The impact of COVID-19 on patients of Italian mental health supported accommodation services
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LETTER TO THE EDITOR
The impact of COVID‑19 on patients of Italian mental health supported accommodation services Alessandra Martinelli1,2 · Mirella Ruggeri1,2 Received: 5 May 2020 / Accepted: 9 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
At this pandemic time, each person has been experiencing a feeling of being at risk of a sudden and invincible attack of an invisible enemy. This is a sensation that in psychopathology might be called a ‘predelusional state’ [1]. With daily observation, in some mental health supported accommodation services in the area of Verona, we have found that users with severe mental illness (SMI) [2] have reacted differently to the pandemic lockdown, depending on the specific mental health disorder they suffer. Overall, severe psychotic patients with depersonalization symptoms are those who are showing more difficulties in following basic rules to avoid infection, such as keeping selfhygiene, security distances, and masks. Particularly, people with a diagnosis of schizophrenia, during the first two weeks of lockdown, were relaxed and quiet, probably because of the under-stimuli situation characterized by a suspension of individual and group activities both inside and outside the supported accommodation, supporting the typical research of social withdrawal of these patients. However, from the third week of lockdown, patients with schizophrenia have started to lose control mostly on positive symptoms, showing disorientation and an increased difficulty to maintain a connection with reality. Generally, the typical delusional topic of each patient has strongly emerged. Specifically, schizoaffective patients have shown peaks of manic symptoms with sexual disinhibition, while psychotic patients characterized by negative symptoms have developed loneliness feelings, with increasing protective psychotic regressions: initially, they need support to take * Mirella Ruggeri [email protected] Alessandra Martinelli [email protected] 1
Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
Verona Hospital Trust, AOUI, Verona, Italy
2
care of self-hygiene; then they need support to carry on basic daily life activities such as eating and drinking. Other psychotic patients, after 2 weeks of lockdown, have started to reschedule their daily plan with compulsive activities, such as excessive physical activities or eating, while others have increased specific unusual thoughts focussed on the fear of being infected by others or to infect others. On the other hand, patients suffering from anxiety and depression symptoms have reacted with a worsening of their state, needing more caregiving and sometimes with dysphoria because of the frustration of the impossibility of going out. Patients with a diagnosis of borderline personality disorder have shown a range of different reactions: from locking themselves in their rooms hypothesizing to have had close contacts with infected people—interpretable as an
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