COVID‐19 lockdown: A perfect storm for older people’s mental health

Webb, Lucy

doi:10.1111/jpm.12644

Cited by 114 publications

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“… 48 Elderly people are at especially high risk of severe COVID-19 illness and mental-health-related consequences because they might already have some cognitive decline. 49 , 50 Institutions can become epicentres for infection. Physical distancing can be challenging in these contexts, either because the nature of patients' conditions makes it difficult to manage (eg, people with learning disabilities) or because of overcrowding (eg, prisons).…”

Section: Potential Consequences Of Covid-19 For Mental Healthmentioning

confidence: 99%

How mental health care should change as a consequence of the COVID-19 pandemic

Moreno

Wykes

Galderisi

et al. 2020

The Lancet Psychiatry

1,343

1,070

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The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.

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Section: Potential Consequences Of Covid-19 For Mental Healthmentioning

confidence: 99%

How mental health care should change as a consequence of the COVID-19 pandemic

Moreno

Wykes

Galderisi

et al. 2020

The Lancet Psychiatry

1,343

1,070

View full text Add to dashboard Cite

show abstract

“…For instance, after lockdown, referrals accelerated again across genders. Unexpectedly, no such acceleration was observed among those aged ≤19 or ≥65, who have been suspected to be especially vulnerable to mental health problems resulting from social distancing or lockdown (10,12,(19)(20)(21), even though all age groups exhibited the significant instantaneous drop in referrals at lockdown. The lack of acceleration in referrals for older adults after lockdown was also to some extent inconsistent with a study (22) conducted in Hong Kong at the time of the severe acute respiratory syndrome (SARS) epidemic in 2003, which found SARS to be associated with a 30% increase in suicide in those aged ≥65.…”

Section: Discussionmentioning

confidence: 95%

The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study

et al. 2020

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To date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders. We aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services. We conducted a controlled interrupted time series study using data from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment population ~0.86 million). The UK lockdown resulted in an instantaneous drop in mental health referrals but then a longer-term acceleration in the referral rate (by 1.21 referrals per day per day, 95% confidence interval [CI] 0.41–2.02). This acceleration was primarily for urgent or emergency referrals (acceleration 0.96, CI 0.39–1.54), including referrals to liaison psychiatry (0.68, CI 0.35–1.02) and mental health crisis teams (0.61, CI 0.20–1.02). The acceleration was significant for females (0.56, CI 0.04–1.08), males (0.64, CI 0.05–1.22), working-age adults (0.93, CI 0.42–1.43), people of White ethnicity (0.98, CI 0.32–1.65), those living alone (1.26, CI 0.52–2.00), and those who had pre-existing depression (0.78, CI 0.19–1.38), severe mental illness (0.67, CI 0.19–1.15), hypertension/cardiovascular/cerebrovascular disease (0.56, CI 0.24–0.89), personality disorders (0.32, CI 0.12–0.51), asthma/chronic obstructive pulmonary disease (0.28, CI 0.08–0.49), dyslipidemia (0.26, CI 0.04–0.47), anxiety (0.21, CI 0.08–0.34), substance misuse (0.21, CI 0.08–0.34), or reactions to severe stress (0.17, CI 0.01–0.32). No significant post-lockdown acceleration was observed for children/adolescents, older adults, people of ethnic minorities, married/cohabiting people, and those who had previous/pre-existing dementia, diabetes, cancer, eating disorder, a history of self-harm, or intellectual disability. This evidence may help service planning and policy-making, including preparation for any future lockdown in response to outbreaks.

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“…Several studies conducted on people's mental health during lockdown or isolation reported restriction of movement showed that when people are restricted to a certain kind of environment, their mental health is adversely affected [10][11][12][13] . Historically, quarantine has been related to psychological outcomes such as anxiety, depression, panic, irritability, somatic disorder, and insomnia 14 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis

Hossain¹,

Rahman²,

Trisha³

et al. 2020

Preprint

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Introduction: The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. Method: We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. Results: A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7-48.1, I2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9-39.4, I2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity and varying prevalence across sub-groups. Conclusion: South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.

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COVID‐19 lockdown: A perfect storm for older people’s mental health

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 114 publications

References 0 publications

How mental health care should change as a consequence of the COVID-19 pandemic

How mental health care should change as a consequence of the COVID-19 pandemic

The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study

Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis

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