The present situation, a global virus pandemic, is not only relevant for epidemiologists and microbiologists (and the general public). In psychiatry too, we are facing an unprecedented situation.
In Germany a step-by-step procedure to reduce the potential Covid19 disease burden was iniated on county level with the closing of all public institutions (nursery homes, schools, theatres, …) as well as restaurants on March 16th. A non-contact order („Kontaktsperre“) was announced by chancellor Merkel and implemented on March 23rd, prohibiting gathering of people who don’t normally live together.
Social isolation has never been implemented on such a large scale and by that, consequences have never been investigated. It has to been kept in mind that the effects might different in different societies, different health care systems, different quarantine measures and thus cannot easily be generalized. What might works for the Chinese might fail badly in the US. However, studies of the local effects are warranted.
So far consequences of social isolation can only be hypothesized:
- General reduction of requests of help with potential patients staing at home
- Increased number of cases of major depressive disorder (and depression-like states in other mental disorders, suicides)
- Increased number of cases of anxiety disorders
- Increased number of cases of substance abuse
- Increased number of cases or relapses of psychotic disorders (due to stress or non-adherence)
- Forced reduction of assistance, e.g. cancelling of group therapy
- There also can be positive effects: Reduction of occasional substance abuse, deceleration of work and life (except for health professionals)
- Increased number of cases of domestic violence (and post traumatic stress disorder)
Finally, this is not a one-way situation: Mentally ill people are more likely to get infected and have a bad course, because they might be unable to follow safety measures and they often suffer from comorbid cardiovascular diseases.