key: cord-0872739-ern66w9j
authors: Piacenza, Francesco; Ong, Suet K.
title: Impact of social distancing due to coronavirus disease 2019 in old age psychiatry
date: 2021-01-24
journal: Psychogeriatrics
DOI: 10.1111/psyg.12657
sha: 341425d9399adec0b75bdf20c578045403683a75
doc_id: 872739
cord_uid: ern66w9j

nan

Coronavirus disease 2019 (COVID-19) is a threat to all of humankind and, in particular, to older people. As at November 2020, there had been more than 57 million confirmed cases of COVID-19 and almost 1.5 million of deaths worldwide, including more than 70 000 cases and over 2000 deaths in the Republic of Ireland. Common symptoms of COVID-19 include fever, a new cough, shortness of breath, and loss or change to sense of taste and/or smell. 1 In severe cases, these symptoms can evolve to provoke acute respiratory distress syndrome and multi-organ failure. The likelihood of a fatal outcome is directly proportional to both age and immunocompromised status. 2 Older people, even if in good health, are one of the most high-risk population groups, together with people with chronic and severe diseases. 1 Consequently, older people have been living under a constant fear of death and losing their loved ones, and they have even experienced guilt for being a carrier and spreading the COVID-19 infection. 3 In addition, the necessity for older people to self-isolate and 'cocoon' can be extremely challenging, especially for those who live alone and in isolated areas, which is not uncommon in rural Ireland. Furthermore, because of the pandemic, most services that were helping older people to remain active and to maintain socialization are closed. The detrimental effect of social isolation, social disconnectedness, and loneliness on the mental health of older people has been well described. 4 These measures of COVID-19 prevention have helped to decrease the likelihood of being infected, but with the stress and the fear provoked by the pandemic, they may have also contributed to the onset or deterioration of psychiatric disorders such as depression, adjustment disorder, anxiety disorders, and psychosis. 3 In addition, Banerjee has raised concerns that the stress of COVID-19 isolation may increase the risk of suicidal ideation and suicide attempts in older people with an existing risk. 3 In our daily practice in an old age psychiatry service in the South-East of Ireland, we have realized how much the COVID-19 pandemic is affecting the mental health of our service users. The most common presentation is that of either an anxiety disorder or a depressive disorder triggered by various psychosocial factors, including the fear of infection and death, the inability to perform physical and social activities, loneliness, and feeling like a burden on their family and society. In some cases, we have witnessed a deterioration in anxiety and depressive symptoms to apparent psychotic symptoms. Such deterioration has been corroborated by a recent study that described several cases of new-onset psychosis during the COVID-19 pandemic. 5 The most common symptoms were thoughts of reference and structured delusional beliefs.

Symptoms of COVID-19

The impact of Covid-19 pandemic on elderly mental health

Age and ageism in COVID-19': elderly mental healthcare vulnerabilities and needs

Psychological impact of COVID-19 on older adults

Psychotic symptoms in COVID-19 patients. A retrospective descriptive study

Disclosure: The authors have no conflicts of interest to declare in the research.