in Brazilians one month after social distancing measures were implemented. Methods: Depression, Anxiety, and Stress Scale (DASS-21) and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) were the two self-report instruments used to assess the symptoms. Variables related to demographics, social distancing, exposure to the news of coronavirus pandemic, substance use, and traumatic situations were also analyzed. Data was gathered through a web-based survey. Multivariate analyses were performed through hierarchical multiple linear regression models (HMLR). Result: A sample of 3,587 participants completed the questionnaire, among which approximately two-thirds considered that their mental health worsened after the beginning of the social restriction measures. Stress, anxiety, depression, and PTSD levels were highly correlated with this self-perception. The five most important predictors of psychological distress were the distress related to pandemic news, younger age, current psychiatric diagnosis, trouble sleeping, and emotional abuse or violence. Limitations: This is an internet survey-based study in which convenience sample bias may limit its external validity. It does not represent the northern regions of the country and most participants are white wealthier females. It was not possible to evaluate if symptoms are clinically relevant to infer an increased incidence of mental illness. Conclusions: These results confirm the hypothesis that a pandemic would have important impacts on the mental health of the population and indicate the level of distress related to the media as an important predictor of mental symptoms.
In view of the evolution of the pandemic by COVID-19 in Brazil, and the adoption of social restriction measures, an increase in cases of posttraumatic stress disorder (PTSD), anxiety disorder and depression is expected. In epidemic situations, mental health services can become overloaded; however, the evolution of these disorders over time is not known. This study aims to monitor the evolution of PTSD symptoms, anxiety and depression during the COVID-19 pandemic in Brazilians, and to investigate sociodemographic risk factors related to psychiatric history and contagion, as well as maladaptive personality traits and posttraumatic growth. It will be a longitudinal study, conducted through online questionnaires, with a sample of non-probabilistic convenience. The inclusion criteria are: being brazilian born or living in Brazilian territory; be over 18 years old; have access to digital devices; and be literate. A sample of at least 2000 people is expected. The instruments applied are a research questionnaire, the Posttraumatic Checklist 5 (PCL-5), the Depression, Anxiety and Stress Scale (DASS-21), the Personality Inventory for the DSM-5 – brief form (PID-5-BF), and the PostTraumatic Growth Inventory (PTGI). The study will be carried out in four stages: entry, one month, three months, and six months after the entry. The study relies on voluntary participation, with the agreement through the Free and Informed Consent Form. Data collection will be conducted in 2020, and the study will be completed in 2021. It will be financed with its own resources, and encouragement will be sought through research funding agencies.
A Síndrome de DRESS (do inglês, Drug Rash with Eosinophilia and Systemic Symptoms) é um raro distúrbio que decorre de uma reação adversa severa do corpo, potencialmente fatal, em resposta a determinadas medicações, principalmente da classe dos anticonvulsivantes. Dentre os usuários dessa classe medicamentosa, a síndrome tem prevalência estimada de um caso para 500 expostos, sendo mais frequente na raça negra. Neste relato de caso, apresenta-se paciente do sexo feminino, 14 anos, admitida na emergência apresentando mal estado geral, icterícia, edema e exantemas em todo corpo. Mãe relatou uso de carbamazepina para quadro convulsivo. Uma vez diagnosticada com Síndrome de DRESS, evoluiu sem intercorrências após suspensão da carbamazepina e administração de metilprednisolona sistêmica. Através da metodologia de análise de prontuários e revisão de literatura, objetivamos o curso clínico da doença e investigar os possíveis fatores desencadeantes na paciente em questão. Concluímos, baseados nos dados encontrados, que o diagnóstico precoce associado à terapêutica adequada é crucial para o prognóstico favorável.
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