Survey Reveals Challenges Faced by Psychiatric Patients in China Amid COVID-19 Outbreak

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More than 20% of patients diagnosed with depression, bipolar disorder, or schizophrenia who receive care at a large Chinese medical center reported they were not able to receive their routine care due to suspended hospital visits during the COVID-19 pandemic. This was one of the findings of a survey reported in an article in press in the American Journal of Psychiatry.

Moreover, nearly all of those patients with existing diagnoses who couldn’t get care experienced a deterioration in their condition. Almost a quarter of new patients experiencing anxiety, depression, or insomnia could not get timely care, the survey found.

“[O]ur data reiterated the importance of implementing appropriate mental health measures in the face of the COVID-19 pandemic,” wrote Junying Zhou, M.D., Ph.D., of West China Hospital of Sichuan University in Chengdu, China, and colleagues.

Using the “Questionnaire Starr” survey program on WeChat, a popular Chinese smartphone application, Zhou and colleagues surveyed 2,065 outpatients seeking care in the departments of Psychiatry, Neurology, or Sleep Medicine in West China Hospital from February 25 to March 9. There were 589 new patients and 1,476 patients with existing psychiatric diagnoses. Here are the major findings:

• 25.5% of the respondents in the combined groups experienced anxiety (defined as a score of 5 or more on the Generalized Anxiety Disorder-7 scale), and 26.2% experienced insomnia (defined as a score of 8 or more on the Insomnia Severity Index). Just under 17% experienced depression (defined as a score of 5 or more the Patient Health Questionnaire-9).
• Among existing patients, 22.2% could not get their routine care, and 20.9% experienced a deterioration in symptoms. Just over 17% stopped taking their medications because of problems related to filling their prescriptions during the outbreak.
• Among new patients, 24.5% could not get “timely diagnosis and treatment” at the hospital. These included 46 patients with anxiety, 37 patients with depression, 79 patients with insomnia, and 21 patients with schizophrenia.

The researchers wrote that “transport restriction, isolation at home, and fear of cross-infection in the hospital have inevitably become the major concerns and barriers to treatment for these patients during the outbreak.”

The researchers noted that a number of hospitals in China have initiated telemedicine services for patients in need, and in January, West China Hospital opened a free online outpatient service to provide prescriptions to existing patients and consultations to new patients. Although thousands of patients have received health care through this service, only 7.4% of those with mental disorders in the survey did so. “Thus, there is a need for promoting online mental health services across China to manage mental problems during the pandemic,” they wrote.

(Image: PeopleImage/shutterstock.com)

The commentary describing the results of the survey is in press at the American Journal of Psychiatry and can be cited as follows: Zhou J: Mental health response to COVID-19 outbreak in China. Am J Psychiatry [doi: 10.1176/appi.ajp.2020.20030304]

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