Outpatient psychiatric service utilization during the Covid-19 pandemic

Background The conditions related to the Covid-19 pandemic and quarantine have endangered the mental health of people in the community, especially psychiatric patients. This study aims to determine the mental health services usage of outpatient psychiatric patients who attended a public mental health clinic in Tehran, during the quarantine. The study sample consisted of 387 patients with an active record in the mental health clinic. They were selected using systematic random sampling. Data was gathered with the telephone interviews using the researcher-made checklist. The data were then collected and analyzed. Results Participants in this study included 141 male and 264 female patients. One-hundred forty-two patients (36.7%) felt better during this period, and the rest got worse or did not make a difference. Among the patients who felt the need to visit, 144 (47.2%) referred for services, of which 81.7% had visited in person. Among the applicants, 84 (56%) succeeded in receiving the service. A total of 53.5% of patients had used at least one face to face, telephone, or online visit. Among them, women are compared to men (p = 0.002), educated people to low education (p < 0.001), and adults to children and the elderly (p = 0.02), and Tehran residents to foreigners (p = 0.01) used significantly more services. Conclusions Experience with pandemic quarantine conditions has shown that face-to-face use of these services faces significant barriers. In this situation, the expansion of online services can help improve the condition of patients and should be on the agenda of mental health policymakers.

COVID-19 in Older Adults: Iran Health Care System Response.

Cite this article as: Shati M, Mortazavi SS, Moghadam M, Solbi Z, Barakati SH, Rezaei F. COVID-19 in Older Adults: Iran Health Care System Response. Med J Islam Repub Iran. 2022 (25 Apr);36:41. https://doi.org/10.47176/mjiri.36.41.

Mourning During Corona: A Phenomenological Study of Grief Experience Among Close Relatives During COVID-19 Pandemics.

Considering the need for observing health protocols, the experience of the loss and the grieving process has changed in nature during this disease. Therefore, this study aims to gain a deep understanding of the experience of mourning during COVID-19 pandemic by exploring the experiences of survivors of the death of their loved. During COVID-19 pandemic, the inability to hold the usual ceremonies for mourning and receive the social support needed in this period, the relatives of the deceased encounter various conditions that disrupt the grieving process and may lead to the spread of unresolved grief in future.

Adherence to Self-isolation measures by older adults during coronavirus disease 2019 (COVID-19) epidemic: A phone survey in Iran.

Background: Older adults are at higher risk for severe illness and death associated with coronavirus disease 2019 (COVID-19). As Iran was affected by COVID-19 pandemic, the elderly population soon were told to self-isolate for a very long time. We aimed to identify the coverage, efficacy, and integrity of self-isolation and its predictors in the Iranian older adults (≥60 years) from February 19 to 19 March 2020. Methods: Quota sampling was performed to recruit respondents from 16 cities that were selected based on their population size (4, 7, and 5 cities for localities with ≤500 000, 500 000-1 000 000, and ≥1 000 000 populations) and geographical direction (West = 4 cities; North, East, South, Center = 3 each). At least 30 respondents per locality were selected. Phone interviews of 558 respondents (out of 560; response rate = 99.6%) were performed by local trained interviewers using a validated interview form. Association between age, sex, and living condition (with family vs alone) was assessed with Pearson Chi Square and logistic regression analyses. Results: Complete self-isolation was reported by 61% of the respondents. In 72%, self-isolation led to 80%-100% contact reduction. Self-isolation was broken by 26% of the respondents. Females had better self-isolation behaviors (OR adjusted: 2.3, 95% CI: 1.5, 3.3) and higher contact reduction rates (p: 0.067). They kept the integrity of self-isolation better (OR adjusted: 1.8; 95% CI: 1.2, 2.7). Those aged older than 80 years were 2.3-folds more likely to completely self-isolate than younger elderly (95% CI adjusted: 1.2, 4.3). Living alone did not significantly predict self-isolation features in the elderly. Conclusion: About one third of the interviewed Iranian older adults did not adhere to important self-isolation measures, with males and younger ages showing lower adherence. With the relaxation of social distancing measures, protection measures of the elderly should be strengthened. Given that prolonged self-isolation adversely affects physical and mental health status of the elderly, it is highly recommended to think of creative and gender-specific methods that best tailor the needs of this population in Iran.

Fear, Loss, Social Isolation, and Incomplete Grief Due to COVID-19: A Recipe for a Psychiatric Pandemic.

The experience of the loss of the relatives, which is naturally one of the most stressful events in a person's life, has turned into a new concept and challenge for survivors and mental health professionals during the coronavirus era. We discussed how restrictions caused by social distancing potentially increase the likelihood of a phenomenon called complicated grief or prolonged bereavement disorder and multilayer response by case finding to increase the access to public education to manage this complicated situation.