COVID-19-associated psychiatric disorders: Difference between revisions
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*Based on a large national study done in the United States, the [[prevalence]] of [[depression]] has more than doubled during the [[COVID-19]] [[pandemic]].<ref name="pmid33426559">{{cite journal| author=Khubchandani J, Sharma S, Webb FJ, Wiblishauser MJ, Bowman SL| title=Post-lockdown depression and anxiety in the USA during the COVID-19 pandemic. | journal=J Public Health (Oxf) | year= 2021 | volume= 43 | issue= 2 | pages= 246-253 | pmid=33426559 | doi=10.1093/pubmed/fdaa250 | pmc=7928742 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33426559 }} </ref> | *Based on a large national study done in the United States, the [[prevalence]] of [[depression]] has more than doubled during the [[COVID-19]] [[pandemic]].<ref name="pmid33426559">{{cite journal| author=Khubchandani J, Sharma S, Webb FJ, Wiblishauser MJ, Bowman SL| title=Post-lockdown depression and anxiety in the USA during the COVID-19 pandemic. | journal=J Public Health (Oxf) | year= 2021 | volume= 43 | issue= 2 | pages= 246-253 | pmid=33426559 | doi=10.1093/pubmed/fdaa250 | pmc=7928742 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33426559 }} </ref> | ||
*The [[prevalence]] of [[depression]] among adults older than 18 years old in the United States was estimated at 28.6%, only from April to May 2020. During this time, 8.4% of adults reported having [[suicide|suicidal ideation]] and 18.2% initiated or increased substance usage. Only three months later (September 2020) the rate of [[depression]] among American adults older than 18 years old raised to 33%, and the [[prevalence]] rate of [[suicide|suicidal ideation]] increased to 11.9% (Lee & Singh, 2021).<ref name="pmid34358622">{{cite journal| author=Lee H, Singh GK| title=Monthly trends in self-reported health status and depression by race/ethnicity and socioeconomic status during the COVID-19 Pandemic, United States, April 2020 - May 2021. | journal=Ann Epidemiol | year= 2021 | volume= 63 | issue= | pages= 52-62 | pmid=34358622 | doi=10.1016/j.annepidem.2021.07.014 | pmc=8435379 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34358622 }} </ref> | *The [[prevalence]] of [[depression]] among adults older than 18 years old in the United States was estimated at 28.6%, only from April to May 2020. During this time, 8.4% of adults reported having [[suicide|suicidal ideation]] and 18.2% initiated or increased substance usage. Only three months later (September 2020) the rate of [[depression]] among American adults older than 18 years old raised to 33%, and the [[prevalence]] rate of [[suicide|suicidal ideation]] increased to 11.9% (Lee & Singh, 2021).<ref name="pmid34358622">{{cite journal| author=Lee H, Singh GK| title=Monthly trends in self-reported health status and depression by race/ethnicity and socioeconomic status during the COVID-19 Pandemic, United States, April 2020 - May 2021. | journal=Ann Epidemiol | year= 2021 | volume= 63 | issue= | pages= 52-62 | pmid=34358622 | doi=10.1016/j.annepidem.2021.07.014 | pmc=8435379 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34358622 }} </ref> | ||
*Based on some evidences, 0.9% to 4% of [[COVID-19]] [[patients]] developed [[psychosis|psychotic spectrum disorders]].<ref name="pmid34795193">{{cite journal| author=Borovina T, Mastelić T, Glavina G, Glavina T| title=COVID-19 Associated Psychotic Disorder with Suicidal Behaviour - Case Report. | journal=Psychiatr Danub | year= 2021 | volume= 33 | issue= 3 | pages= 421-424 | pmid=34795193 | doi=10.24869/psyd.2021.421 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34795193 }} </ref> | |||
===Age=== | ===Age=== | ||
*[[Patients]] of all [[ageing|age]] groups may develop [[Mental disorder|mental disorder]] due to the [[COVID-19]], nevertheless, younger [[population]] were more vulnerable to develop [[mental disorder|psychiatric disorders]] during the [[COVID-19]] [[pandemic]].<ref name="pmid32605422">{{cite journal| author=Ustun G| title=Determining depression and related factors in a society affected by COVID-19 pandemic. | journal=Int J Soc Psychiatry | year= 2021 | volume= 67 | issue= 1 | pages= 54-63 | pmid=32605422 | doi=10.1177/0020764020938807 | pmc=7331110 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32605422 }} </ref><ref name="pmid33093946">{{cite journal| author=Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L | display-authors=etal| title=Epidemiology of mental health problems in COVID-19: a review. | journal=F1000Res | year= 2020 | volume= 9 | issue= | pages= 636 | pmid=33093946 | doi=10.12688/f1000research.24457.1 | pmc=7549174 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33093946 }} </ref><ref name="pmid33426559">{{cite journal| author=Khubchandani J, Sharma S, Webb FJ, Wiblishauser MJ, Bowman SL| title=Post-lockdown depression and anxiety in the USA during the COVID-19 pandemic. | journal=J Public Health (Oxf) | year= 2021 | volume= 43 | issue= 2 | pages= 246-253 | pmid=33426559 | doi=10.1093/pubmed/fdaa250 | pmc=7928742 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33426559 }} </ref><ref name="pmid34805060">{{cite journal| author=Gilsbach S, Herpertz-Dahlmann B, Konrad K| title=Psychological Impact of the COVID-19 Pandemic on Children and Adolescents With and Without Mental Disorders. | journal=Front Public Health | year= 2021 | volume= 9 | issue= | pages= 679041 | pmid=34805060 | doi=10.3389/fpubh.2021.679041 | pmc=8602182 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34805060 }} </ref> | *[[Patients]] of all [[ageing|age]] groups may develop [[Mental disorder|mental disorder]] due to the [[COVID-19]], nevertheless, younger [[population]] were more vulnerable to develop [[mental disorder|psychiatric disorders]] during the [[COVID-19]] [[pandemic]].<ref name="pmid32605422">{{cite journal| author=Ustun G| title=Determining depression and related factors in a society affected by COVID-19 pandemic. | journal=Int J Soc Psychiatry | year= 2021 | volume= 67 | issue= 1 | pages= 54-63 | pmid=32605422 | doi=10.1177/0020764020938807 | pmc=7331110 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32605422 }} </ref><ref name="pmid33093946">{{cite journal| author=Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L | display-authors=etal| title=Epidemiology of mental health problems in COVID-19: a review. | journal=F1000Res | year= 2020 | volume= 9 | issue= | pages= 636 | pmid=33093946 | doi=10.12688/f1000research.24457.1 | pmc=7549174 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33093946 }} </ref><ref name="pmid33426559">{{cite journal| author=Khubchandani J, Sharma S, Webb FJ, Wiblishauser MJ, Bowman SL| title=Post-lockdown depression and anxiety in the USA during the COVID-19 pandemic. | journal=J Public Health (Oxf) | year= 2021 | volume= 43 | issue= 2 | pages= 246-253 | pmid=33426559 | doi=10.1093/pubmed/fdaa250 | pmc=7928742 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33426559 }} </ref><ref name="pmid34805060">{{cite journal| author=Gilsbach S, Herpertz-Dahlmann B, Konrad K| title=Psychological Impact of the COVID-19 Pandemic on Children and Adolescents With and Without Mental Disorders. | journal=Front Public Health | year= 2021 | volume= 9 | issue= | pages= 679041 | pmid=34805060 | doi=10.3389/fpubh.2021.679041 | pmc=8602182 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34805060 }} </ref> | ||
Revision as of 08:04, 31 December 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Synonyms and keywords: COVID-19-associated psychiatric disorders
Overview
Historical Perspective
- In November 2019, the new coronavirus (COVID-19) was detected in Wuhan in the Hubei state of China for the first time.[1]
- By April 2020, stay-at-home advisories, or shelter-in-place policies have been applied in 42 states of the United States affecting no less than 316 million people (close to 96% of the US population).[2]
- Based on multiple studies done in early 2020, the number of internet searches for mental health symptoms has been significantly increased. Furthermore, from the start of the pandemic, more people requested mental health services.[3]
Classification
The following are COVID-19-associated mental disorders that have been reported:[4][5][6][7][8][9][10][11][12][13][14]
- Depression
- Post-traumatic stress disorder
- Acute stress disorder
- Anxiety
- Somatization
- Mood swing
- Attention-deficit hyperactivity disorder (ADHD)
- Panic disorder
- Obsessive-compulsive disorder
- Psychosis
- Delirium
- Mania
- Catatonia
- Insomnia
Pathophysiology
The pathophysiology of COVID-19-associated psychiatric disorders can be explained by the body's immunologic response to the virus or due to the psychological stressors such as isolation, loneliness, stigma, concerns about infecting others, and fear of death.
Immunologic Response To the Virus
- Respiratory viral diseases are associated with psychological disorders, which can be presented both acutely and chronically.[5]
- The coronavirus is a neurotropic virus and can cause mental disorder by affecting the central nervous system or via the immune system response.[7][5][15][12]
- Some data supported the role of inflammatory biomarkers from an infection on development of depression's symptoms such as anhedonia.[16]
Psychological Trauma
- Data from previous studies delineated the increased rate of mental disorders following major traumatic events such as natural disasters and pandemics.[8][10]
- The unknown nature of the virus within the first months, the uncertainty of its transmission route, and the high rate of hospitalization and mortality led to serious concern and distress among individuals.[17][18]
- Disruption of the routine day-to-day life due to strict quarantine measures, closing of schools, and cancelling all social events was one of the important determinants.[8]
- The following concerns were associated with a higher rate of psychiatric disorders during the COVID-19 pandemic:[19][20]
- The role of reduced physical activity, increased screen time, irregular sleep patterns and lack of interpersonal contacts has been related to mental disorders among children and adolescents who experienced the quarantine.[18]
Side Effects of COVID-19 Treatment
Some of the medications used for COVID-19 treatment were known to cause neuropathic and neuropsychiatric side effects.[21][22]
Causes
Differentiating [disease name] from other Diseases
Epidemiology and Demographics
- Based on a large national study done in the United States, the prevalence of depression has more than doubled during the COVID-19 pandemic.[23]
- The prevalence of depression among adults older than 18 years old in the United States was estimated at 28.6%, only from April to May 2020. During this time, 8.4% of adults reported having suicidal ideation and 18.2% initiated or increased substance usage. Only three months later (September 2020) the rate of depression among American adults older than 18 years old raised to 33%, and the prevalence rate of suicidal ideation increased to 11.9% (Lee & Singh, 2021).[24]
- Based on some evidences, 0.9% to 4% of COVID-19 patients developed psychotic spectrum disorders.[14]
Age
- Patients of all age groups may develop mental disorder due to the COVID-19, nevertheless, younger population were more vulnerable to develop psychiatric disorders during the COVID-19 pandemic.[1][8][23][18]
- Based on a systematic review, mental disorder due to COVID-19 pandemic was higher in the age group of 21-40 years.[17]
- Another study which was done on 1653 participants globally, suggested that the high rate of mental disorders among the younger population was related to poor sleep and loneliness of this population.[3]
Gender
- Females are more commonly affected with COVID-19-related mental disorders than male.[25][1][8][18]
- Supported by a study in Canada, young females are among the populations with a high prevalence of mental disorders during the pandemic.[26]
Race
- Ethnic and racial minorities were related to a higher rate of mental health difficulties during the COVID-19 pandemic. Based on a large national study, Hispanics and African Americans had the highest rate of Depression in the United States, compared to other races.[23]
Risk Factors
Common risk factors relating to COVID-19-associated psychiatric disorders:[26][1][24][27][8][28][29][6][30][18][31][32][19]
- Economic status
- Economic inequalities have been known as a risk factor for mood disorders such as depression and the COVID-19 pandemic exacerbated the economic issues of many people in the United States.[33]
- Marital status
- Being single (unmarried, living with parents, widow, or divorcee) is one of the factors associated with a higher rate of mental illnesses such as depression during the pandemic.
- Level of education
- Based on some studies, a higher level of education has been related to a higher rate of anxiety due to the COVID-19.
- In contrast, other studies in the United States confirmed a significant association between lower education and a higher rate of mental disorders due to the COVID-19.
- A systematic review delineated that being a student is a risk factor associated with mental disorders.
- Female gender
- Certain occupations such as medical workers
- Social media exposure
- Based on a study in China, more than two hours of exposure to the COVID-19 news via social media was associated with a higher rate of depression.
- History of a chronic underlying medical illness[8]
- History of previous mental disorder[8][23]
- Sever pain during the COVID-19
- Poor sleep
- Having a relative with COVID-19
- Prolonged hospitalization
Natural History, Complications and Prognosis
- The clinical presentations are strongly related to the type of the COVID-19-associated mental disorder.
- As a result of the COVID-19 pandemic the following chain of emotional issues developed among individuals:[26][8]
- Guilt
- Stress
- Loneliness
- Stigma
- Helplessness
- Anger
- Despair
- Fear of infecion
- Behaviors such as substance abuse (such as smoking, overconsumption of alcohol, and drug abuse) has been increased during the COVID-19 pandemic in the United States.[24][19]
- If left untreated, complications such as suicide can occur.[24][19]
- Presence of some mental disorders such as bipolar disorder, unipolar depression and schizophrenia spectrum disorders was associated with poorer outcomes in COVID-19 patients.[34]
Diagnostic Criteria
- Diagnosis can be made if a psychiatric disorder associated to the COVID-19; either in a COVID-19 patient, or in an individual who lived during the COVID-19 pandemic has been observed.
History and Symptoms
- Symptoms of the COVID-19-associated psychiatric disorders depends on the type of mental disorder, nevertheless the following are some of the general observed symptoms:[21][35]
- Anhedonia
- Sleep difficulty
- Reduced appetite
- Anxiety
- Lethargy
- Irritability
- Inattention
Physical Examination
- Patients with COVID-19-associated psychiatric disorders usually appear normal.
Laboratory Findings
- There are no specific laboratory findings associated with COVID-19-associated psychiatric disorders.
Electrocardiogram
There are no ECG findings associated with COVID-19-associated psychiatric disorders.
X-ray
There are no x-ray findings associated with COVID-19-associated psychiatric disorders.
Echocardiography or Ultrasound
There are no echocardiography/ultrasound findings associated with COVID-19-associated psychiatric disorders.
CT scan
There are no CT scan findings associated with COVID-19-associated psychiatric disorders.
MRI
There are no MRI findings associated with COVID-19-associated psychiatric disorders.
Other Imaging Findings
There are no other imaging findings associated with COVID-19-associated psychiatric disorders.
Other Diagnostic Studies
There are no other diagnostic studies associated with COVID-19-associated psychiatric disorders.
Treatment
Medical Therapy
Non-Medical Therapy
Telepsychiatry
- Usage of telepsychiatry to deliver psychiatric care during the COVID-19 pandemic may help the populations who are at risk.[32]
- The talk-based nature of most psychiatric therapies makes utilizing technological means more convenient during the quarantine.[32]
- In addition, this method of psychiatric care can be utilized for group therapy as well.
- A systematic review, reported that video teleconference groups and in-person groups were similar in their treatment outcomes.[36]
- Telepsychiatry is not feasible for certain cohorts of patients. The following may limit the use of telepsychiatry:[32]
Surgery
- There is no surgical treatment for COVID-19-associated psychiatric disorders
Prevention
- Practiced by some countries, policies and interventions can help individuals to have a better mental health status during the COVID-19 pandemic. For instance Australia developed an initiative called "Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access)" in order to provide psychological therapy sessions for patients suffering from mental disorders.[19]
- Proposing guidelines to provide an overview regarding the COVID-19-associated psychiatric disorders for health care providers to improve their knowledge could also be helpful and has been practiced in some countries such as Singapore, India, China, and Malaysia.[19][37][38]
References
- ↑ 1.0 1.1 1.2 1.3 Ustun G (2021). "Determining depression and related factors in a society affected by COVID-19 pandemic". Int J Soc Psychiatry. 67 (1): 54–63. doi:10.1177/0020764020938807. PMC 7331110 Check
|pmc=value (help). PMID 32605422 Check|pmid=value (help). - ↑ Ettman CK, Abdalla SM, Cohen GH, Sampson L, Vivier PM, Galea S (2020). "Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic". JAMA Netw Open. 3 (9): e2019686. doi:10.1001/jamanetworkopen.2020.19686. PMC 7489837 Check
|pmc=value (help). PMID 32876685 Check|pmid=value (help). - ↑ 3.0 3.1 Varma P, Junge M, Meaklim H, Jackson ML (2021). "Younger people are more vulnerable to stress, anxiety and depression during COVID-19 pandemic: A global cross-sectional survey". Prog Neuropsychopharmacol Biol Psychiatry. 109: 110236. doi:10.1016/j.pnpbp.2020.110236. PMC 7834119 Check
|pmc=value (help). PMID 33373680 Check|pmid=value (help). - ↑ Halaris AE, Belendiuk KT, Freedman DX (1975). "Antidepressant drugs affect dopamine uptake". Biochem Pharmacol. 24 (20): 1896–7. doi:10.1016/0006-2952(75)90412-8. PMID psychiatric disorders COVID-19-associated psychiatric disorders Check
|pmid=value (help). - ↑ 5.0 5.1 5.2 Mazza MG, De Lorenzo R, Conte C, Poletti S, Vai B, Bollettini I; et al. (2020). "Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors". Brain Behav Immun. 89: 594–600. doi:10.1016/j.bbi.2020.07.037. PMC 7390748 Check
|pmc=value (help). PMID 32738287 Check|pmid=value (help). - ↑ 6.0 6.1 de Sousa Moreira JL, Barbosa SMB, Vieira JG, Chaves NCB, Felix EBG, Feitosa PWG; et al. (2021). "The psychiatric and neuropsychiatric repercussions associated with severe infections of COVID-19 and other coronaviruses". Prog Neuropsychopharmacol Biol Psychiatry. 106: 110159. doi:10.1016/j.pnpbp.2020.110159. PMC 7605739 Check
|pmc=value (help). PMID 33147504 Check|pmid=value (help). - ↑ 7.0 7.1 Steardo L, Steardo L, Verkhratsky A (2020). "Psychiatric face of COVID-19". Transl Psychiatry. 10 (1): 261. doi:10.1038/s41398-020-00949-5. PMC 7391235 Check
|pmc=value (help). PMID 32732883 Check|pmid=value (help). - ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L; et al. (2020). "Epidemiology of mental health problems in COVID-19: a review". F1000Res. 9: 636. doi:10.12688/f1000research.24457.1. PMC 7549174 Check
|pmc=value (help). PMID 33093946 Check|pmid=value (help). - ↑ Smith CM, Komisar JR, Mourad A, Kincaid BR (2020). "COVID-19-associated brief psychotic disorder". BMJ Case Rep. 13 (8). doi:10.1136/bcr-2020-236940. PMC 7418683 Check
|pmc=value (help). PMID 32784244 Check|pmid=value (help). - ↑ 10.0 10.1 Raudenská J, Steinerová V, Javůrková A, Urits I, Kaye AD, Viswanath O; et al. (2020). "Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic". Best Pract Res Clin Anaesthesiol. 34 (3): 553–560. doi:10.1016/j.bpa.2020.07.008. PMC 7367798 Check
|pmc=value (help). PMID 33004166 Check|pmid=value (help). - ↑ Horn M, Wathelet M, Fovet T, Amad A, Vuotto F, Faure K; et al. (2020). "Is COVID-19 Associated With Posttraumatic Stress Disorder?". J Clin Psychiatry. 82 (1). doi:10.4088/JCP.20m13641. PMID 33296149 Check
|pmid=value (help). - ↑ 12.0 12.1 Uvais NA (2021). "COVID-19-Associated Panic Disorder". Prim Care Companion CNS Disord. 23 (1). doi:10.4088/PCC.20l02826. PMID 34000140 Check
|pmid=value (help). - ↑ Richter K, Kellner S (2021). "["Coronasomnia"-promoting resilience through insomnia treatment]". Somnologie (Berl): 1–5. doi:10.1007/s11818-021-00322-8. PMC 8381348 Check
|pmc=value (help). PMID 34456621 Check|pmid=value (help). - ↑ 14.0 14.1 Borovina T, Mastelić T, Glavina G, Glavina T (2021). "COVID-19 Associated Psychotic Disorder with Suicidal Behaviour - Case Report". Psychiatr Danub. 33 (3): 421–424. doi:10.24869/psyd.2021.421. PMID 34795193 Check
|pmid=value (help). - ↑ Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L; et al. (2020). "Nervous system involvement after infection with COVID-19 and other coronaviruses". Brain Behav Immun. 87: 18–22. doi:10.1016/j.bbi.2020.03.031. PMC 7146689 Check
|pmc=value (help). PMID 32240762 Check|pmid=value (help). - ↑ Miller AH, Raison CL (2016). "The role of inflammation in depression: from evolutionary imperative to modern treatment target". Nat Rev Immunol. 16 (1): 22–34. doi:10.1038/nri.2015.5. PMC 5542678. PMID 26711676.
- ↑ 17.0 17.1 Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M; et al. (2020). "Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis". Global Health. 16 (1): 57. doi:10.1186/s12992-020-00589-w. PMC 7338126 Check
|pmc=value (help). PMID 32631403 Check|pmid=value (help). - ↑ 18.0 18.1 18.2 18.3 18.4 Gilsbach S, Herpertz-Dahlmann B, Konrad K (2021). "Psychological Impact of the COVID-19 Pandemic on Children and Adolescents With and Without Mental Disorders". Front Public Health. 9: 679041. doi:10.3389/fpubh.2021.679041. PMC 8602182 Check
|pmc=value (help). PMID 34805060 Check|pmid=value (help). - ↑ 19.0 19.1 19.2 19.3 19.4 19.5 Samy AL, Awang Bono S, Tan SL, Low WY (2021). "Mental Health and COVID-19: Policies, Guidelines, and Initiatives from the Asia-Pacific Region". Asia Pac J Public Health. 33 (8): 839–846. doi:10.1177/10105395211025901. PMID 34308673 Check
|pmid=value (help). - ↑ Rodríguez-Hidalgo AJ, Pantaleón Y, Dios I, Falla D (2020). "Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression". Front Psychol. 11: 591797. doi:10.3389/fpsyg.2020.591797. PMC 7674167 Check
|pmc=value (help). PMID 33224080 Check|pmid=value (help). - ↑ 21.0 21.1 Soltani S, Tabibzadeh A, Zakeri A, Zakeri AM, Latifi T, Shabani M; et al. (2021). "COVID-19 associated central nervous system manifestations, mental and neurological symptoms: a systematic review and meta-analysis". Rev Neurosci. 32 (3): 351–361. doi:10.1515/revneuro-2020-0108. PMID 33618441 Check
|pmid=value (help). - ↑ Russo MW, Fried MW (2003). "Side effects of therapy for chronic hepatitis C." Gastroenterology. 124 (6): 1711–9. doi:10.1016/s0016-5085(03)00394-9. PMID 12761728.
- ↑ 23.0 23.1 23.2 23.3 Khubchandani J, Sharma S, Webb FJ, Wiblishauser MJ, Bowman SL (2021). "Post-lockdown depression and anxiety in the USA during the COVID-19 pandemic". J Public Health (Oxf). 43 (2): 246–253. doi:10.1093/pubmed/fdaa250. PMC 7928742 Check
|pmc=value (help). PMID 33426559 Check|pmid=value (help). - ↑ 24.0 24.1 24.2 24.3 Lee H, Singh GK (2021). "Monthly trends in self-reported health status and depression by race/ethnicity and socioeconomic status during the COVID-19 Pandemic, United States, April 2020 - May 2021". Ann Epidemiol. 63: 52–62. doi:10.1016/j.annepidem.2021.07.014. PMC 8435379 Check
|pmc=value (help). PMID 34358622 Check|pmid=value (help). - ↑ Moghanibashi-Mansourieh A (2020). "Assessing the anxiety level of Iranian general population during COVID-19 outbreak". Asian J Psychiatr. 51: 102076. doi:10.1016/j.ajp.2020.102076. PMC 7165107 Check
|pmc=value (help). PMID 32334409 Check|pmid=value (help). - ↑ 26.0 26.1 26.2 McQuaid RJ, Cox SML, Ogunlana A, Jaworska N (2021). "The burden of loneliness: Implications of the social determinants of health during COVID-19". Psychiatry Res. 296: 113648. doi:10.1016/j.psychres.2020.113648. PMID 33348199 Check
|pmid=value (help). - ↑ Firew T, Sano ED, Lee JW, Flores S, Lang K, Salman K; et al. (2020). "Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers' infection and psychological distress during the COVID-19 pandemic in the USA". BMJ Open. 10 (10): e042752. doi:10.1136/bmjopen-2020-042752. PMC 7580061 Check
|pmc=value (help). PMID 33087382 Check|pmid=value (help). - ↑ Kämpfen F, Kohler IV, Ciancio A, Bruine de Bruin W, Maurer J, Kohler HP (2020). "Predictors of mental health during the Covid-19 pandemic in the US: Role of economic concerns, health worries and social distancing". PLoS One. 15 (11): e0241895. doi:10.1371/journal.pone.0241895. PMC 7657497 Check
|pmc=value (help). PMID 33175894 Check|pmid=value (help). - ↑ Ni MY, Yang L, Leung CMC, Li N, Yao XI, Wang Y; et al. (2020). "Mental Health, Risk Factors, and Social Media Use During the COVID-19 Epidemic and Cordon Sanitaire Among the Community and Health Professionals in Wuhan, China: Cross-Sectional Survey". JMIR Ment Health. 7 (5): e19009. doi:10.2196/19009. PMC 7219721 Check
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|pmc=value (help). PMID 32363492 Check|pmid=value (help). - ↑ 32.0 32.1 32.2 32.3 O'Brien M, McNicholas F (2020). "The use of telepsychiatry during COVID-19 and beyond". Ir J Psychol Med. 37 (4): 250–255. doi:10.1017/ipm.2020.54. PMC 7411439 Check
|pmc=value (help). PMID 32434596 Check|pmid=value (help). - ↑ Kujawa A, Green H, Compas BE, Dickey L, Pegg S (2020). "Exposure to COVID-19 pandemic stress: Associations with depression and anxiety in emerging adults in the United States". Depress Anxiety. 37 (12): 1280–1288. doi:10.1002/da.23109. PMID 33169481 Check
|pmid=value (help). - ↑ Barcella CA, Polcwiartek C, Mohr GH, Hodges G, Søndergaard K, Niels Bang C; et al. (2021). "Severe mental illness is associated with increased mortality and severe course of COVID-19". Acta Psychiatr Scand. 144 (1): 82–91. doi:10.1111/acps.13309. PMC 8250986 Check
|pmc=value (help). PMID 33894064 Check|pmid=value (help). - ↑ Jiao WY, Wang LN, Liu J, Fang SF, Jiao FY, Pettoello-Mantovani M; et al. (2020). "Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic". J Pediatr. 221: 264–266.e1. doi:10.1016/j.jpeds.2020.03.013. PMC 7127630 Check
|pmc=value (help). PMID 32248989 Check|pmid=value (help). - ↑ Gentry MT, Lapid MI, Clark MM, Rummans TA (2019). "Evidence for telehealth group-based treatment: A systematic review". J Telemed Telecare. 25 (6): 327–342. doi:10.1177/1357633X18775855. PMID 29788807.
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|pmid=value (help). - ↑ Lim WP, Seet XY, Rahman H (2020). "Designing a psychological preparedness toolkit for healthcare workers in the wake of COVID-19: A Singapore perspective". Asian J Psychiatr. 53: 102204. doi:10.1016/j.ajp.2020.102204. PMC 7286254 Check
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