İzolasyon, Karantina, Sosyal Mesafe ve Ruh Sağlığı
DOI:
https://doi.org/10.17986/blm.2020.v25i.1412Anahtar Kelimeler:
COVID-19- ruh sağlığı- anksiyete- depresyon- izolasyon- karantinaÖz
COVID-19 pandemisi dünyada 4 milyonun üzerinde insanı doğrudan, hemen hemen tüm dünyayı ise toplusal sonuçları nedeniyle dolaylı yollardan etkileyen bir süreç olarak hayatlarımıza girdi. Pandemi olarak kabul edilen bulaşıcı hastalıkların yayılmasını engellemek için tüm dünyada kabul gören izolasyon, karantina, sosyal mesafenin kısıtlanması gibi yöntemler bulunmaktadır. Modern çağda hızla uygulamaya geçirilen bu yöntemler enfeksiyonların yayılmasını ciddi biçimde engellese de, yarattığı ruhsal sorunlar bireylerin ve tüm toplumun yaşamını uzun süre olumsuz biçimde etkilemektedir. Bu yazıda izolasyon, karantina ve sosyal mesafe gibi uygulamaların insanların ruh sağlığı üzerindeki etkilerinin incelenmesi hedeflenmiştir.
Bu uygulamalar insanlarda başta kaygı ve depresif belirtiler olmak üzere, farklı emosyonel yanıtlara yol açmaktadır. Stresle baş etme biçimi ve stresin şiddetine bağlı olarak, yatkınlığı olan bireylerde bu uygulamalar başta anksiyete bozuklukları, depresif bozukluklar ve stresle ilişkili bozukluklar olmak üzere pek çok ruhsal bozukluğa neden olabilmektedir. COVID-19 enfeksiyonu yaşlı bireylerde daha kötü seyrettiğinden, bu bireylerde sıkça deliryum tablosu görülebilmektedir. Bu süreçte yaşanan ölümler izole ortamlarda olduğundan komplike yas gelişme riski yüksektir. Ek olarak, bireylere ciddi zararı olan stigmatizasyon bu dönemde izolasyon ya da karantinada olan bireyler için gelişebilecek tehlikeli bir durumdur.
Bu sürecin en az zararla atlatılabilmesi için bu uygulamaların süresinin olabildiğince kısa tutulması, sosyal ve ekonomik açıdan toplumun desteklenmesi, sağlık sistemine ulaşımın kolaylaştırılması ve ruh sağlığı hizmetlerinin yaygınlaştırılması önemlidir.
İndirmeler
Kaynaklar
Merrill R. Foundations of Epidemiology. In: Introduction to Epidemiology. 5th ed. Boston: Jones & Bartlett Learning; 2010. p. 6–7.
Taylor S. Contemprorary Methods for Managing Pandemics. In: The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. Cambridge Scholars Publishing; 2019. p. 15–22.
Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: Risks, Impacts, and Mitigation. In: Disease Control Priorities, Third Edition (Volume 9): Improving Health and Reducing Poverty. The World Bank; 2017. p. 315–45. DOI: https://doi.org/10.1596/978-1-4648-0527-1_ch17
Jain V, Duse A, Bausch DG. Planning for large epidemics and pandemics: Challenges from a policy perspective. Vol. 31, Current Opinion in Infectious Diseases. Lippincott Williams and Wilkins; 2018. p. 316–24. DOI: https://doi.org/10.1097/QCO.0000000000000462
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. Rapid Review The psychological impact of quarantine and how to reduce it: rapid review of the evidence. www.thelancet.com [Internet]. 2020 [cited 2020 May 10];395. Available from: https://doi.org/10.1016/ DOI: https://doi.org/10.1016/S0140-6736(20)30460-8
Zhang SX, Wang Y, Rauch A, Wei F. Unprecedented disruption of lives and work: Health, distress and life satisfaction of working adults in China one month into the COVID-19 outbreak. Psychiatry Res. 2020 Apr;288:112958. DOI: https://doi.org/10.1016/j.psychres.2020.112958
Polizzi C, Lynn SJ, Perry A. Perspective article Stress and Coping in the Time of COVID-19: Pathways to Resilience and Recovery Craig Polizzi, Steven Jay Lynn, Andrew Perry. Clin Neuropsychiatry. 2020;59–62.
Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect [Internet]. 2008 [cited 2020 May 10];136(7):997–1007. Available from: https://doi.org/10.1017/S0950268807009156 DOI: https://doi.org/10.1017/S0950268807009156
Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–12. DOI: https://doi.org/10.3201/eid1007.030703
Li S, Wang Y, Xue J, Zhao N, Zhu T. The Impact of COVID-19 Epidemic Declaration on Psychological Consequences: A Study on Active Weibo Users. Int J Environ Res Public Health. 2020 Mar;17(6). DOI: https://doi.org/10.3390/ijerph17062032
Courtin E, Knapp M. Social isolation, loneliness and health in old age: a scoping review. Vol. 25, Health and Social Care in the Community. Blackwell Publishing Ltd; 2017. p. 799–812. DOI: https://doi.org/10.1111/hsc.12311
Wang J, Lloyd-Evans B, Giacco D, Forsyth R, Nebo C, Mann F, et al. Social isolation in mental health: a conceptual and methodological review. Vol. 52, Social Psychiatry and Psychiatric Epidemiology. Dr. Dietrich Steinkopff Verlag GmbH and Co. KG; 2017. p. 1451–61. DOI: https://doi.org/10.1007/s00127-017-1446-1
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. Vol. 7, The Lancet Psychiatry. Elsevier Ltd; 2020. p. 228–9. DOI: https://doi.org/10.1016/S2215-0366(20)30046-8
Júnior JG, de Sales JP, Moreira MM, Pinheiro WR, Lima CKT, Neto MLR. A crisis within the crisis: The mental health situation of refugees in the world during the 2019 coronavirus (2019-nCoV) outbreak. Vol. 288, Psychiatry research. 2020. p. 113000. DOI: https://doi.org/10.1016/j.psychres.2020.113000
Vieta E, Pérez V, Arango C. Psychiatry in the aftermath of COVID-19. Rev Psiquiatr Salud Ment. 2020 Apr; DOI: https://doi.org/10.1016/j.rpsm.2020.04.004
Wallace CL, Wladkowski SP, Gibson A, White P. Grief During the COVID-19 Pandemic: Considerations for Palliative Care Providers. J Pain Symptom Manage. 2020 Apr; DOI: https://doi.org/10.1016/j.jpainsymman.2020.04.012
Sadock BJ, Sadock VA, Ruiz P. Neurocognitive Disorders. In: Synopsis of Psychiatry. 11th ed. Philadelphia: Wolters Kluwer; 2015. p. 694–704.
Kotfis K, Williams Roberson S, Wilson JE, Dabrowski W, Pun BT, Ely EW. COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Crit Care [Internet]. 2020 [cited 2020 May 10];24(1):176. Available from: https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02882-x DOI: https://doi.org/10.1186/s13054-020-02882-x
Setters B, Solberg LM. Delirium. Vol. 44, Primary Care - Clinics in Office Practice. W.B. Saunders; 2017. p. 541–59. DOI: https://doi.org/10.1016/j.pop.2017.04.010
LaHue SC, James TC, Newman JC, Esmaili AM, Ormseth CH, Ely EW. Collaborative Delirium Prevention in the Age of COVID-19. J Am Geriatr Soc. 2020 Apr 11; DOI: https://doi.org/10.1111/jgs.16480
Schwartz AC, Fisher TJ, Greenspan HN, Heinrich TW. Pharmacologic and nonpharmacologic approaches to the prevention and management of delirium. Int J Psychiatry Med. 2016 Feb 1;51(2):160–70. DOI: https://doi.org/10.1177/0091217416636578
Lu YC, Shu BC, Chang YY, Lung FW. The mental health of hospital workers dealing with severe acute respiratory syndrome. Psychother Psychosom. 2006 Oct;75(6):370–5. DOI: https://doi.org/10.1159/000095443
Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54(5):302–11. DOI: https://doi.org/10.1177/070674370905400504
Ferguson E. Hypochondriacal Concerns and the Five Factor Model of Personality. J Pers [Internet]. 2000 Aug 1 [cited 2020 May 10];68(4):705–24. Available from: http://doi.wiley.com/10.1111/1467-6494.00113 DOI: https://doi.org/10.1111/1467-6494.00113
Huremović D. Mental Health Care for Survivors. In: Psychiatry of Pandemics. 2019. p. 131–3. DOI: https://doi.org/10.1007/978-3-030-15346-5
Banerjee DD. The other side of COVID-19: Impact on obsessive compulsive disorder (OCD) and hoarding. Vol. 288, Psychiatry research. 2020. p. 112966. DOI: https://doi.org/10.1016/j.psychres.2020.112966
Chambers LA, Rueda S, Baker DN, Wilson MG, Deutsch R, Raeifar E, et al. Stigma, HIV and health: A qualitative synthesis [Internet]. Vol. 15, BMC Public Health. BioMed Central Ltd.; 2015 [cited 2020 May 10]. p. 848. Available from: http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2197-0 DOI: https://doi.org/10.1186/s12889-015-2197-0
James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: A cross-sectional study. BMC Public Health [Internet]. 2020 Feb 5 [cited 2020 May 10];20(1):182. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8279-7 DOI: https://doi.org/10.1186/s12889-020-8279-7
James PB, Wardle J, Steel A, Adams J. Post‐Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review. Trop Med Int Heal [Internet]. 2019 Jun 20 [cited 2020 May 10];24(6):671–91. Available from: https://onlinelibrary.wiley.com/doi/abs/10.1111/tmi.13226 DOI: https://doi.org/10.1111/tmi.13226
Johal SS. Psychosocial impacts of quarantine during disease outbreaks and interventions that may help to relieve strain. N Z Med J. 2009 Jun 5;122(1296):47–52.
WHO. Guidelines for the Management of Conditions Specifically Related to Stress. Assess Manag Cond Specifically Relat to Stress mhGAP Interv Guid Modul (version 10) [Internet]. 2013;1–273. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24649518
Departments of Veterans Affairs and Defense. VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Clinician Summary. Focus (Madison) [Internet]. 2018 [cited 2020 Feb 26];16(4):430–48. Available from: www.tricare.mil DOI: https://doi.org/10.1176/appi.focus.16408
WHO. Psychological first aid: Guide for field workers [Internet]. 2011. Available from: https://www.who.int/mental_health/publications/guide_field_workers/en/
Ćosić K, Popović S, Šarlija M, Kesedžić I. Impact of Human Disasters and COVID-19 Pandemic on Mental Health: Potential of Digital Psychiatry. Psychiatr Danub. 2020;32(1):25–31. DOI: https://doi.org/10.24869/psyd.2020.25
İndir
Yayınlanmış
Sayı
Bölüm
Lisans
Telif Hakkı (c) 2020 Adli Tıp Bülteni

Bu çalışma Creative Commons Attribution 4.0 International License ile lisanslanmıştır.
Dergimiz ve bu internet sitesinin tüm içeriği Creative Commons Attribution (CC-BY) lisansının şartları ile ruhsatlandırılmıştır. Creative Commons Attribution Lisansı, kullanıcıların bir makaleyi kopyalamasına, dağıtmasına ve nakletmesine, makaleyi uyarlamasına ve makalenin ticari olarak kullanılmasına imkan tanımaktadır. CC BY lisansı, yazarına uygun şekilde atfedildiği sürece açık erişimli bir makalenin ticari ve ticari olmayan mahiyette kullanılmasına izin vermektedir.