The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders

Nicole Kozloff; Benoit H. Mulsant; Vicky Stergiopoulos; Aristotle N. Voineskos

Disclosures

Schizophr Bull. 2020;46(4):752-757. 

In This Article

Abstract and Introduction

Abstract

The coronavirus disease-19 (COVID-19) global pandemic has already had an unprecedented impact on populations around the world, and is anticipated to have a disproportionate burden on people with schizophrenia and related disorders. We discuss the implications of the COVID-19 global pandemic with respect to: (1) increased risk of infection and poor outcomes among people with schizophrenia, (2) anticipated adverse mental health consequences for people with schizophrenia, (3) considerations for mental health service delivery in inpatient and outpatient settings, and (4) potential impact on clinical research in schizophrenia. Recommendations emphasize rapid implementation of measures to both decrease the risk of COVID-19 transmission and maintain continuity of clinical care and research to preserve safety of both people with schizophrenia and the public.

Introduction

Starting in January 2020, coronavirus disease-19 (COVID-19) has rapidly developed into a global pandemic with the number of deaths continuing to climb worldwide.[1] The World Health Organization (WHO) and many governments have promulgated social distancing and social isolation to slow the spread of the virus (ie, "flatten the curve").[2] These public health efforts are targeting the entire population. However, these strategies may be less effective for certain marginalized groups, notably those with schizophrenia and related disorders (referred as schizophrenia in the rest of this manuscript). Features of these disorders, such as delusions, hallucinations, disorganized behavior, cognitive impairment, and poor insight, and sociodemographic characteristics, including living in congregate housing and homelessness,[3] may put these individuals at higher risk of becoming infected with COVID-19. Furthermore, people living with schizophrenia are at greater risk for adverse outcomes, including death, because compared with the general population, they typically have poorer physical health,[4–6] greater socioeconomic disadvantage,[7] are more socially disconnected,[8] and experience pervasive stigma and discrimination.[9] Here, we discuss (1) why people with schizophrenia are at increased risk of infection with COVID-19 and poor outcomes; (2) possible mental health consequences of COVID-19 infection in people with schizophrenia; (3) possible consequences for health professionals and institutions that serve patients with schizophrenia; and (4) potential adverse impact on clinical research related to schizophrenia.

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