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The pandemic and mental impact: The reason for growing concern

Without a doubt, the pandemic deeply transformed our lives. In face of the initial uncertainty of the behavior, or the causing agent and the absence of effective treatments against the disease, the measures taken to stop the contagion included what has generally been called “measures of non-pharmacological intervention” as occurred in past pandemics1.

Schools were closed and also a good part of commercial establishments; aerial, maritime, and land traveling was restricted; massive events and large crowds were prohibited; and, the authorities urged leaving aside intimate forms of interaction such as hugging and kissing.

This all ended in strong social interaction restrictions. Abrupt changes in family dynamics and a generalized sense of anguish, stimulated by a febrile and frightening informative bombing from different communication media. Working from home and remote education were imposed to several sectors of the community and the domestic load and care increased, disproportionately impacting women due to the patriarchal structure of our societies2.

These changes have not gone unnoticed for those of us who work in healthcare, and in fact, there is a growing concern for the consequences of this all. Especially, some have thought about the consequences of these transformations, and the situations that we lived amid the pandemic have had over the mental health of all of us. So, the fundamental concern is in the air: Will we live a pandemic of mental disorders after the COVID-19 pandemic?

This question, which is not easy to answer, is accompanied by many others. On one hand, psychologists ask themselves about the consequences the pandemic has had over cognitive, emotional, and behavioral processes of people and especially in young people, and children; psychiatrists wonder for the types of mental disorders that are emerging and the usefulness of pharmacological therapies, while public health professionals wonder about the populational mental situation created as a consequence of the pandemic and the measures to prevent damages and complications.

There are several studies on the matter and the reviews show a worrisome scenario. Here I will only show some of the most relevant discoveries, to create awareness of the great challenge we have ahead of us.

Concerning scenario

Since the quarantine and massive lock-up measures were taken in many countries and a state of general alarm was instilled, some started to consider that the situation could have an important psychosocial impact, cause mental healthcare issues, and increase the preexisting.

For March of 2020, in a quick review of the evidence in face of the impact of the quarantine, researchers in the U.K. confirmed that in most of the studies reviewed, which at the moment were 24, the negative psychological effects including posttraumatic stress, confusion, and anger. Analyzing the factors that most caused stress, they discovered the long duration of the quarantine, fear of being infected, frustration, boredom, disinformation, and concerns in face of the economic losses and the stigmatization3.

Later, other projects have reiterated these findings and have shown with greater insistence that the COVID-19 pandemic has negatively impacted the mental health of the community at large and that the situation tends to get worse in some populational groups considered vulnerable.

In a study of the factors linked to the result of mental health among healthcare workers in China exposed to COVID-19, researchers in that country discovered that a large portion of these workers, and especially women, reported having symptoms of depression, anxiety, insomnia, and anguish4.

Another study on mental health in healthcare workers in Singapore and Indian hospitals discovered that some of them had positive signals of depression, anxiety, severe stress, and anxiety, although the percentages were not very high (between 3 and 9%)5.

A study in Ireland in people over 18 years of age in isolation and quarantine discovered that 40% of the affected had clinically significant depression, while 19% had signs of some kind of posttraumatic disorder. The rates of depression and posttraumatic stress were significantly greater in women, in people with mental health backgrounds, and in people that were experiencing social conflict.  A little more than half of the people also perceived stigmatization6.

A UNICEF survey in a group of Latin-American youngsters between 13 and 29 years of age, discovered that 27% reported feeling anxiety and 15% depression in the last seven days. And 30% said that the main factor that impacted their emotions was the distressing economic situation. Among women, 43% said they felt pessimistic in the face of the future and 31% of the men felt the same sensation7.

A literature review carried out by two Colombian psychologists discovered that 43 studies carried out on psychological impacts of the COVID-19 pandemic, included negative effects such as anxiety, commotion, hostility, fear, and loneliness; negative thoughts such as rejection in face of the situation, concerns for death and financial issues; anxiety and depression; behavioral alterations such as an excessive search for information of the pandemic and obsessive-compulsive behaviors; and several physiological symptoms such as headaches, loss of appetite, and sleep deprivation.

In this review, it is noteworthy that the authors also discovered studies that mentioned some positive changes in people such as greater family support, more leisure time, the opportunity for pondering, and greater interest in the environment and the emotional world8.

A meta analysis carried out by researchers of two universities in China, one in The Netherlands, and another in the United States, that analyzed 71 studies, discovered an important prevalence of anxiety (32%), depression (27%), and posttraumatic stress (16%).

In analyzing the population groups, they found that the prevalence of anxiety and depression was greater amongst those who had been diagnosed with COVID-19, and in general, these prevalence were lower in China than in other countries.

Finally, it is worth noting that in a review carried out by a Universidad de Antioquia, Faculty of Medicine Psychiatry research group on the effect of the pandemic on children and youngsters that had previous psychiatric disorders, the pandemic and confinement are psychosocial adversities that threaten the stability of the family and that this stressor may cause flaring of the symptoms of a previous mental disorder9.

Mental health and psychological development in children and adolescents acquire great current importance and produce enormous concern, as we have experienced a dramatic situation that profoundly alters their home living conditions, socialization dynamics, and educational processes. Ultimately, we are living a social experiment in which we will see the results in the mid and long-term.

Surely, the matter is not restricted to children and youngsters, because the impact is generalized and every person faces diverse situations according to the stage of the life they are living, the social situation he/she had, the gender and the ethnicity, the type of society and the social relationships.

For all the previous reasons, mental health is currently a great concern and should be analyzed in detail, with an open mind and ample criteria to allow understanding the complexity of the sociobiological genesis of the psychopathological processes such as the multiple dynamics that enter into play in building a healthy psychic life. This is essential, also to understand our psychosocial reality.












Juan Carlos Eslava C. - Professor of the Universidad Nacional de Colombia (UNal) Department of Public Health