The Impact of the COVID-19 Pandemic on the Health of People with Mental Disorders

The aim of the review was to analyze published studies on the impact of the COVID-19 pandemic on the health status (mental and physical) of people with mental disorders. Materials and methods: by keywords "COVID-19”, "depressive disorders”, "affective disorders”, "schizophrenia”, "anxiety disorders” search for papers in English and Russian in the databases MEDLINE/ PubMed, Scopus, Web of Science, eLibrary for the period from 2017 to 2022 was carried out. Conclusion: the analysis of published works has demonstrated that factors such as social distancing, isolation, or changing the availability of medical services can have a signifi cant infl uence on the health of people with mental disorders. It has been established that people suffering from mental illness are at a higher risk of contracting COVID-19, they have less effective post-vaccination immunity and have a more severe course of the disease. The past coronavirus infection can lead to both an increase in pre-existing symptoms of a mental disorder, and the emergence of new ones. Possible physiological mechanisms of mental disorders after past COVID-19 include a wide range of pathogenetic processes: from prolonged systemic infl ammation of varying intensity to vascular microthrombosis and neurodegenerative changes. Cognitive impairment during COVID-19, associated with damage to brain structures by the virus, may exacerbate existing psychopathological symptoms. The special features of psychopathological symptoms that develop in response to a pandemic situation are closely related to the structure of the previous mental status of patients, and therefore the types of psychosocial assistance needed is different for people with various mental disorders. © 2023, Psychiatry (Moscow). All Rights Reserved.

An increase in somatization in pandemic time in association with lexical characterictic of statements about pandemic

Introduction: One of the negative consequences of the COVID-19 pandemic may be an increase in somatization. Objective(s): identification of implicit characteristics of texts indicating the peculiarities of the opinion about the pandemic by people with high somatization level. Method(s): Survey (03/23/2020-01/29/2021, N=1188). Used: SCL-90-R, COPE, Constructive Thinking Inventory (CTI). It was offered to express an opinion on the pandemic. The statements were divided into the two text arrays - "high somatization" and "low somatization" (based on the parameter "somatization" SCL-90R). The frequency of words in these text arrays was estimated (LIWC). Result(s): The analysis showed an increase in somatization as the pandemic developed (Std.J-T Statistic=4,327). The relationship between somatization and anxiety, sleep disturbances, and depression was revealed. Higher rates of somatization are associated with a decrease in emotional coping, global constructive thinking and personal superstitious thinking, an increase in categorical thinking. The connection between somatization and a number of nonconstructive copings is shown. Texts associated with high somatization demonstrate higher number of pronouns of the first person (30.77%, 17.19%), a decrease in the tonality of words, a vocabulary (LIWC) of suffering, negative sthenic emotions (1,53%, 0,93%), a decrease in the vocabulary of motivation and resistance (0,93%, 1,49%), a decrease in vocabulary associated with the body (0,20%, 0,32%). Conclusion(s): The connection between somatization and high emotional distress, which manifests itself in negative emotional vocabulary and is associated with a low level of emotional coping, is shown. The "representation" of the pandemic, presented in the text, is "divorced" from somatic manifestations, fear of illness and death.

Perception of the COVID-19 pandemic by individuals who previously sought psychiatric assistance

Introduction: COVID-19 pandemic leads to high levels of stress. Individuals who have previously sought psychiatric assistance are more sensitive. Objective(s): Analysis of the perception of the pandemic by people who have previously sought psychiatric care. Method(s): An internet-survey (20.03.2020 - 13.01.2021) (N=659;152 - previously sought psychiatric assistance);included SCL-90-R;questions about the levels of anxiety, depression, and fear (assessed on 0-10 scale);question about opinion on COVID-19 pandemic (coded further on the basis of meaning);question about epidemiological situation of COVID-19 in respondents' places of residence and their social circles. Result(s): Individuals who had previously sought psychiatric assistance demonstrated higher levels of anxiety (5,533+/-2,489 versus 4,774+/-2,590), depression (4,945+/-2,926 versus 3,861+/-2,988), and fear (0,195+/-0,397 versus 0,278+/-0,448). They showed roughly equivalent reactions to both anticipated and real danger (z-score GSI of SCL-90-R 0,90 versus 0,90 for anticipated and real danger respectively), the same indicator of the control group (0,53 and 0,65). In statements about the pandemic, they are more often referred to the topic of"positive effects" of pandemic (3,30% versus 0,99%), expressed "curiosity" (5,92% versus 2,37%). They were less drawn to conspiracy (9,87% versus 16,17%), and exploited more readily the topic "about myself" (20,39% versus 13,21%), negative images of "the present" (3,64% versus c 1,58%) and "the future" (15,79% versus 9, 47%), vocabulary of "anger" (5,92% versus 2,17%). Conclusion(s): Individuals who had previously sought psychiatric assistance were ambivalent in their attitudes towards pandemic, and tended to concentrate more on feelings and the negative vision of the future. They perceived anticipated danger roughly equivalent to real danger.

Relationship between attitude towards vaccination against COVID-19 and psychological characteristics of personality

Introduction: Vaccination is an effective way to control the infection. COVID-19 is a new disease, and so is the vaccine against it. Objective(s): The aim of the study was to investigate psychological characteristics associated with attitude towards vaccination. Method(s): An online survey was used (N=1336) (31.03.2020- 9.02.2021). Respondents completed COPE, Moral dilemmas (30 Green's Dilemmas, 10 of each type) and decided which strategy to stop the pandemic they found the effective (vaccination, herb immunity, innovative treatment or simply waiting until it fades away on its own). The study analyzed groups of those who see the benefits of vaccination and those who do not consider vaccination as a way to solve the problem of coronavirus. Result(s): Vaccination attitude is more typical for men, for younger people and is also associated with assessment of COVID-19 as a dangerous disease (61% versus 21% for vaccination and no vaccination groups respectively), more diligent compliance with anti-epidemic rules (3,7 and 2,9 mean number of protection methods used), at the same time, the "vaccination" group responds about the less inconvenience associated with restrictions during the pandemic. This social attitude is associated with need for creativity and constructive coping: planning, concentration on emotions, the use of instrumental and emotional social support. There is a difference in personal moral choices (3,6 versus 2,9 for vaccination and no vaccination groups respectively), that demonstrated that positive attitude towards vaccination signifies an active personal position. Conclusion(s): Positive attitude towards vaccination is associated with a proactive personal position and involvement in social interaction using interpersonal coping strategies.

Belief in conspiracy theories and esoteric thinking during COVID-19 pandemic

Introduction: Psychological distress during the SARS-CoV-2 pandemic can manifest itself in interpretations of what is happening. Objective(s): To analyze response to COVID-19 pandemic in people with high level of esoteric thinking. Method(s): Internet survey 23.03.20-29.01.21 (N=621);Constructive Thinking Inventory(CTI);SCL-90R. It was proposed to assess statements: "The authorities are hiding the true scale of the coronavirus pandemic", "Coronavirus is the result of biological weapons development", "Coronavirus is a punishment or a sign sent to people from above","The emergence of the coronavirus is the Earth's response to its pollution". It was offered to express an opinion about pandemic. The answers were coded on the basis of qualitative semantic analysis. Result(s): The growth of "esoteric thinking" was revealed (Std.J-T, p =.025). With a high level of esoteric thinking, emotional statements ("fear, anxiety, panic") are more common (27.8% versus 16.9% for group with high and low level of esoteric thinking). Correlations of the level of esoteric thinking with level of depression (Spearman's correlation ,085*), anxiety (,097*), GSI (,130**), fears for the life (23.4% versus 14.5%) show high emotional distress. With an increase in the level of esoteric thinking, belief in various conspiracy theories increases;Spearman's correlation ,370** with the belief is biological weapons, punishment for sins (,355**), belief in concealing information about the pandemic (,167**). Conclusion(s): A high level of esoteric thinking is associated with an increased emotional response to the pandemic and with belief in conspiracy theories, and can increase emotional instability by itself also making constructive decisions difficult in situations related to protecting personal health and safety.

[Dynamics of psychopathological symptoms during the COVID-19 pandemic in Russia]. / Dinamika psikhopatologicheskoi simptomatiki vo vremya pandemii COVID-19 v Rossii.

OBJECTIVE: The results of the analysis of psychopathological symptom dynamics during the COVID-19 pandemic in Russia are presented. MATERIAL AND METHODS: The study uses the data of the Internet survey, which included a block of sociodemographic questions and the SCL-90-R symptomatic questionnaire. Nine hundred and eight responses received from 22.03.20 to 22.06.20 were analysed. The change in the responses over time was assessed: 3 periods of time were allocated, associated with the change in countermeasures to the pandemic in Russia. In addition, the change in the values of the SCL-90 parameters was assessed depending on the existence of respondent's acquaintances infected with the coronavirus. RESULTS: It was shown that SCL-90 symptoms (Somatization, Depression, Obsession, all integral parameters, including the Global Severity Index) increased from 22.03.20 to 22.06.20. With infected people appearing in the respondent's environment psychopathological symptoms increase. The growth of hostility, sensitivity and anxiety is associated with a personal experience of a danger of the pandemic, which intensifies when infected persons appear in the immediate environment. CONCLUSION: The increase in psychopathological symptoms after the mitigation or cancellation of the quarantine restrictions suggests the persistence of long-term consequences.

Depressive symptoms and suicidal ideation during the COVID-19 pandemic in Russia

IntroductionThe COVID-19 pandemic may bear serious consequences for mental health, such as the increase in psychopathological symptoms.ObjectivesAnalysis of changes in depressive suicidal ideation symptoms and during the COVID-19. Depressive symptoms and suicidality were considered separately.MethodsInternet survey 22.03.20–22.06.20 (908 responses), included SCL-90R, COPE, question about suicidal ideation.ResultsThe analysis showed a positive correlation between suicidal thoughts and depression (Spearman .45;p<.001), a growing trend in the depressive symptoms (Std.J-T=2.51, p=.012), and the increase in severity of suicidal thoughts (Fisher’s Exact Test, 5.92, p=.046). Severity of depression positively correlates with the emergence of the virus in the city, contraction of disease among friends (Spearman .165;p<.001), sick and die fears, an also is linked to more expressed seeking «emotional, social and instrumental help» (COPE). The intensity of suicidal ideation was not associated with these factors, but negatively correlated with «acceptance» and «planning».ConclusionsThe increase in depressive symptoms and suicidal thoughts is determined by different factors. Depressive symptoms is associated with various fears and mediated by non-constructive ways of coping, but there are also constructive coping-strategies as the search for help. The intensity of suicidal thoughts is associated with higher levels of stress, which cannot be explained by the «objective» threat of contagion and fears, but is experienced as an «indefinite» anxiety, supposedly linked to the measures to counter the pandemic, such as restrictions on social interactions, loneliness and uncertainty. The increase in depressive symptoms is linked with an orientation to another person, but the suicidal ideation is not.DisclosureNo significant relationships.

Changes in moral decision-making during the COVID-19 pandemic

IntroductionStress can influence moral decisions.ObjectivesThe aim of the study was to evaluate whether the stress experienced by people during the COVID-19 pandemic can change moral decision making.Methods311 respondents took part in the Internet survey 30.03.20-31.05.20, including SCL-90-R, and a subset of moral dilemmas proposed by Greene J.D (30 dilemmas in Russian), with «footbridge dilemma» among them as a personal dilemma and «trolley dilemma» as impersonal. The relationship of utilitarian personal dilemmas choices with psychopathological characteristics was analyzed. Personal moral dilemma choices were considered separately, in subgroups with a high level of somatization (N=107) and a high level of psychopathological symptoms (N=76).ResultsThe results showed an increase in personal dilemmas choices: 2.84 mean utilitarian choice in March - April and 3.17 in May (Univariate Analysis of Variance, age, gender as Covariates, p<0.01). At the beginning of the study the groups did not differ in the number of utilitarian personal choices, and at the end of the study the number of personal choices increased in the subgroup with a high level of psychopathology (4.7 utilitarian choices in May) and became statistically higher than in other groups (ANOVA with Bonferonni correction). In the subgroup with a high level of somatization, personal choices slightly decreased by the end of the survey (2.68 choices).ConclusionsThe level of stress during the COVID-19 ambiguously affects moral decisions: a higher level of psychopathological symptoms leads to an increase in utilitarian choices and a high level of somatization leads to a decrease in utilitarian choices.DisclosureNo significant relationships.

THE DYNAMICS OF DEPRESSIVE SYMPTOMS AND SUICIDAL IDEATION DURING THE COVID-19 PANDEMIC IN RUSSIA

The COVID-19 pandemic may bear serious consequences for mental health, such as the increase in psychopathological symptoms, including suicidal ideation and autoaggressive actions. In our study, depressive symptoms and suicidality were viewed as two separate characteristics, which, during the pandemic, may be influenced by different factors. Study objective: analysis of the increase in depressive symptoms and suicidal ideation during the COVID-19 pandemic in Russia. Materials and methods. The materials for the study were the data from an anonymous internet survey, conducted during the period of March, 22 - June, 22, 2020. The survey included information on sociodemographic indicators and questions on how respondents assess their conditions during the pandemic;there was also a question on whether they were recently bothered by the thoughts of killing themselves. The following questionnaires were used: Symptom Check List 90-Revised (SCL-90-R) and the COPE Inventory. Statistical processing was performed with the SPSS program. Results: Nine hundred eight responses were received. The analysis showed a statistically significant positive correlation between the intensity of suicidal thoughts and severity of depressive symptoms according to the SCL-90-R (Spearman's coefficient 0.45;p<0.001). The analysis found a statistically significant growth trend in depressive symptoms as the pandemic progressed (Jonckheere - Terpstra test, Std. J-T stat. = 2.51, p = 0.012), and the increase in frequency of suicidal thoughts that were expressed as 'strong' and 'very strong' in the last period of time (Fisher's Exact Test, 5.92, p = 0.046). The correlation analysis showed that the severity of depression is higher in women and younger respondents, and statistically significantly associated with the current situation of the pandemic: it is increased with the emergence of the virus in the city of residence, with the contraction of disease among friends, with increasing fears of getting sick and die, with the presence of various somatic diseases in respondents, and the number of methods used for protection from the infection. The intensity of suicidal ideation was not associated with the risk of contagion, with the presence of ill persons among the close others, with the fears for the self and close others, but was linked to the higher proneness to risk, was higher in males and younger respondents. Along with that, the severity of depressive symptoms was linked to the higher level of search for emotional, social and instrumental help as a coping strategy. With the growing frequency of suicidal thoughts, the acceptance and planning deteriorated. Conclusions: The increase in depressive symptoms and suicidal thoughts is determined by different factors. The increase in depressive symptoms is associated with various fears and mediated by non-constructive ways of coping with stress. But there are also constructive coping-strategies present, such as the search for help. The intensity of suicidal thoughts increases during the COVID-19 pandemic and is associated with the higher levels of stress, which cannot be explained by the 'objective' threat of contagion and fears for own life or lives of significant others, but is experienced as an 'indefinite' anxiety, supposedly linked to the measures to counter the pandemic, such as the restrictions on social interactions, loneliness, uncertainty. The increase in indices of depressive symptoms is linked with the orientation to another person, while the severity of suicidal ideation has no correlation with that.

TARGETS OF PSYCHOLOGICAL ASSISTANCE FOR PEOPLE WHO INCREASED ALCOHOL CONSUMPTION DURING THE COVID-19 PANDEMIC

The COVID-19 pandemic has dramatically increased the level of everyday stress, leading to an increase in alcohol consumption by part of the population. The purpose of this work was to identify targets of psychological assistance for people who increased alcohol consumption during the COVID-19 pandemic. The study was conducted from 22.03.2020 to 06.05.2020 as an anonymous online survey in which 927 persons took part. The study included sociodemographic data, a question regarding the change in alcohol consumption in the COVID-19 pandemic, as well as the SCL-90-R, the COPE Inventory, and the Constructive Thinking Inventory. For statistical analysis, we used ANOVA, Mann-Whitney U test, and Chi-square test. The data indicated that 96 of the respondents increased alcohol use, 831 did not change or even decreased alcohol consumption. The following targets for work were identified based on the results obtained: 1) working to reduce the subjective stressfulness of the situation by support in overcoming rigid attitudes towards oneself, others and the situation and by help in developing greater flexibility;2) widening the range of available constructive coping strategies;3) working to reduce interpersonal sensitivity, training constructive communication skills and seeking social support;4) planning for the future in conditions of high uncertainty;5) preventive activity in epidemic foci. Пандемия COVID-19 резко увеличила уровень повседневного стресса, что привело к увеличению употребления алкоголя частью населения. Цель работы - выявление мишеней психологической помощи людям, увеличившим употребление алкоголя в ходе пандемии COVID-19. Материалом стали данные интернет-опроса, проведенного с 22.03.2020 по 6.05.2020, в котором приняли участие 927 человек. Опрос включал в себя социодемографический блок, вопрос относительно изменения употребления алкоголя в пандемию COVID-19, а также методики SCL-90-R, COPE, ОКМ-97. Для статистического анализа использовались метод ANOVA, критерий Манна-Уитни, критерий chi2. На основе полученных результатов выявлены следующие мишени работы: 1) снижение субъективной стрессогенности ситуации за счет поддержки в преодолении ригидных установок в отношении себя, других и ситуации, и помощь в развитии большей гибкости;2) расширение диапазона доступных в долгосрочной перспективе более конструктивных стратегий совладания со стрессом;3) работа по снижению межличностной сенситивности, обучению навыкам конструктивного взаимодействия с окружающими и обращению за социальной поддержкой;4) планирование будущего в условиях высокой неопределенности;5) профилактическая работа в очагах эпидемии.

The first experience with Angiovit in the combination treatment of acute COVID-19 infection

On March 11, 2020, the WHO announced the COVID-19 outbreak a pandemic. The disease was established to be caused by a new single-stranded RNA virus (ss-RNA, 29903 bp) that belongs to a group of coronaviruses (CoV). Objective: to assess the results of a pilot analysis of the efficiency of using Angiovit in the combination treatment of acute COVID-19 with pneumonia or acute respiratory viral infection. Patients and methods. The study enrolled 50 patients with acute COVID-19. In all the patients, the diagnosis of coronavirus infection was confirmed by polymerase chain reaction. Angiovit was used in 25 patients (13 (52%) women) (mean age, 39.4 years) with moderate infection who had been admitted on an average of disease day 3 (a study group). A comparison group consisted of 25 patients whose gender, age, and clinical features of COVID-19 did not differ at the time of admission;they were prescribed only mainstay therapy. Results and discussion. Adding Angiovit to the mainstay therapy contributed to an average reduction in the fever period from 5.88 to 4.12 days (p<0.05) and to the earlier hospital discharge of patients with an improvement (on day 13 versus on day 16.8 days in the comparison group;p<0.05);Normalization of CRP, D-dimer, and homocysteine levels occurred considerably and faster. Conclusion. The pilot study has shown that the use of Angiovit in the combination therapy of COVID-19 reduces the clinical and laboratory manifestations of inflammation and hypercoagulation, which may also be associated with the action of folic acid.