Psychological Aspects of the COVID-19 Pandemic
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Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse Bethesda, MD, USA; 2Department of Psychiatry, New York State Psychiatric Institute/Columbia UniversityNew York, NY, USA.
J Gen Intern Med DOI: 10.1007/s11606-020-05955-3 © Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2020
of coronavirus disease 2019 (COVID-19) D iagnoses in close to 200 countries have led the World Health Organization to declare it a global pandemic. To date, most actions related to COVID-19 have understandably focused on containing or mitigating the spread of the virus, testing new treatments, and seeking to develop vaccines. Much less attention has been directed towards the psychological consequences associated with the pandemic and the measures considered or adopted to combat its life-threatening consequences, even as distress has increased with growing numbers of individuals testing positive, seeing loved ones die, and with uncertainty about when and how a return to previous ways of life might be possible. We outline some potential adverse psychological consequences and offer suggestions for their prevention or mitigation.
INCREASED PREVALENCE OF PSYCHIATRIC DISORDERS AND SYMPTOMS
Experience from previous disasters suggests that the pandemic is likely to be associated with increased prevalence of psychiatric disorders and clinical symptoms,1 although responses may vary by population and local prevalence of the disease. In prior crisis, restricted access to basic necessities (such as food, protective equipment, and medical care) and risk of death, all of which have occurred during the pandemic, have been associated with increased incidence of psychiatric disorders and psychological distress.2 Racial and ethnic minorities and those fighting on the front lines appear to be at increased risk of the psychological consequences of natural disasters.2 Received April 8, 2020 Revised May 5, 2020 Accepted June 1, 2020
EFFECT OF QUARANTINES AND POTENTIAL FOR HEIGHTENED PHYSICAL ILLNESS CONCERN
Some of the public health measures that may be necessary to contain the spread of the pandemic, such as quarantines and social distancing, may further increase the risk of adverse psychological consequences. A recent review revealed that these risks are greater with longer quarantine periods, and when there are infection fears, frustration, boredom, inadequate supplies, inadequate information, and financial loss.3 Even in the absence of formal quarantines, appeals for social and physical distancing may result in increased loneliness and social isolation for many, particularly those most vulnerable, which can further increase risks to physical and psychological health.4 Stigmatization of populations perceived as responsible for spreading the virus may arise as an unintended consequence of initiatives enacted to slow or eliminate transmission, such as sealing off borders or restricting travel, and may persist af
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