Pandemia COVID‑19 e Perturbação Mental: Breve Revisão da Literatura

  • Sandra Nascimento Serviço de Psiquiatria no Centro Hospitalar Psiquiátrico de Lisboa (CHPL), Lisboa, Portugal
  • Camila Pereira Serviço de Psiquiatria no Centro Hospitalar Psiquiátrico de Lisboa (CHPL), Lisboa, Portugal
  • Inês Caldas Serviço de Psiquiatria no Centro Hospitalar Psiquiátrico de Lisboa (CHPL), Lisboa, Portugal
  • Mariana Silva Serviço de Psiquiatria no Centro Hospitalar Psiquiátrico de Lisboa (CHPL), Lisboa, Portugal
  • Teresa Mendonça Serviço de Psiquiatria no Hospital Garcia de Orta (HGO), Almada, Portugal
  • Beatriz Lourenço Serviço de Psiquiatria no Centro Hospitalar Psiquiátrico de Lisboa (CHPL), Lisboa, Portugal
  • Marco Gonçalves Serviço de Psiquiatria no Centro Hospitalar Psiquiátrico de Lisboa (CHPL), Lisboa, Portugal
Palavras-chave: COVID‑19, Infeções por Coronavírus, Pandemia, Perturbações Mentais, Saúde Mental

Resumo

A pandemia COVID‑19 foi declarada uma emergência de saúde mundial. Estima‑se que poderá originar um elevado nível de sofrimento, prevendo‑se que o período de crise origine variados desafios na esfera da saúde mental, tanto na população geral como nas pessoas com perturbação mental prévia. O sofrimento psicológico e angústia generalizada devido ao impacto imediato do vírus na saúde, mas também a necessidade de implementar medidas de quarentena, de isolamento físico associado à perda nas atividades educativas e laborais, adivinham o medo da doença, o receio da morte e incerteza quanto ao futuro. Por outro lado, estima‑se que a pandemia COVID‑19 poderá afetar de modo desproporcional populações mais vulneráveis, nomeadamente os profissionais de saúde e aqueles com antecedentes prévios de perturbação mental. 

Pela ameaça de problemas da saúde mental que a população em geral pode enfrentar e a possível agudização da condição de base nos doentes com perturbação mental prévia éimportante uma avaliação dos vários problemas emergentes. Com efeito, os serviços de saúde mental necessitam de uma adaptação estrutural de modo a lidar com o risco acrescido das morbidades psiquiátricas, desenvolvendo e implementando programas de rastreio e intervenção precoce, que visem não apenas os efeitos agudos, mas também os efeitos a longo prazo ou crónicos desta pandemia. 

A elaboração deste artigo de revisão tem por objetivo reunir, de forma rigorosa, a informação dispersa em variadas fontes científicas atualmente existentes sobre o impacto da infeção por COVID‑19 na saúde mental, assim como a experiência clínica no terreno. Deste modo, os autores realizaram uma revisão da literatura, pela pesquisa através da PubMed e Medscape usando as palavras‑chave “Pandemic”, “COVID‑19”, “Mental Health”, “Mental Disorder”. 

O artigo propõe‑se a desenvolver de forma concisa e sumária algumas das problemáticas particulares inerentes à pandemia COVID‑19 e saúde mental, propondo ainda algumas estratégias e intervenções para fazer face à situação de crise vivida. Considera‑se, no entanto, a necessidade futura da contínua realização de estudos e avaliação da experiência prática, de modo a reorientar as políticas e medidas de intervenção na saúde mental. 

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Referências

World Health Organization. Coronavirus Disease 2019 (COVID‑19) Situation Report—70; 2020. [Jun 2020] Available from: https://www.who.int/docs/default‑source/ coronaviruse/situation‑reports/ 20200330‑sitrep‑70‑covid‑19. pdf?sfvrsn=7e0fe3f8_4.

Mackenzie JS, Smith DW. COVID‑19: a novel zoonotic disease caused by a coronavirus from China: what we know and what we don’t. Microbiol Aust. 2020;41:45. doi:10.1071/MA20013

Adalja AA, Toner E, Inglesby TV. Priorities for the US Health Community Responding to COVID‑19. JAMA. 2020;323:1343. doi:10.1001/jama.2020.3413

Ko CH, Yen CF, Yen JY, Yang MJ. Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan. Psychiatry Clin Neurosci. 2006;60:397‑403. doi:10.1111/j.1440‑1819.2006.01522. x

Peng EY, Lee MB, Tsai ST, Yang CC, Morisky DE, Tsai LT, et al. Population‑based Post‑crisis Psychological Distress: An Example From the SARS Outbreak in Taiwan. J Formos Med Assoc. 2010;109:524‑32. doi:10.1016/S0929‑6646( 10)60087‑3

Okusaga O, Yolken RH, Langenberg P, Lapidus M, Arling TA, Dickerson FB, et al. Association of seropositivity for influenza and coronaviruses with history of mood disorders and suicide attempts. J Affect Disord. 2011;130:220‑5. doi:10.1016/j.jad.2010.09.029

Lam MH. Mental Morbidities and Chronic Fatigue in Severe Acute Respiratory Syndrome Survivors. Arch Intern Med. 2009;169:2142. doi:10.1001/ archinternmed.2009.384

Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID‑19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun. 2020;87:34‑39. doi:10.1016/j.bbi.2020.04.027

Center for the Study of Trumatic Stress. Sustaining the Well‑Being of Healthcare Personnel during Coronavirus and other Infectious Disease Outbreaks. 2020:20814. [Jun 2020] Available from: http://www.cstsonline.org.

Tsai J, Wilson M. COVID‑19: a potential public health problem for homeless populations. Lancet Public Heal. 2020;5:e186‑e187. doi:10.1016/ S2468‑2667( 20)30053‑0

Banerjee D. The COVID‑19 outbreak: Crucial role the psychiatrists can play. Asian J Psychiatr. 2020;50:102014. doi:10.1016/j.ajp.2020.102014

Xiang Y‑T, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7:228‑9. doi:10.1016/ S2215‑0366( 20)30046‑8

Yang Y, Li W, Zhang Q, Zhang L, Cheung T, Xiang YT. Mental health services for older adults in China during the COVID‑19 outbreak. The Lancet Psychiatry. 2020;7:e19. doi:10.1016/S2215‑0366( 20)30079‑1

Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395:912‑20. doi:10.1016/ S0140‑6736( 20)30460‑8

Tsamakis K, Rizos E, Manolis A, Chaidou S, Kympouropoulos S, Spartalis E, et al. COVID‑19 pandemic and its impact on mental health of healthcare professionals. Exp Ther Med. 2020;19: 3451‑3. doi:10.3892/etm.2020.8646

Galbraith N, Boyda D, McFeeters D, Hassan T. The mental health of doctors during the COVID‑19 pandemic. BJPsych Bull. 2020 (in press). doi:10.1192/ bjb.2020.44

El‑Hage W, Hingray C, Lemogne C, Yrondi A, Brunault P, Bienvenu T, et al. Les professionnels de santé face à la pandémie de la maladie à coronavirus (COVID‑19) : quels risques pour leur santé mentale ? Encephale. 2020;46:S73‑S80. doi:10.1016/j. encep.2020.04.008

Su T, Lien T, Yang C, Su YL, Wang JH, Tsai SL, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: A prospective and periodic assessment study in Taiwan. J Psychiatr Res. 2007;41:119‑30. doi:10.1016/j. jpsychires.2005.12.006

Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei Net al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3:e203976. doi:10.1001/jamanetworkopen.2020.3976

Wu P, Liu X, Fang Y, Fan B, Fuller CJ, Guan Z, et al. Alcohol abuse/dependence symptoms among hospital employees exposed to a SARS outbreak. Alcohol Alcohol. 2008;43:706‑12. doi:10.1093/alcalc/agn073

Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on

hospital employees in china: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54:302‑11. doi:10.1177/070674370905400504

Liu X, Kakade M, Fuller CJ, Fan B, Fang Y, Kong J, et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatry. 2012;53:15‑23. doi:10.1016/j.comppsych.2011.02.003

Lee S, Chan LY, Chau AM, Kwok KP, Kleinman A. The experience of SARS‑related stigma at Amoy Gardens. Soc Sci Med. 2005;61:2038‑46. doi:10.1016/j.socscimed.2005.04.010

Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008;136:997‑1007. doi:10.1017/ S0950268807009156

Dutheil F, Aubert C, Pereira B, Dambrun M, Moustafa F, Mermillod M et al. Suicide among physicians and health‑care workers: A systematic review and meta‑analysis. PLoS One. 2019;14:e0226361. doi:10.1371/ journal.pone.0226361

Manuell M‑E, Cukor J. Mother Nature versus human nature: public compliance with evacuation and quarantine. Disasters. 2011;35:417‑42. doi:10.1111/j.1467‑7717.2010.01219. x

Rubin GJ, Brewin CR, Greenberg N, Simpson J, Wessely S. Psychological and behavioural reactions to the bombings in London on 7 July 2005: cross sectional survey of a representative sample of Londoners. BMJ. 2005;331:606. doi:10.1136/bmj.38583.728484.3a

United Nations. Policy Brief : COVID‑19 and the Need for Action on Mental Health EXECUTIVE SUMMARY : COVID‑19 and the Need for Action on Mental Health. Geneva: World Health Organization;3‑10.

Asmundson GJG, Taylor S. How health anxiety influences responses to viral outbreaks like COVID‑19: What all decision‑makers, health authorities, and health care professionals need to know. J Anxiety Disord. 2020;71:102211. doi:10.1016/j.janxdis.2020.102211

Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID‑19 pandemic: A systematic review and meta‑analysis. Brain Behav Immun. 2020;88:901‑907. doi:10.1016/j.bbi.2020.05.026

Rajkumar RP. COVID‑19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020;52:102066. doi:10.1016/j.ajp.2020.102066

Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, et al. A longitudinal study on the mental health of general population during the COVID‑19 epidemic in China. Brain Behav Immun. 2020;87:40‑8. doi:10.1016/j. bbi.2020.04.028

Huremović D. Psychiatry of Pandemics. Cham: Springer International Publishing; 2019. doi:10.1007/978‑3‑030‑15346‑5

Gunnell D, Appleby L, Arensman E, Hawton K, John A, Kapur N, et al. Suicide risk and prevention during the COVID‑19 pandemic. Lancet Psychiatry. 2020;7:468‑71. doi:10.1016/S2215‑0366( 20)30171‑1

Sønderskov KM, Dinesen PT, Santini ZI, Østergaard SD. The depressive state of Denmark during the COVID‑19 pandemic. Acta Neuropsychiatr. 2020;32:226‑8. doi:10.1017/neu.2020.15

Huang Y, Zhao N. Mental health burden for the public affected by the COVID‑19 outbreak in China: Who will be the high‑risk group? Psychol Health Med. 2020:1‑12. doi:10.1080/13548506.2020.1754438

Yardley S, Rolph M. Death and dying during the pandemic. BMJ. 2020 (in press). doi:10.1136/bmj.m1472

de Girolamo G, Cerveri G, Clerici M, Hawton K, John A, Kapur N, et al. Mental Health in the Coronavirus Disease 2019 Emergency — The Italian Response. JAMA Psychiatry. 2020; 7:468‑71. doi:10.1001/ jamapsychiatry.2020.1276

Morris SE, Moment A, Thomas J de Lima. Caring for bereaved family members during the COVID‑19 pandemic: before and after the death of a patient. J Pain Symptom Manage. 2020;60:e70‑e74. doi:10.1016/j. jpainsymman.2020.05.002

Selman LE, Chao D, Sowden R, Marshall S, Chamberlain C, Koffman J. Bereavement Support on the Frontline of COVID‑19: Recommendations for Hospital Clinicians. J Pain Symptom Manage. 2020;60:e81‑e86. doi:10.1016/j.jpainsymman.2020.04.024

Dutheil F, Mondillon L, Navel V. PTSD as the second tsunami of the SARS‑Cov‑2 pandemic. Psychol Med. 2020:1‑2. doi:10.1017/S0033291720001336

Röhr S, Müller F, Jung F, Apfelbacher C, Seidler A, Riedel‑Heller SG. Psychosocial Impact of Quarantine Measures During Serious Coronavirus Outbreaks: A Rapid Review. Psychiatr Prax. 2020;47:179‑89. doi:10.1055/a‑1159‑5562

Mengin A, Allé MC, Rolling J, Ligier F, Schroder C, Lalanne L, et al. Conséquences psychopathologiques du confinement. Encephale. 2020;46:S43‑S52. doi:10.1016/j.encep.2020.04.007

DePierro J, Lowe S, Katz C. Lessons learned from 9/11: Mental health perspectives on the COVID‑19 pandemic. Psychiatry Res. 2020;288:113024. doi:10.1016/j.psychres.2020.113024

Adam D. The hellish side of handwashing: how coronavirus is affecting people with OCD. The Guardian. 2020.

Apergis‑Schoute AM, Gillan CM, Fineberg NA, Fernandez‑Egea E, Sahakian BJ, Robbins TW. Neural basis of impaired safety signaling in Obsessive Compulsive Disorder. Proc Natl Acad Sci. 2017;114:3216‑21. doi:10.1073/pnas.1609194114

Gottwald J, de Wit S, Apergis‑Schoute AM, Morein‑Zamir S, Kaser M, Cormack F, et al. Impaired cognitive plasticity and goal‑directed control in adolescent obsessive–compulsive disorder. Psychol Med. 2018;48:1900‑8. doi:10.1017/S0033291717003464

International OCD Foundation. Resources for the OCD and related disorders community during the COVID‑19 outbreak. [Jun 2020] Available from:https:// iocdf.org/covid19‑old/. Published 2020.

Fineberg NA, Van Ameringen M, Drummond L, et al. How to manage obsessive‑compulsive disorder (OCD) under COVID‑19: A clinician’s guide from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) and the Obsessive‑Compulsive and Related Disorders Research Network (OCRN) of the Europ. Compr Psychiatry. 2020;100:152174. doi:10.1016/j.comppsych.2020.152174

CDC. Coronavirus Disease, Older Adults. [Jun 2020] Available from:https://www.cdc.gov/coronavirus/2019‑ncov/ need‑extra‑precautions/ older‑adults. html. Published 2020.

Disease C, Report DS. Coronavirus Disease 2019 Daily Situation Report of the Robert Koch Institute Epidemiological Situation in Germany. J Immunol Res. 2020;2019:1‑8. doi:10.1155/2018/3174868

Lightfoot J, Harris D, Haustead D. Challenge of managing patients with COVID‑19 and acute behavioural disturbances. Emerg Med Australas. 2020;32:714‑5. doi:10.1111/1742‑6723.13522

Comas‑Herrera A, Zalakain J. Mortality associated with COVID‑19 outbreaks in care homes : early international evidence. Resour to Support community institutional Long‑Term Care responses to COVID‑19. [Jun 2020] Available from: https://www.ontario.ca/ page/how‑ontario‑is‑responding‑covid‑19# section‑1% 0ALTCcovid.org.

Graves TC. Influenza in relation to the onset of acute psychoses. J Neurol Neurosurg Psychiatry. 1928;34:97‑112. doi:10.1136/jnnp.s1‑9.34.97

Allardyce J, Boydell J. Environment and schizophrenia: review: the wider social environment and schizophrenia. Schizophr Bull. 2005;32:592‑8. doi:10.1093/ schbul/sbl008

Severance EG, Dickerson FB, Viscidi RP, et al. Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophr Bull. 2011;37:101‑7. doi:10.1093/schbul/sbp052

Jacomy H, Talbot PJ. Vacuolating encephalitis in mice infected by human coronavirus OC43. Virology. 2003;315:20‑33. doi:10.1016/S0042‑6822( 03)00323‑4

Carter CJ. Schizophrenia: a pathogenetic autoimmune disease caused by viruses and pathogens and dependent on genes. J Pathog. 2011;2011:1‑37. doi:10.4061/2011/128318

Severance EG, Yolken RH. From Infection to the Microbiome: An Evolving Role of Microbes in Schizophrenia. In: ; 2019:67‑84. doi:10.1007/7854_2018_84

Druss BG. Addressing the COVID‑19 Pandemic in Populations With Serious Mental Illness. JAMA Psychiatry. April 2020. doi:10.1001/ jamapsychiatry.2020.0894

Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al. Progression of Mental Health Services during the COVID‑19 Outbreak in China. Int J Biol Sci. 2020;16:1732‑8. doi:10.7150/ijbs.45120

Zandifar A, Badrfam R. COVID‑19: Considering the prevalence of schizophrenia in the coming decades. Psychiatry Res. 2020;288:112982. doi:10.1016/j. psychres.2020.112982 63. Kar SK, Arafat SM, Sharma P, Dixit A, Marthoenis M, Kabir R. COVID‑19 pandemic and addiction: Current problems and future concerns. Asian J Psychiatr. 2020;51:102064. doi:10.1016/j.ajp.2020.102064 64. Russell B. Influenza Pandemic, Mental Illnesses. Addictions. 2010;5:1‑5.

O’Sullivan TL, Bourgoin M. Vulnerability in an Influenza Pandemic : Looking Beyond Medical Risk. 2011.

Shore JH, Schneck CD, Mishkind MC. Telepsychiatry and the Coronavirus Disease 2019 Pandemic—Current and Future Outcomes of the Rapid Virtualization of Psychiatric Care. JAMA Psychiatry. 2020. doi:10.1001/jamapsychiatry.2020.1643

Zhu J, Sun L, Zhang L, Wang H, Fan A, Yang B, et al. Prevalence and Influencing Factors of Anxiety and Depression Symptoms in the First‑Line Medical Staff Fighting Against COVID‑19 in Gansu. Front Psychiatry. 2020;11:386. doi:10.3389/fpsyt.2020.00386

Pires AM, Leuschner A, Marques C. COVID‑19: Fase de mitigação ‑ Saúde Mental. Lisboa: Direcção Geral da Saúde; 2020.

Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID‑19). J Telemed Telecare. 2020;26:309‑313. doi:10.1177/1357633X20916567

Monaghesh E, Hajizadeh A. The role of telehealth during COVID‑19 outbreak: a systematic review based on current evidence. BMC Public Health. 2020;20:1193. doi:10.1186/s12889‑020‑09301‑4

Soron TR, Shariful Islam SM, Ahmed HU, Ahmed SI. The hope and hype of telepsychiatry during the COVID‑19 pandemic. Lancet Psychiatry. 2020;7:e50. doi:10.1016/S2215‑0366( 20)30260‑1

Faro A, Bahiano M de A, Nakano T de C, Reis C, Silva BF, Vitti LS. COVID‑19 e saúde mental: a emergência do cuidado. Estud Psicol. 2020;37. doi:10.1590/1982‑0275202037e200074

Publicado
2020-11-27
Como Citar
Nascimento, S., Pereira, C., Caldas, I., Silva, M., Mendonça, T., Lourenço, B., & Gonçalves, M. (2020). Pandemia COVID‑19 e Perturbação Mental: Breve Revisão da Literatura. Revista Portuguesa De Psiquiatria E Saúde Mental, 6(2), 67-76. https://doi.org/10.51338/rppsm.2020.v6.i2.146
Secção
Revisão Narrativa