Psychiatrist in post-COVID-19 era – Are we prepared?
Identifieur interne : 000425 ( Pmc/Corpus ); précédent : 000424; suivant : 000426Psychiatrist in post-COVID-19 era – Are we prepared?
Auteurs : Nileswar DasSource :
- Asian Journal of Psychiatry [ 1876-2018 ] ; 2020.
Abstract
First communication from India with psychiatry residents perspective. Authors had first-hand experience of working in the COVID designated areas. Highlights the need of the hour.
Url:
DOI: 10.1016/j.ajp.2020.102082
PubMed: 32283513
PubMed Central: 7139240
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Psychiatrist in post-COVID-19 era – Are we prepared?</title><author><name sortKey="Das, Nileswar" sort="Das, Nileswar" uniqKey="Das N" first="Nileswar" last="Das">Nileswar Das</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32283513</idno><idno type="pmc">7139240</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139240</idno><idno type="RBID">PMC:7139240</idno><idno type="doi">10.1016/j.ajp.2020.102082</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000425</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000425</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Psychiatrist in post-COVID-19 era – Are we prepared?</title><author><name sortKey="Das, Nileswar" sort="Das, Nileswar" uniqKey="Das N" first="Nileswar" last="Das">Nileswar Das</name></author></analytic><series><title level="j">Asian Journal of Psychiatry</title><idno type="ISSN">1876-2018</idno><idno type="eISSN">1876-2026</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label><p id="par0005">First communication from India with psychiatry residents perspective.</p></list-item><list-item id="lsti0010"><label>•</label><p id="par0010">Authors had first-hand experience of working in the COVID designated areas.</p></list-item><list-item id="lsti0015"><label>•</label><p id="par0015">Highlights the need of the hour.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Brooks, S K" uniqKey="Brooks S">S.K. Brooks</name></author><author><name sortKey="Webster, R K" uniqKey="Webster R">R.K. Webster</name></author><author><name sortKey="Smith, L E" uniqKey="Smith L">L.E. Smith</name></author><author><name sortKey="Woodland, L" uniqKey="Woodland L">L. Woodland</name></author><author><name sortKey="Wessely, S" uniqKey="Wessely S">S. Wessely</name></author><author><name sortKey="Greenberg, N" uniqKey="Greenberg N">N. Greenberg</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Goyal, K" uniqKey="Goyal K">K. Goyal</name></author><author><name sortKey="Chauhan, P" uniqKey="Chauhan P">P. Chauhan</name></author><author><name sortKey="Chhikara, K" uniqKey="Chhikara K">K. Chhikara</name></author><author><name sortKey="Gupta, P" uniqKey="Gupta P">P. Gupta</name></author><author><name sortKey="Singh, M P" uniqKey="Singh M">M.P. Singh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liu, S" uniqKey="Liu S">S. Liu</name></author><author><name sortKey="Yang, L" uniqKey="Yang L">L. Yang</name></author><author><name sortKey="Zhang, C" uniqKey="Zhang C">C. Zhang</name></author><author><name sortKey="Xiang, Y T" uniqKey="Xiang Y">Y.-T. Xiang</name></author><author><name sortKey="Liu, Z" uniqKey="Liu Z">Z. Liu</name></author><author><name sortKey="Hu, S" uniqKey="Hu S">S. Hu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mak, I W C" uniqKey="Mak I">I.W.C. Mak</name></author><author><name sortKey="Chu, C M" uniqKey="Chu C">C.M. Chu</name></author><author><name sortKey="Pan, P C" uniqKey="Pan P">P.C. Pan</name></author><author><name sortKey="Yiu, M G C" uniqKey="Yiu M">M.G.C. Yiu</name></author><author><name sortKey="Chan, V L" uniqKey="Chan V">V.L. Chan</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Asian J Psychiatr</journal-id><journal-id journal-id-type="iso-abbrev">Asian J Psychiatr</journal-id><journal-title-group><journal-title>Asian Journal of Psychiatry</journal-title></journal-title-group><issn pub-type="ppub">1876-2018</issn><issn pub-type="epub">1876-2026</issn><publisher><publisher-name>Elsevier B.V.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32283513</article-id><article-id pub-id-type="pmc">7139240</article-id><article-id pub-id-type="publisher-id">S1876-2018(20)30193-3</article-id><article-id pub-id-type="doi">10.1016/j.ajp.2020.102082</article-id><article-id pub-id-type="publisher-id">102082</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Psychiatrist in post-COVID-19 era – Are we prepared?</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Das</surname><given-names>Nileswar</given-names></name><email>dr.nileswar@gmail.com</email></contrib></contrib-group><aff id="aff0005">Department of Psychiatry, AIIMS, Room no- 4096, 4<sup>th</sup> floor, Teaching block, New Delhi, 110029, India</aff><pub-date pub-type="pmc-release"><day>7</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="ppub"><month>6</month><year>2020</year></pub-date><pub-date pub-type="epub"><day>7</day><month>4</month><year>2020</year></pub-date><volume>51</volume><fpage>102082</fpage><lpage>102082</lpage><history><date date-type="received"><day>2</day><month>4</month><year>2020</year></date><date date-type="accepted"><day>3</day><month>4</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 Elsevier B.V. All rights reserved.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder>Elsevier B.V.</copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract abstract-type="author-highlights" id="abs0005"><title>Highlights</title><p><list list-type="simple" id="lis0005"><list-item id="lsti0005"><label>•</label><p id="par0005">First communication from India with psychiatry residents perspective.</p></list-item><list-item id="lsti0010"><label>•</label><p id="par0010">Authors had first-hand experience of working in the COVID designated areas.</p></list-item><list-item id="lsti0015"><label>•</label><p id="par0015">Highlights the need of the hour.</p></list-item></list></p></abstract></article-meta></front><body><p content-type="salutation">Sir,</p><p id="par0020">At the time of writing this letter (end March 2020) the world is facing one of the most feared pandemic of all time named – COVID-19, caused by a novel corona virus, SARS-CoV-2 (<xref rid="bib0005" ref-type="bibr">Anon., 2020</xref>). Although the disease started in December 2019 in China, but rapidly progressed to affect more than half a million people across 176 countries (till 27.03.2020) and these numbers are only expected to rise further. A time when world’s best health-care facilities and global public-health researchers are in dare setback, it’s worth raising the question that, are we prepared enough to handle the psychological ill-effect and psychiatric issues that are anticipated in post-pandemic periods?</p><p id="par0025">Fear and anxiety are common psychological response during disastrous situations like this (<xref rid="bib0015" ref-type="bibr">Dong and Bouey, 2020</xref>). But undue prolonged stress with social isolation can act as a <xref rid="tbl0005" ref-type="table">Table 1</xref>niche for developing a pathological mental state (<xref rid="bib0020" ref-type="bibr">Goyal et al., 2020</xref>). While higher income countries already apprehending worse recession and socio-economic setbacks, low-and-middle income countries like India is high likely to face the worse. Many already proven social factors like: <italic>being sick, prolonged hospitalization, death of loved ones, loss of job, months of forced quarantine, lack of supply, stigma</italic> – is likely to hit us all, especially those who are more vulnerable to stress and already suffering from mental illness (<xref rid="bib0030" ref-type="bibr">Mak et al., 2009</xref>; <xref rid="bib0010" ref-type="bibr">Brooks et al., 2020</xref>) (<xref rid="tbl0005" ref-type="table">Table 1</xref>).<table-wrap position="float" id="tbl0005"><label>Table 1</label><caption><p>Possible vulnerable groups, risk factors and psychological symptoms in the aftermath of pandemic.</p></caption><alt-text id="at0010">Table 1</alt-text><table frame="hsides" rules="groups"><thead><tr><th align="left">Possible vulnerable groups:</th><th align="left">Possible risk factors</th><th align="left">Possible psychological symptoms</th></tr></thead><tbody><tr><td align="left">Children and adolescents</td><td align="left">Vulnerable to misinformation, disruption of daily routine</td><td align="left">Tantrums, clingy behavior, increased bed wetting, repeated cry, substance use</td></tr><tr><td align="left">Elderly adults</td><td align="left">Age, medical comorbidities</td><td align="left">Anxiety, insomnia, depression, worsening of medical condition</td></tr><tr><td align="left">Jobless and homeless persons</td><td align="left">Lack of support, uncertainties</td><td align="left">Anxiety, insomnia, depression, stress disorders, suicide</td></tr><tr><td align="left">Persons diagnosed/suspected of COVID-19 (active or recovered)</td><td align="left">Stigma, prolonged isolation, social rejection, death of loved one</td><td align="left">Anxiety, depression, insomnia, obsessive symptom, fear of contracting illness, stress disorders, grief, suicide</td></tr><tr><td align="left">Health care providers of COVID-19 cases</td><td align="left">Work stress, burn out, being in direct contact with active cases</td><td align="left">Anxiety, depression, insomnia, fear of contracting illness, post-traumatic stress</td></tr><tr><td align="left">Persons with mental illness/substance use disorder</td><td align="left">Discrimination, outstanding stress, economic burden</td><td align="left">Exacerbation of symptoms/relapse</td></tr></tbody></table></table-wrap></p><p id="par0030">We are among few, in our institute, being involved since beginning in active management of COVID-19 cases. We found, many patients in the designated isolation ward had reported – excessive fear, restlessness and sleep disturbances during hospital stay. Many frontline healthcare workers had shown signs of anxiety and depression. Therefore, we as psychiatrists need to take urgent action in finding and managing such issues.</p><p id="par0035">Acute medical emergency may last many months and may be year(s) – and therefore until we have an effective preventive or curative treatment for COVID-19, primary focus would continue to be manpower development and resource allocation for detection and management of active cases. However, at the same time we cannot ignore the psychological aftermath of this pandemic.</p><p id="par0040">Three primary concerns to be addressed by fellow psychiatrists are: (1) generating evidence by well conducted studies, (2) generating awareness and psychological preparedness among common men and essential service providers, (3) delivering active psychological and psychiatric intervention to those in need.</p><p id="par0045">Well-conducted studies are needed to assess, (i) the magnitude (i.e. spectrum and severity) of various psychological problems – aiding the policymaking process, (ii) the immediate and long term psychological consequences of such life-changing events in various subgroups of the population, and (iii) the response to various therapeutic interventions. We believe, use of digital media (telepsychiatry) for early and active search of individuals with psychological infirmity, and also as mode of delivering information and psychological interventions can be an effective tool to reduce the sufferings of all vulnerable individuals (<xref rid="bib0025" ref-type="bibr">Liu et al., 2020</xref>). Later, integration of public mental health – delivering essential psychiatric and psychological services may become pivotal. Humanity has faced worse during two previous world-wars but we cannot wait until we heal. Psychiatrists have to be the flag-bearer of the best known medicine of all time – Hope.</p><sec id="sec0005"><title>Financial disclosure</title><p id="par0050">The present study was non-funded. The authors do not have financial disclosures</p></sec><sec sec-type="COI-statement"><title>Declaration of Competing Interest</title><p id="par0055">The authors do not have any conflicts of interest to report</p></sec></body><back><ref-list id="bibl0005"><title>References</title><ref id="bib0005"><mixed-citation publication-type="other" id="oref0005">Naming the coronavirus disease (COVID-19) and the virus that causes it [Internet]. [cited 2020 Mar 30]. 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Hosp. Psychiatry</source><volume>31</volume><issue>August (4)</issue><year>2009</year><fpage>318</fpage><lpage>326</lpage><pub-id pub-id-type="pmid">19555791</pub-id></element-citation></ref></ref-list><ack id="ack0005"><title>Acknowledgement</title><p>Dr Siddharth Sarkar, Assistant professor of psychiatry, AIIMS, New Delhi – for his constant encouragement and constructive inputs.</p></ack></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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