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Year : 2022  |  Volume : 7  |  Issue : 1  |  Page : 10-12

Mental health in coronavirus disease 2019: From small to tall

Consultant Oral Pathologist, Kozhikode, Kerala, India

Date of Submission31-Jan-2022
Date of Acceptance16-Feb-2022
Date of Web Publication30-Jun-2022

Correspondence Address:
Dr. Vinit Shashikant Patil
C/o Sheetal Patil, Near Megha Battery, Peth-Sangli Road, Sangli, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmo.ijmo_2_22

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Coronavirus disease 2019 (COVID-19) has spread worldwide causing an unprecedented public health crisis. Strong social restraint, social distancing, and quarantine measures to prevent the COVID-19 spread have raised concerns about their mental health. Therefore, it is crucial to analyze and identify the psychological concepts and protective factors that support and constitute these guidelines and strategies and prepare practical suggestions and guidelines to protect the mental health of the children, adolescents, adults, and elderly during COVID-19. These discussions will facilitate a deeper understanding and expansion of these guidelines and strategies. Therefore, this review explores factors–including pandemic-induced stress, self-integration, self-efficacy, and resilience–to prepare practical and detailed suggestions and guidelines using studies that considered these factors, including coping with COVID-19-induced stress, social support, and physical activity.

Keywords: Coronavirus disease 2019, elderly, mental health, pandemic, protective factors

How to cite this article:
Patil VS. Mental health in coronavirus disease 2019: From small to tall. Int J Med Oral Res 2022;7:10-2

How to cite this URL:
Patil VS. Mental health in coronavirus disease 2019: From small to tall. Int J Med Oral Res [serial online] 2022 [cited 2022 Dec 4];7:10-2. Available from: http://www.ijmorweb.com/text.asp?2022/7/1/10/349242

  Introduction Top

The coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, in December 2019 and was declared a public health emergency on January 30, 2020, and a global pandemic by the World Health Organization (WHO) on March 11. As COVID-19 heads into its 3rd year, the impact on children and young people's mental health and well-being continues to weigh heavily. According to the latest available data from UNICEF, globally, at least 1 in 7 children has been directly affected by lockdowns. The disruption to routines, education, recreation, and concern for family income and health, is leaving many young and old people feeling afraid, angry, and concerned for their future. Some groups may be more vulnerable than others to the psychosocial effects of pandemics. The history of this pandemic has experienced unparalleled changes in recent world history.[1],[2],[3],[4] In this review, we would highlight Mental Health in COVID-19: from Small to Tall.

  Effect of Coronavirus Disease 2019 Pandemic on Mental Health of Children and Adolescents Top

Stress starts showing its adverse effect on a child even before he or she is born. During stress, parents, particularly pregnant mothers, are in a psychologically vulnerable state to experience anxiety and depression, which is biologically linked to the well-being of the fetus. In young children and adolescents, the pandemic and lockdown have a greater impact on emotional and social development compared to that in grown-ups. It was also shown that children experienced disturbed sleep, nightmares, poor appetite, agitation, inattention, and separation-related anxiety.[1],[2],[3],[4] Globally, the prelockdown learning of children and adolescents predominantly involved one-to-one interaction with their mentors and peer groups. Unfortunately, the nationwide closures of schools and colleges have negatively impacted over 91% of the world's student population. Some children have expressed lower levels of affect for not being able to play outdoors, not meeting friends, and not engaging in in-person school activities. These children have become more clingy, attention-seeking, and more dependent on their parents due to the long-term shift in their routine. It is presumed that children might resist going to school after the lockdown gets over and may face difficulty in establishing rapport with their mentors after the schools reopen. Consequently, the constraint of movement imposed on them can have a long-term negative effect on their overall psychological well-being. A study found that older adolescents and youth are anxious regarding the cancellation of examinations, exchange programs, and academic events. COVID-19 infection is expressed differently in children and adolescents. Yet the incidents of infection in minors have been reported worldwide, which result in children being quarantined. Although quarantining measures are for the benefit of the community at large, its psychological effects cannot be ignored. The children who are in isolation require special attention as these children might be at risk of developing mental health problems due to grief caused by parental separation. As during the formative years of life, the role of parents is very crucial, any disruption in the form of isolation from parents can have long-term effects of perceived attachment of the child. It is found that separation from the primary caregivers can make a child more vulnerable and can pose a threat to a child's mental health. The children may develop feelings of sadness, anxiety, fear of death, fear of parents' death, and fear of being isolated in the hospital, which may have a very detrimental effect on their psychological development.[5],[6],[7] With the objective of universal prevention and mental health promotion, the international organizations and advisory bodies have issued various guidelines taking into account the mental health needs of the children group during the COVID-19. They have suggested parents to interact constructively with the children and adolescents by communicating with them about the current pandemic, according to their maturity level and their ability to comprehend the crisis. Parents should plan their children's tasks one at a time, involve them in various home activities, educate them about following hygiene habits and social distancing, and engage in indoor play and creative activities. In addition to these activities, adolescents are advised to be involved in household chores and understand their social responsibilities. Interventions supervised by adults can help them in understanding their concerns. The activities of children and adolescents should include more structure in homeschooling activities. Children should be encouraged to socialize with their friends and classmates through digital forums under adult supervision. The advisory committees have also provided guidelines for managing children with special needs and neurodevelopmental disorders. The children are prone to risk for trauma and heightened anxiety. The children need early identification prompt management involving the parents and experts to prevent long-term mental health morbidity.

  Effect of Coronavirus Disease 2019 Pandemic on Mental Health of Adults and Geriatric Age Group Top

The psychological and mental health issues caused by COVID-19 among the elderly should be discussed thoroughly and comprehensively. Particularly, more effort and attention are required for those aged >60 years and are classified in the high-risk group. In a study conducted on the general public, 53.8% of the respondents reported being psychologically affected at a moderate or severe level, with 16.5%, 28.8%, and 8.1% reporting symptoms of severe depression, anxiety, and stress, respectively. Furthermore, 37.1% of the elderly had experienced depression and anxiety during the pandemic, and the emotional response of the elderly aged >60 years was more apparent as compared to other age groups. Efforts to protect mental health are as equally important as the effort to physically prevent and treat COVID-19, among adults and especially among the elderly–the highest risk group. Thus, analyzing, proposing, and implementing strategies for practical, psychological, and mental treatment for the elderly is a priority relevant task.[8],[9],[10] Many can be based on psychological support manuals for mental health suggested by international organizations, such as the WHO, and disease control organizations such as the Center for Disease Control. Several psychological concepts and protective factors that support and compose the suggested guidelines and strategies should be addressed together while discussing the interventions for psychological and mental treatment during COVID-19.

  1. First, the discussion about COVID-19-induced stress is essential because epidemic-induced stress is the root of negative psychological and mental influences and, concurrently, a chief key concept that can offset those negative influences
  2. Second, a factor that must be addressed in this discussion is “ego-integrity.” Ego-integrity is the most ideal psychological state a person can have during advanced age and includes self-worth and self-esteem
  3. Third, another important factor is “self-efficacy.” “Self-efficacy” refers to the confidence or expectation of one's ability to successfully perform an action or activity to produce desired results. Self-efficacy not only helps the elderly to recognize their abilities in stressful situations caused by COVID-19 but also helps demonstrate the belief that they can overcome difficult situations
  4. Finally, from the positive psychology perspective, “resilience” should receive attention. Resilience is defined as a positive strength to overcome and adapt to difficulties or stressful situations. Importantly, high resilience among the adults and elderly predict variables such as high coping skills, long life span, low depression, a positive mind, strong social support networks, and dynamic physical activity; thus, resiliency is particularly important among the elderly where psychological, social, physical, and socioeconomic stresses are the highest among all other age groups. [Table 1] shows practical suggestions for maintaining mental health during COVID-19 among all age groups.[1]
Table 1: Practical suggestions for maintaining mental health during coronavirus disease 2019 among all age groups

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  Conclusion Top

It is imperative to plan strategies to enhance children, adolescent's, adults, and elderly access to mental health services during and after the current crisis. Recommendations for ensuring the mental well-being of people during the COVID-19 pandemic and lockdown and the role of parents, teachers, doctors, community volunteers, the health system, and policymakers should be further discussed.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Lee K, Jeong GC, Yim J. Consideration of the psychological and mental health of the elderly during COVID-19: A theoretical review. Int J Environ Res Public Health 2020;17:8098.  Back to cited text no. 1
World Health Organization Archive: WHO Timeline-COVID-19. Available from: https://www.who.int/news-room/detail/27-04-2020-who-timeline---covid-19. [Last accessed on 2020 Nov 21].  Back to cited text no. 2
Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M, Benedek DM. Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: Mental health consequences and target populations. Psychiatry Clin Neurosci 2020;74:281-2.  Back to cited text no. 3
Wilburn VR, Smith DE. Stress, self-esteem, and suicidal ideation in late adolescents. Adolescence 2005;40:33-45.  Back to cited text no. 4
Gerst-Emerson K, Jayawardhana J. Loneliness as a public health issue: The impact of loneliness on health care utilization among older adults. Am J Public Health 2015;105:1013-9.  Back to cited text no. 5
Park SC, Park YC. Mental health care measures in response to the 2019 novel coronavirus outbreak in Korea. Psychiatry Investig 2020;17:85-6.  Back to cited text no. 6
Viner RM, Russell SJ, Croker H, Packer J, Ward J, Stansfield C, et al. School closure and management practices during coronavirus outbreaks including COVID-19: A rapid systematic review. Lancet Child Adolesc Health 2020;4:397-404.  Back to cited text no. 7
Kinsella MT, Monk C. Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 2009;52:425-40.  Back to cited text no. 8
World Health Organization Mental Health and Psychosocial Considerations during Outbreak, COVID-19; 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf. [Last accessed on 2020 Dec 15].  Back to cited text no. 9
Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry 2020;7:228-9.  Back to cited text no. 10


  [Table 1]


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