Evaluation of the Perceptions About the Covid-19 Pandemic of Patients with the Diagnosis of Generalized Anxiety Disorder: A Qualitative Study 'Fires Again, Me Again'

Abstract

Abstract: Objective: Covid-19 pandemic has raised concerns about how to deal with the psychiatric aspects of the pandemic and it was a matter of curiosity how the perceptions of individuals would be who already had a psychiatric diagnosis, especially a vulnerable diagnosis of Generalized Anxiety Disorder (GAD). We aimed to explore the perceptions about Covid-19 pandemic in a sample of individuals with the diagnosis of GAD. Methods: Qualitative data obtained using a semi-structured interview questionnaire by a psychiatrist with 33 individuals diagnosed with GAD. Results: 14(42.4%) of the participants were male, 19(57.6%) were female. Average age was 34.7. 7(21.2%) participants had Covid-19 infection. Three main themes were determined as " learning from the pandemic process", "impact of the pandemic process on changes in personal development", "effects on the psychiatric treatment process". Sub-themes; 'value of health ',' patience', 'importance of cleanliness and hygiene', 'changing world', 'difficulties of staying at home', ' necessity of preparing yourself for the worst', 'people are no good for anyone but themselves', 'things happen to happen' 'learning to be happy with little things', 'being able to read more books', ‘uncertainty’ 'spending time with children' 'enduring', 'discipline', 'negativities added to health', ‘no change’ 'fires again, me again' and 'worsening with stress factor' ' awareness ' 'experience' 'helped-it, it was good’ have been detected. Conclusions: People with the diagnosis of GAD may be particularly vulnerable to the psychological effect of the COVID-19 pandemic. But their positive and negative appraisals and coping behaviour could prevent or ameliorate future problems.

Keywords

• generalized axiety disorder,
• COVID-19
• perceptions about the pandemic
• qualitative study

References

1. References 1. World Health Assosication. (2020, 11 March). Director-General’s opening remarks at the media briefing on COVID-19-March11,2020. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-medya-covid-19----11-march-2020.
2. 2. American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5. 5th Edn. Washington, DC: American Psychiatric Association.
3. 3. Merikangas KR, Ames M, Cui L et al. (2007). The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Arch. Gen. Psychiatry 64, 11801188.doi:10.1001/archpsyc.64.10.1180
4. 4. Kessler RC, Keller MB, Wittchen HU. The epidemiology of generalized anxiety disorder. Psychiatr Clin North Am 2001;2419- 39
5. 5. Asmundson GJG, Taylor S. How health anxiety influences responses to viral outbreaks like COVID-19: what all decision-makers, health authorities, and health care professionals need to know J Anxiety Disord, 71 (2020), p. 102211
6. 6. Dubey S, Biswas P, Ghosh R et al. Psychosocial impact of COVID-19 Diabetes & Metabolic Syndrome: Clinical Research & Reviews Volume 14, Issue 5, September–October 2020, Pages 779-788
7. 7. Montemurro N. The emotional impact of COVID-19: From medical staff to common people. Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.03.032
8. 8. Bhat R, Singh VK, Naik N et al. COVID 2019 outbreak: the disappointment in indian teachers. Asian J. Psychiatry. 2020; March (28)

9. 9. Hao F, Tan W, Jiang L et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry Brain, Behavior, and Immunity Volume 87, July 2020, Pages 100-106
10. 10. Brooks SK, Webster RK, Smith LE et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;February (26)
11. 11. Jeong H, Yim HW, Song YJ et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health 2016;38:e2016048.
12. 12. Li Z, Ge J, Yang M et al. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.03.007
13. 13. Qiu JY, Zhou DS, Liu J, Yuan TF. Mental wellness system for COVID-19. Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.04.032
14. 14. Wang C, Pan R, Wan X et al. Psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health, 17 (5) 2020, p. 1729
15. 15. Zhang J, Lu H, Zeng H et al. The differential psychological distress of populations affected by the COVID-19 pandemic. Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.04.031
16. 16. Chew N, Lee LG, Tan BY et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav. Immun. (2020)
17. 17. Mukhtar S. Mental health and emotional impact of COVID-19: applying health belief model for medical staff to general public of Pakistan. Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.04.012
18. 18. Brewer G, Centifanti L, Castro Caicedo J et al. Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder. Illness, Crisis & Loss 0(0) 1–17 june 18 2021
19. 19. Novaco RW. Stress: Concepts, Cognition, Emotion, and Behavior. Handbook of Stress Series Volume 1,2016, Chapter 35 – Anger, Pages 285-292
20. 20. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019-nCoV epidemic: address mental health care to empower society. Lancet, 395 (10224), 2020, pp. e37-e38
21. 21. Abad C, Fearday A, Safdar N. Adverse effects of isolation in hospitalised patients: a systematic review. J Hosp Infect. 2010;76:97-102.
22. 22. Simblett SK, Wilson E, Morris D et al. Keeping well in a COVID-19 crisis: a qualitative study formulating the perspectives of mental health service users and carers. Journal of Mental Health, volume 30/2021 Issue 2 Pages 138-147,27 Jan 2021
23. 23. Gautam R, Sharma R. 2019-nCoV Pandemic: a disruptive and stressful atmosphere for Indian academic fraternity. Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.04.025
24. 24. Joob B, Wiwanitkit V. Traumatization in medical staff helping with COVID-19 control Brain Behav. Immun. (2020), 10.1016/j.bbi.2020.03.020
25. 25. Emmelkamp P, Krijn M, Hulsbosch AM et al. Virtual reality treatment versus exposure in vivo: A comparative evaluation in acrophobia. Behaviour Research and Therapy, 40, 2002, pp. 509-516
26. 26. Sun N, Wei L, Shi S et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control, 48(6), 2020, 592–598. https://doi.org/10.1016/j.ajic.2020.03.018
27. 27. Dawson DL, Golijani-Moghaddam N. COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic. Journal of Contextual Behavioral Science,17, 2020, 126–134. https://doi.org/10.1016/j.jcbs.2020.07.010
28. 28. Killgore WDS, Taylor EC, Cloonan SA, Dailey NS. Psychological resilience during the COVID-19 lockdown. Psychiatry Research, 291, 2020 113216. https://doi.org/10.1016/j.psychres.113216
29. 29. Reich JW. Three psychological principles of resilience in natural disasters. Disaster Prevention and Management, 15(5), 2006, 793–798. https://doi.org/10.1108/09653560610712739
30. 30. Gao W, Ping S, Liu X. Gender differences in depression, anxiety, and stress among college students: A longitudinal study from China. Journal of Affective Disorders, 263, 2020, 292–300. https://doi.org/10.1016/j.jad.2019.11.121