Attempted suicide of two confirmed SARS-CoV-2 infected patients in an isolation facility and recommendations to prevent COVID-19 suicides: a case report

Abstract

COVID-19 pandemic has disrupted our way of life and continue to exert significant psychological impact. A surge in suicide has been associated with all previous major epidemics and pandemics. The suicide rate associated with COVID-19 pandemic would continue increasing if urgent measures are not put in place. We report two cases of attempted suicide among confirmed COVID-19 patients. The first case is a 30-year-old nurse who attempted suicide in an isolation facility and the second case is a 43-year-old male who travelled with his wife and a trusted friend from Burkina-Faso to Ghana to access haemodialysis care for his wife in a COVID-19 pandemic era. Unfortunately, the couple tested positive for SARS-CoV-2 infection. We discussed interventions to prevent suicide in treatment facilities. We recommend psychological assessment and counselling for all COVID-19 patients. We also recommend social interaction among patients in the isolation or treatment centres, and active management of COVID-19 related stigma and misinformation. Screening for means of suicide should be conducted in treatment facilities. Pre-test and post-test counselling are essential interventions. Also, telemedicine, telephone calls, computer assisted psychotherapy, mobile applications, self-guided digital interventions have been identified as effective tools for administering psychotherapeutic interventions to COVID-19 patients particularly in instances where face-to-face may not be possible.

Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review

“…Most of the studies had been conducted in China ( n = 15) ( 30 , 33 , 34 , 45 , 50 , 52–55 , 63 , 64 , 66–69 ), Iran ( n = 6) ( 38 , 47 , 48 , 58 , 61 , 62 ), Italy ( n = 5) ( 29 , 31 , 41 , 44 , 57 ), India ( n = 4) ( 36 , 46 , 56 , 59 ), United States ( n = 2) ( 28 , 35 ), and Korea ( n = 2) ( 49 , 65 ). The remaining studies had been developed in Saudi Arabia ( n = 1) ( 27 ), Nigeria ( n = 1) ( 32 ), Indonesia ( n = 1) ( 39 ), France ( n = 1) ( 42 ), Turkey ( n = 1) ( 43 ), Thailand ( n = 1) ( 51 ), Latvia ( n = 1) ( 40 ), Ghana ( n = 1) ( 37 ), and Poland ( n = 1) ( 60 ).…”

“…Regarding emotional disorders or symptoms addressed, the vast majority of studies were focused on depressive symptoms alone ( 30 ) or combined with anxiety ( n = 15) ( 33 , 34 , 40–42 , 44 , 47 , 48 , 50–52 , 55–57 , 60 ), panic attacks ( n = 6) ( 59 , 62 , 64 , 66–68 ), suicidal ideation or self-harming attempts ( n = 2) ( 36 , 37 ) or post-traumatic stress disorder (PTSD) ( n = 1) ( 38 ). On the other hand, six studies were focused on patients who presented with anxiety symptoms alone ( 43 , 46 , 53 , 54 , 58 , 61 ) or combined it with panic attacks ( 29 , 35 ).…”

“…Four case studies ( 30 , 32 , 35 , 36 ) and two pre-post studies without control group ( 63 , 65 ) did not provide information about the type of psychotherapy that was applied. One study ( 37 ) described two different psychological programs, one of them based on CBT and the other focused on social support, positive recovery and relaxation training.…”

“…Case studies found inconclusive results related to the intervention’s efficacy. Most case studies reported a reduction after the intervention on outcomes such as intrusive thoughts ( 27 ), post-traumatic symptoms ( 28 , 31 , 38 ), anxiety ( 28 , 33–35 , 37–40 ), depression ( 28 , 33 , 34 , 37–39 ), general clinical symptoms ( 30 , 32 ), suicidal ideation ( 36 ) and insomnia ( 39 ). However, some studies did not indicate the cut-off selected to establish the recovery of symptoms and no size effect or significance of change was calculated.…”