Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic

INTRODUCTION@#Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks.@*METHODS@#We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks.@*RESULTS@#A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation.@*CONCLUSION@#Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self-care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.

Antipsychotics And Electrocardiographic Monitoring In Patients With Schizophrenia

Objectives: Patients with schizophrenia are more likely to die prematurely than the general population. They have a higher risk of cardiovascular related morbidity and mortality. Antipsychotic medications are also known to be associated with the prolongation of the rate-corrected QT (QTc) interval, which is linked to dangerous arrhythmias. The primary objective of our study is to investigate the practice of electrocardiogram (ECG) monitoring for patients with schizophrenia who were hospitalised. The secondary objective is to evaluate the prevalence of QTc prolongation in this group of patients. Methods: We included patients with schizophrenia who were discharged from the acute general adult psychiatric wards of the Institute of Mental Health in Singapore from 1 July 2014 to 21 July 2014. A retrospective analysis of the medical records was carried out to assess if they had received ECG during their hospitalisation. We also analysed their risk of developing QTc prolongation. Results: We had a sample size of 107 patients. There were 31 patients (29·0%) who received ECG during their hospitalisation. Of the 95 patients who had moderate-to-high risk of developing QTc prolongation, 29 of them received ECG. Of the 31 patients who received ECG, 10 of them (32·3%) had QTc prolongation. Conclusion: The ECG monitoring in the study patients was inadequate, and as a result, we were unable to evaluate the prevalence of prolonged QTc interval with confidence. We recommend performing baseline ECGs for these patients and conducting ECG teachings for clinicians who work in the psychiatric service settings. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Improving mental health care for people with an intellectual disability in Singapore: bridging the health-social care divide

Intellectual disability is known to be associated with a high incidence of psychiatric co-morbidity and problem behaviours. However, there are many challenges in trying to meet the mental health needs of people with an intellectual disability, and these are often not adequately addressed in Singapore's current healthcare system. This article outlines the present service provisions for this area in the country and details the importance of, as well as difficulties in the integration of health and social care measures in service development and delivery.