The coronavirus disease 2019 pandemic affects psychiatric patients disproportionately compared to the general population. In this narrative review, we examine the impact of the pandemic on significant global health disparities affecting vulnerable populations of psychiatric patients: People of diverse ethnic background and color, children with disabilities, sexual and gender minorities, pregnant women, mature adults, and those patients living in urban and rural communities. The identified disparities cause worsened mental health outcomes placing psychiatric patients at higher risk for depression, anxiety and posttraumatic stress disorder symptoms. Those psychiatric patients who are ethnic minorities display barriers to care, including collective trauma and structural racism. Sexual and gender minorities with mental illness face discrimination and limited access to treatment. Pregnant women with psychiatric diagnoses show higher exposure to domestic violence. Children with disabilities face a higher risk of worsening behavior. Mature adults with psychiatric problems show depression due to social isolation. Psychiatric patients who live in urban communities face pollutants and overcrowding compared to those living in rural communities, which face limited access to telehealth services. We suggest that social programs that decrease discrimination, enhance communal resilience, and help overcome systemic barriers of care should be developed to decrease global health disparities in vulnerable population.

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Objective To examine gender disparities in the diagnosis of bipolar disorder (BD) within a privately insured population in the United States and investigate potential contributing factors for these gender differences. Methods This retrospective cohort study utilized 2005–2017 claims data from the MarketScan® Commercial Claims and Encounters database. The study cohort included subjects, aged 10–64 years, who had a minimum of 1‐year continuous insurance coverage and no record of a BD diagnosis before cohort entry. We examined the gender difference in BD diagnosis rate, overall and by subgroups. We then used Cox regression models to evaluate the gender effect on time to first BD diagnosis, and the potential moderators of gender effect. Results The study cohort consisted of 97,193,443 subjects; 0.45% of subjects were diagnosed with BDs after cohort entry with males having a lower diagnosis rate than females (0.36% vs. 0.54%). The Cox regression analysis indicated that males were less likely to be diagnosed with BDs (unadjusted Hazard Ratio, HR [95% CI]: 0.69 [0.68–0.69]) and gender difference remained significant after adjusting for demographics, comorbidity and healthcare utilizations (adjusted HR [95% CI]: 0.77 [0.76–0.77]). Gender disparity was consistently strong among most age groups, but varied in other demographic subgroups. Conclusions Even though the prevalence of BDs is approximately equal between genders in the general population, our study found a much lower diagnosis rate in men compared to women for a privately insured U.S. population. Future studies aimed at identifying and understanding the barriers to diagnosis of BDs in men are warranted.

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INTRODUCTION: Up to 15% of women experience postpartum depression (PPD), and maternal suicide is a leading cause of maternal mortality. Obstetrician-gynecologists (ob-gyns) are intimately involved in postpartum care of women and are in a position to help diagnose and manage PPD. Council on Resident Education in Obstetrics and Gynecology (CREOG) learning objectives include goals for residents to diagnose and perform initial management of postpartum complications such as PPD. The objective of this study was to assess if a psychiatry educational intervention (pre-recorded didactic lecture and facilitated discussion) would improve ob-gyn residents’ knowledge and comfort level in diagnosing and managing PPD. METHODS: We performed an educational intervention study including ob-gyn residents at an academic training program. A pre-lecture survey/test was sent to residents. A prerecorded psychiatric didactic session was sent to residents. Participants were instructed to complete the post-lecture survey/test. A facilitated discussion via Zoom at which time presubmitted questions were reviewed and discussed with a psychiatrist was performed. A postdiscussion survey was then sent out. RESULTS: Before the intervention, 32% of residents agreed/strongly agreed that they felt comfortable diagnosing PPD; after the intervention, this increased to 81% of residents. Before the intervention, 25% of residents agreed/strongly agreed that they felt comfortable treating PPD; after the lecture/discussion this increased to 69% of residents. The difference in pre and post test scores was significantly improved (POST-PRE difference of 2.6 with a 95% CI of 1.8-3.5, P<.0001). CONCLUSION: This study helps show the importance of interdisciplinary didactics and interactive learning sessions which can help improve ob-gyn residents’ knowledge and comfort level in diagnosing/managing PPD in patients.