The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients - A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany.

The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.

[Psychological stress during the COVID-19 pandemic: consequences for psychiatric patients and therapeutic implications]. / Psychische Belastung während der COVID-19-Pandemie: Konsequenzen für psychiatrisch Erkrankte und therapeutische Implikationen.

BACKGROUND: The outbreak of the COVID-19 disease and the rapid spread of the inducing coronavirus SARS-CoV­2 threatens not only people's physical health but also their mental health. Its influence on incidence and course of existing illnesses in the psychiatric outpatient sector in Germany is still unknown. METHODS: The medical reports of 682 persons in psychiatric treatment were retrospectively investigated, regarding their subjective response to this pandemic and its clinical relevance. RESULTS: Of the patients 60.5% (n = 378) experienced greater psychological stress, 14.5% (n = 99) reported fear of the SARS-CoV­2 and the possible danger of infection, 25.5% (n = 174) reported fear resulting from the protective measures taken (lock down) and 4.3% (n = 29) reported fear of both. This differed significantly across diagnoses: people with anxiety disorders reported significantly greater stress as well as greater fear of the virus, whereas people with psychoses were significantly less affected than the other patients. Of the participants 43.7% (n = 132) were so strongly affected that acute treatment had to be implemented and 6.0% (n = 18) had to be referred to inpatient care. DISCUSSION: People with mental illnesses are particularly vulnerable to the psychological strain of the COVID-19 pandemic. Long-term studies on the further course of disease will be necessary. Additional studies that test interventions to build resilience in this population will also be needed.

[Cultural Influence on Attitude towards Psychotherapy - A Comparison of Individuals of Turkish Origin with Individuals without Migration Background]. / Kulturabhängigkeit der Einstellung gegenüber psychotherapeutischer Behandlung bei Türkeistämmigen und Personen ohne Migrationshintergrund.

AIM: The present study compares the attitude towards psychotherapy of persons living in Germany with or without Turkish background. In this context, gender-related, disorder-specific and sociodemographic differences in openness towards psychotherapy are taken into account. METHODS: Individuals of Turkish origin (n=129) and individuals without migration background (n=129) were interviewed with the Questionnaire on Attitudes towards Psychotherapeutic Treatment, the Social Support Questionnaire, a short version of the Symptom-Checklist with the subscales anxiety, depression and somatization, and a sociodemographic questionnaire. RESULTS: The attitude towards psychotherapy is less positive in Turkish migrants than in people without migration background. Females, depressive individuals, persons with high social support, with children and a high level of education are more open towards psychotherapy. DISCUSSION: The attitude towards psychotherapy is influenced by gender, socio-demographic and disorder-specific factors and in particular by cultural factors. CONCLUSION: These results elucidate the need for better information about psychotherapy and the development of intercultural consulting services for migrants in Germany.

[Clinical and sociodemographic Differences Between Patients with and without Migration Background in a Psychiatric Outpatient Service]. / Klinische und soziodemografische Unterschiede zwischen Patienten mit und ohne Migrationshintergrund in einer Psychiatrischen Institutsambulanz.

OBJECTIVE: A better understanding of specific sociodemographic and clinical factors in patients with migration background may help to significantly improve psychiatric treatment outcome of these patients. Therefore, we investigated these factors in a large sample of psychiatric outpatients. METHODS: N = 423 psychiatric patients of a large outpatient service were assessed for sociodemographic variables as well as clinical variables including diagnosis, psychopharmacological treatment, treatment duration and current symptom load (SCL-14). RESULTS: We found significant differences between patients with and without migration background in terms of sociodemographic and clinical factors such as education, employment and main diagnose. Patients with migration background had a significantly higher current symptom load, especially for somatic symptoms. CONCLUSION: The data underline the large differences between patients with and without migration background regarding sociodemographic and clinical factors. These differences should be considered in psychiatric treatment of these patients.

[What do Interpreters Cost? - A Retrospective Analysis of the Costs for Interpreters in Treatment of Refugees in a Psychiatric Outpatient Clinic in Berlin]. / Was kosten uns Dolmetscher? ­ Eine retrospektive Analyse der Dolmetscherkosten in der Behandlung von Flüchtlingen in einer Psychiatrischen Institutsambulanz in Berlin.

Clinical diagnostics of mental disorders especially among refugees and asylum seekers come with unique difficulties: language barriers, different forms of expression and concepts of the understanding of mental illness as well as a different cultural background. Therefore professional interpreters are needed but associated with a higher effort related to costs and time. We conducted a retrospective analysis of costs, which incurred by the use of professional interpreters in our outpatient clinic in Berlin, Germany, in the first quarter 2016 for the treatment of refugees and asylum seekers. The sample consisted of 110 refugees and asylum seekers; the highest costs in the use of interpreters incurred among Neurotic, stress-related and somatoform disorders (53.04%), especially Posttraumatic Stress Disorder (39.04%), as well as affective disorders (38.47%), especially major depressive episodes (25.23%). Our data point out the crucial need of a regulation of costs with regard to the service of professional interpreters in Germany.