[Psychological stress during the COVID-19 pandemic: consequences for psychiatric patients and therapeutic implications]. / Psychische Belastung während der COVID-19-Pandemie: Konsequenzen für psychiatrisch Erkrankte und therapeutische Implikationen.

BACKGROUND: The outbreak of the COVID-19 disease and the rapid spread of the inducing coronavirus SARS-CoV­2 threatens not only people's physical health but also their mental health. Its influence on incidence and course of existing illnesses in the psychiatric outpatient sector in Germany is still unknown. METHODS: The medical reports of 682 persons in psychiatric treatment were retrospectively investigated, regarding their subjective response to this pandemic and its clinical relevance. RESULTS: Of the patients 60.5% (n = 378) experienced greater psychological stress, 14.5% (n = 99) reported fear of the SARS-CoV­2 and the possible danger of infection, 25.5% (n = 174) reported fear resulting from the protective measures taken (lock down) and 4.3% (n = 29) reported fear of both. This differed significantly across diagnoses: people with anxiety disorders reported significantly greater stress as well as greater fear of the virus, whereas people with psychoses were significantly less affected than the other patients. Of the participants 43.7% (n = 132) were so strongly affected that acute treatment had to be implemented and 6.0% (n = 18) had to be referred to inpatient care. DISCUSSION: People with mental illnesses are particularly vulnerable to the psychological strain of the COVID-19 pandemic. Long-term studies on the further course of disease will be necessary. Additional studies that test interventions to build resilience in this population will also be needed.

Attitudes towards psychopharmacology and psychotherapy in psychiatric patients with and without migration background.

BACKGROUND: Sociodemographic factors, attitude towards treatment and acculturation may be important factors influencing the decision of immigrants to seek and maintain psychiatric treatment. A better understanding of these factors may significantly improve treatment adherence and outcome in these patients. Therefore, we investigated factors associated the attitude towards psychotherapy and medication in a sample of psychiatric outpatients with and without migration background. METHODS: N = 381 patients in a psychiatric outpatient unit offering specialized treatment for migrants were included in this study. Attitude towards psychotherapy was assessed using the Questionnaire on Attitudes Toward Psychotherapeutic Treatment, attitude towards medication with the Drug Attitude Inventory-10. Acculturation, symptom load and sociodemographic variables were assessed in a general questionnaire. Statistical analyses included analyses of covariance and hierarchical regression. RESULTS: Patients of Turkish and Eastern European origin reported a significantly more positive attitude towards medication than patients without migration background. When controlling for sociodemographic and clinical variables, we did not observe any significant differences in attitude towards psychotherapy. Acculturation neither influenced the attitude towards psychotherapy nor towards medication. CONCLUSION: Our study indicates that sociodemographic and clinical factors may be more relevant for patients´ attitudes towards treatment than acculturation. Considering these factors in psychiatric treatment of patients with migration background may improve treatment outcome and adherence.

[The Influence of Residence Status on Psychiatric Symptom Load of Asylum Seekers in Germany]. / Psychische Symptombelastung bei Asylsuchenden in Abhängigkeit vom Aufenthaltsstatus.

BACKGROUND: The aim of this study was to assess asylum seekers' views on their legal situations, asylum procedures and living conditions, and the relationship of these factors towards psychological stress. METHODS: 650 asylum seekers in Berlin received a questionnaire. RESULTS: 76,3 % (N = 496) completed the questionnaires in full. According to psychological test criteria, 74,6 % (N = 370) of these respondents indicated symptoms of mental disorders. There were significant correlations between insecure residency status and these symptoms. Respondents with higher symptom load took less advantage of support, participated less in measures designed to assist integration, and described more difficulties in their hearing. Only 11.6 % out of the asylum seekers with mental Illness indicating symptoms in our sample were under psychiatric treatment. CONCLUSION: Our data emphazise the high relevance of mental health burden among refugees.