4.4 Review

An update on psychotic spectrum disorders and disasters

Journal

CURRENT OPINION IN PSYCHIATRY
Volume 34, Issue 3, Pages 211-215

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/YCO.0000000000000700

Keywords

COVID-19; disasters; psychotic spectrum disorders; schizophrenia; severe mental illness; trauma

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Recent studies have found an increased incidence of PSDs in communities affected by disasters, but findings have been inconsistent regarding psychosis incidence in COVID-19 patients. PSD patients have been found to cope poorly in recent disasters, with schizophrenia patients particularly at risk during COVID-19 due to issues such as poor awareness of health precautions and the impact of lockdown. Novel methods such as telepsychiatry have helped ensure consistent care for this population during the pandemic.
Purpose of review The aim of this study is to review the recent literature on disasters' impact on the course of psychotic spectrum disorders (PSDs) and how people with PSD fare during a disaster, including the effects of COVID-19. Recent findings Several, but not all, studies examining disasters including earthquake-affected communities and refugee populations have found increased incidence of PSDs. Studies have been inconsistent regarding psychosis incidence in COVID-19 patients. Meanwhile, patients with PSD have been found to cope poorly in recent disasters including flooding and a nuclear accident. Patients with schizophrenia appear to be at particular risk during COVID-19 due to such issues as poor awareness of health precautions and the psychiatric impact of lockdown. However, novel methods including telepsychiatry have allowed care of this population to remain consistent during COVID-19. There is conflicting evidence as to the association between disasters and onset of PSD, and further study is needed to elucidate this link. Patients with PSDs are more likely to fare worse during disasters. Novel approaches to delivery of care have helped offset the psychiatric risks to PSD patients during the COVID-19 pandemic. These approaches may be applicable to other disaster scenarios or to general outpatient care.

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