This is the conclusion reached by Sofia Oskolkova, Professor, Doctor of Medical Sciences, the author of the article named Outpatient Cases of Mental Disorders during the Coronavirus COVID-19 Pandemic.
Daria Voznesenskaya
Humanity has experienced several pandemics of plague, cholera, smallpox, typhoid and polio epidemics. All of them, one way or another, affected the psyche of people, as they caused stress. During epidemics, the number of suicides increased, people despised laws and disregarded the rules of decency. For some individuals, self-isolation encouraged creativity, but this was rare. For example, Alexander Pushkin wrote poetry in Bolshoy Boldino, waiting for the cholera epidemic to end.
The coronavirus pandemic was no exception and had an impact on the mental state of citizens. According to preliminary data, the disorders are not fundamentally different from those that have been identified in other epidemics and emergencies. But long-term social isolation and constant explanations of its necessity could acquire pathogenic significance in the coronavirus pandemic. It is also possible that a significant role in such circumstances is played by a person's mental and personal characteristics - suggestibility, emotional dependence, the experience of loneliness, the presence of somatic diseases, etc.
In addition, the quality of life has decreased for many amid the coronavirus pandemic. Distance work also often negatively affected family relationships - some were annoyed by it, others were unhappy that they could not work as well. “Thus, isolation psychologically often additionally increased contacts, sometimes undesirable, strengthened the mechanisms of mutual induction, became an additional stressor”, - the article says.
Often, primary delusional disorder or hysterical depression develops in older people with various somatic pathologies or differing in authoritarian behavioral manifestations. Minimal somatic symptoms are interpreted by them as signs of virus infection. Then other family members begin to share their ideas. This is accompanied by increasing panic, calls to acquaintances with requests to buy as many drugs as possible, ambulance calls. Chronic fatigue syndrome develops regardless of age. In such cases, mental disorders can occur. Also, there is often a sharp increase in religious feelings, the search for amulets, measures to protect against the virus. In this case, human behavior can take on ridiculous forms.
"During the period of isolation and fixation on information about the coronavirus, suicidal thoughts and auto-aggression, familial heteroaggression have become more frequent, and intolerance towards loved ones appears", - the article says.
At the same time, during the pandemic, people began to consume more alcohol. And it often aggravates the course of mental illness. In addition, alcohol can affect the immune system, especially when weakened by stress.
Specialists of the FSBI “National Medical Research Center for Psychiatry and Narcology named after VP Serbsky ”was able to conduct an experimental psychological online survey only in 13 people. This is due to the difficulty of movement during the quarantine period and the lack of technical capabilities, as well as the desire of patients to focus on the problem of infection.
Case 1
A 53-year-old university professor, conducting an online lesson, put her husband's panties on her head to avoid contracting the coronavirus. At the same time, the spouse shared the correctness of such actions.
The university psychiatrist found that the woman's history was not psychopathologically burdened. She got married after 30 years, no children, lives in a small apartment with her husband, obeys him in everything, since, in her opinion, he cannot be wrong. The spouses part only for the duration of their work.
At the same time, the husband, who is a physicist by profession, has repeatedly suggested the proximity of biological viruses and "viruses" on the Internet, and admitted the possibility of infection online.
Provisional diagnosis: "induced delusional disorder".
Case 2
During the professor's lecture, one of the students wrapped himself in a blanket. He explained his actions by the fact that the coronavirus can combine with computer "viruses", which increases the likelihood of infection.
According to teachers and students, this student did not previously have any distinct deviations in behavior. However, he was often anxious and concerned about his health. Experts assessed the young man's condition as "reactive with an emotionally labile personality structure and Internet addiction".
Preliminary diagnosis: "hypochondriacal disorder".
Cases 3 and 4
With constant panic fears of contracting a virus, some people actualize the archetypes of memory associated with ancient amulets, mysticism. For example, the concept “my home is my castle” takes on a special meaning. A significant part of the population during the coronavirus pandemic chose self-isolation in the country.
So, a spouse of 60 and 65 years old, living in a dacha, put sacks of salt in front of the door of the house. They told the neighbors that this is how they protect themselves from thieves. But the mystical meaning of salt in Russia has long been known (it was believed that it helps from ailments and troubles).
In a conversation with a psychiatrist, the spouses complained of various hardships - lack of money, inattention of children. At the same time, tears welling up in their eyes.
Psychopathological disorders have not been identified in pensioners, but both of them are observed in a cardiologist and a therapist. During the examination, they admitted that they often fall asleep in front of the TV, fearing to miss important news, closely follow the information about the coronavirus, experience anxiety, memory impairment and often wake up from terrible dreams.
Provisional diagnosis: mixed anxiety and depressive disorder, unspecified.
Cases 5 and 6
Spouses 55 and 60 years old, during self-isolation in the country, began to exhibit behavior close to pagan forms. They regularly cast spells asking them to spare them and "protect them from a new plague", standing in front of the juniper. They brought fruits to the plant, stroked it.
The spouses told the psychiatrist that they have been living in perfect harmony for 30 years. At the same time, the woman's mother was a healer, made amulets from various problems from herbs. But the couple themselves were not religious throughout their lives. They did not have any psychopathological disorders.
However, the wife, according to her husband, in recent years "a little nervous, often cries." At the same time, she explained that she was sorry for the outgoing youth. Both repeated that the coronavirus should not be scolded: "people began to live wrongly, and it came."
Provisional diagnosis: "mixed anxiety and depressive disorder, unspecified," "induced delusional disorder".
Cases 7 and 8
During the pandemic, patients developed or increased obsessive-compulsive disorders (neurosis, obsessive states - editor's note). According to doctors' observations, such disorders were observed in people of different ages - from adolescents to involutionary age (up to 55 years).
Cases 9 and 10
The mother of the teenagers turned to the dispensary. The 16-year-old son constantly wiped the door handles in the apartment, purchased all kinds of disinfectants, and also rubbed his hands with a brush until abrasions appeared. Then his 14-year-old sister took over his behavior. Together they began to constantly wash the cat with various means - the pet's fur fell out, he stopped eating, but this did not stop the teenagers. Moreover, they began to speculate that the cat could also carry the coronavirus. Brother and sister do not believe the official statistics on morbidity. They stopped listening to loved ones. They insisted that they should not be ill, that they should rely on themselves in everything.
The teenagers were brought up by their mother and grandmother on the type of overprotection, the father left the family. It is noted that before the pandemic, the brother and sister were distant from each other.
Preliminary diagnosis: "obsessive syndrome" in brother, sister - "induced genesis".
Cases 11 and 12
Mother and daughter (54 and 26 years old), instead of working, alternately "kept watch" at the elevator, spraying the incoming disinfectants. This happened at night, the women hardly slept. Those who entered were also asked if they often prayed.
In a conversation with a specialist, the women said that they were glad to see any doctor, “even a psychiatrist”, and that they had experienced a lot in life, and the pandemic would not bypass them. In addition, they repeated that "the virus is alien and does not spare people." Neighbors are considered soulless and hostile. It is known from the anamnesis that the mother and daughter were always prone to "anxious agitation".
According to neighbors, the mother was always negatively disposed towards others and raised her daughter with such attitudes. She suggested that her daughter would be lost without her.
Provisional diagnosis: "mixed anxiety and depressive disorder, unspecified" in both cases; the daughter may have "induced genesis".
Case 13
A 66-year-old woman begged for paracetamol from neighbors and acquaintances, claiming that without it she would die of coronavirus immediately, but they would not. She did not argue her opinion or directly stated that they are so terrible that "the virus will not take it". At the same time, she did not notice the absurdity that she turned to “terrible people” for help.
Relatives living in a neighboring apartment described the patient as very selfish, often claiming to be seriously ill. They complained that she had "hysterics" with crying and groans, sometimes deliberately hitting her head against the wall. Having lost the opportunity to walk, she became "unbearable" - she knocks on the wall at night, throws objects so that relatives come to her.
The woman was diagnosed with "organic personality disorder associated with cerebrovascular changes, the initial stage of dementia", "mixed anxiety and depressive disorder".
It is noted that several young people (from 18 to 23 years old) changed their attitude towards the examination during the clinical interview. They were distinguished by the fixation on the age of relatives - "over 60 years old", some had hysterical reactions during tactile contacts with relatives, suicidal thoughts. Sometimes they refused to talk so that the saliva with the coronavirus would not flow.
“A full-fledged clinical analysis of the described cases is not yet possible: the patients agreed to a conversation with a maximum of two doctors or a psychiatrist and a psychologist, which is clearly not enough for a traditional analysis. Absentee clinical examinations with the participation of a group of doctors during the period of very unfavorable dynamics of the incidence of coronavirus in Moscow were not carried out. Clinical examinations are planned after the end of the epidemic and a more complete examination of patients and obtaining follow-up information”, - the article says.
In addition, a systematic analysis of this phenomenon and its consequences from the point of view of psychiatry, neurochemistry, immunology and social beliefs is required.