A Study on Impact of COVID-19 Pandemic on Persons with Preexisting Psychotic Disorder, their Coping Strategies, and Compliance with Preventive Measures

M. Sood, R. Chadda, T. Shukla, Rekha Patel, Dhriti Ratra, M. Mohan, Swaran P. Singh
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Abstract

Background: Coronavirus disease 2019 (COVID-19) pandemic has impacted persons with preexisting psychiatric disorders negatively. There is a lack of studies on the impact on people with preexisting psychotic disorder. Aims: We studied the impact of the COVID-19 pandemic and lockdown on patients with a preexisting psychotic disorder and whether they were following the recommended preventive measures for COVID-19. We also studied coping strategies used by them and their caregivers. We compared persons with first-episode psychosis (FEP) and chronic psychotic disorders (CPD). Methodology: The study sample was a part of the National Institute of Health Research Psychosis Research Group cohort. The subjects belonged to two groups: FEP consisted of patients with the first episode of psychosis, with the duration of illness ≥3 months and ≤2 years, and CPD group consisted of patients with psychosis, with the duration of illness ≥2 years. They were interviewed telephonically on a semistructured questionnaire. Thematic analysis was done to identify coping strategies. Results: Fifty patients were interviewed: 24 in the FEP (26·12 ± 8·0 years) and 26 in the CPD group (34 ± 7.5 years). Forty-six (92%) patients reported difficulty in access to hospitals and 32 (64%) had difficulty in contacting a doctor. Eight (16%) of them reported worsening of symptoms and 12 (24%) reported irregular adherence to treatment. The two groups differed significantly on doing household chores, occupational functioning, and financial issues. The majority of them used emotion-focused coping strategies. Three-fourth (79.1%) of the patients in the FEP group were following all four recommended preventive measures, whereas, in the CPD group, three-fourths (73.1%) were able to follow only one measure. Conclusion: The COVID-19 pandemic had impacted FEP and CPD groups differently. CPD group could follow recommended preventive measures less frequently than FEP.
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COVID-19大流行对既往精神障碍患者的影响、应对策略及预防措施依从性研究
背景:2019冠状病毒病(COVID-19)大流行对既往存在精神障碍的人产生了负面影响。缺乏对已有精神病患者影响的研究。目的:我们研究了COVID-19大流行和封锁对先前存在精神障碍的患者的影响,以及他们是否遵循了建议的COVID-19预防措施。我们还研究了他们和他们的照顾者使用的应对策略。我们比较了首发精神病(FEP)和慢性精神病(CPD)患者。研究方法:研究样本是国立卫生研究院精神病研究组队列的一部分。受试者分为两组:FEP组为首发精神病患者,病程≥3个月≤2年;CPD组为精神病患者,病程≥2年。他们通过电话接受了半结构化问卷调查。进行了专题分析以确定应对策略。结果:共访谈50例患者,其中FEP组24例(26.12±8.0年),CPD组26例(34±7.5年)。46名(92%)患者报告难以前往医院,32名(64%)患者难以联系医生。其中8人(16%)报告症状恶化,12人(24%)报告不规律地坚持治疗。这两组人在做家务、职业功能和财务问题上存在显著差异。他们中的大多数人使用以情绪为中心的应对策略。FEP组中四分之三(79.1%)的患者遵循了所有四种推荐的预防措施,而在CPD组中,四分之三(73.1%)的患者能够仅遵循一种措施。结论:新冠肺炎大流行对FEP组和CPD组的影响不同。CPD组遵循推荐预防措施的频率低于FEP组。
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