Dr Ayan Basak MD DNB
Consultant Psychiatrist

People experience emotional disturbance, irritability, insomnia, depression and post-traumatic stress symptoms immediately after the quarantine period. The long term impact is considerable and wide ranging including anxiety, anger, depression, post-traumatic stress symptoms, alcohol abuse, and behavioural changes such as avoiding crowded places and cautious hand washing. These psychological symptoms can last from several months up to three years after the quarantine period (Brooks et al;, 2020).

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Social distancing could possibly lead to substantial increases in loneliness, anxiety, depression, domestic violence, child abuse and substance abuse (Galea et al;, 2020).

In patients who required hospitalization following COVID-19, delirium is common during the acute stage of the illness. The data on long term psychiatric complications in these group of patients, although not yet fully known, may be comparable to previous corona virus epidemics, severe acute respiratory (SARS) and Middle East Respiratory Syndrome (MERS) with increased prevalence of anxiety, depression, and post-traumatic stress disorder.

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Persistent psychiatric impairment with significant levels of anxiety, depression and post-traumatic stress disorder are seen in survivors of critical illness at 1 year after discharge.

 

Neurocognitive impairment including impaired attention, concentration, memory, and mental processing speed at 1 year was found in majority of patients with severe acute respiratory distress syndrome. Substantial reductions in quality of life were found in patients with severe acute respiratory syndrome and prolonged mechanical ventilation after discharge from intensive care unit compared to admissions for other reasons (Rogers et al;, 2020).

Psychological symptoms including anxiety, depression, insomnia are prevalent in up to 60 % among physicians, nurses and medical residents during Covid-19 pandemic (Que et al;, 2020), which are likely to persist for several years. HCP who worked in respiratory medicine during the SARS outbreak in 2003 had persistent and significantly greater level of psychological symptoms including anxiety, depression and post-traumatic stress symptoms a year later (McAlonan et al., 2007).

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Post-traumatic stress symptoms were reported by 11%–73% of HCP during epidemic or pandemic outbreaks that lasted in up to 10–40% after 1–3 years (Preti et al;, 2020).