The COVID-19 pandemic has had negative effects on mental wellbeing for many, with a decline in mental health reported in the UK after the first month of lockdown, and one study finding that around 18 percent of people infected with the virus went on to be diagnosed with a psychiatric disorder shortly afterward.
Now, a study published in Molecular Psychiatry has indicated that post-traumatic stress disorder (PTSD) could be a major mental health concern in the wake of pandemics like this, with the pooled prevalence of post-pandemic PTSD in all populations found to be 22.6 percent.
“Our findings indicate that post-pandemic PTSD is a significant public health concern after infectious disease pandemics, including COVID-19,” said the authors in the paper. “Appropriate monitoring, timely interventions, social support, and long-term follow-up should be applied to mitigate post-pandemic PTSD and related psychological disturbances, particularly in high-risk populations”
The researchers carried out a meta-analysis of studies on the development of PTSD after infectious disease pandemics in the 21st century, including severe acute respiratory syndrome (SARS), H1N1 (swine flu), Poliomyelitis, Ebola, Zika, Nipah, Middle Eastern respiratory syndrome coronavirus (MERS-CoV), H5N1, and COVID-19.
They extracted their findings from the pooled data, looking at both prevalence and risk factors for post-pandemic PTSD. One limitation of this approach, the authors note, is the substantial heterogeneity of the estimates for PTSD prevalence, meaning different study approaches and differences in populations lead to variations in outcome.
The researchers analyzed the presence of post-pandemic PTSD in healthcare workers, infected patients, and the general public. Within six months of a pandemic, the prevalence of PTSD in healthcare workers was 28.6 percent, and after six months it was 10 percent. However, this was dramatically higher in frontline workers, who had a post-pandemic PTSD prevalence of 30.8 percent compared to 8.2 percent for non-frontline workers.
“Uncomfortable working environments including the long-term use of personal protective equipment, intense and often overloaded work intensity of an extended duration because of severe pandemic conditions, a lack of understanding and specific drugs to fight the disease, and unavoidable psychological shock that is caused by the demise of infected patients all contribute to the high prevalence of PTSD among both frontline healthcare workers and frontline nurses,” stated the authors.
For people in the general public, 19.4 percent were found to have PTSD within six months of a pandemic, and 12.4 percent had it after six months. The prevalence of PTSD in infected patients was found to be 18.6 percent within six months of a pandemic and 28.8 percent after six months.
“Infected patients are not only the vectors of infection, but also often the victim of social stigma following the infection. Healthcare workers can also experience social stigmatization since they work directly with infected patients,” wrote the authors.
The study also revealed a myriad of risk factors for post-pandemic PTSD. Individuals who were low-income, young, female, living in a city, tobacco users, or with a lower level of education were highlighted as having a higher risk of developing PTSD after a pandemic.
Poor psychological health was also associated with a higher risk of post-pandemic PTSD, including factors such as poor sleep quality, high stress, neurotic and psychopathic personality, and high anxiety and depression. Experiencing traumatic events before an outbreak was associated with higher risk, especially when “inappropriate” coping strategies were used. PTSD among family members, as well as loved ones being hospitalized or dying from infection, also increased risk.
Quarantine and social isolation due to a pandemic were found to be a “major” risk factor for post-pandemic PTSD. A high risk of being infected and higher disease severity were also associated with a higher risk. In healthcare workers, longer shifts, low job satisfaction, and less experience were factors that increased the risk of post-pandemic PTSD.
“Public health strategy involving mental health response is warranted, especially in the area of post-pandemic and even after long-term recovery period. Early detection and early interventions should be implemented comprehensively and extensively, especially for vulnerable populations,” concluded the authors.