What you need to know
Post-traumatic stress disorder (PTSD) is a mental health condition that can be triggered in people who have experienced or witnessed a traumatic event. In a recent journal publication, a group of researchers suggest that there are three groups at risk of developing PTSD related to the current COVID-19 pandemic: (a) survivors of severe cases of COVID-19, (b) family members of people who have survived severe cases or died from COVID-19 and (c) frontline healthcare providers who have witnessed life-threatening cases and deaths from COVID-19.
Because of this, the researchers suggest that mental health service providers should get ready for an increase in patients with PTSD symptoms, beginning with routine screening and preparation to deliver evidence-based treatment interventions.
Having a severe case of coronavirus disease 2019 (COVID-19) can be life-threatening. Because of this, the experience may be considered a traumatic event. People who are exposed to traumatic events can develop post-traumatic stress disorder (PTSD). This can include people who faced actual or threatened death and people who witnessed such a traumatic event, learned that a traumatic event happened to someone close to them, or were exposed to repeated or extreme details of the traumatic event.
For this reason, researchers in Poland and the United Kingdom set out to answer two questions:
- Who is at higher risk of developing PTSD related to the COVID-19 pandemic?
- How can mental health specialists prepare for pandemic-related PTSD?
What ideas are the researchers presenting?
The researchers suggest that mental health service providers should expect an increase in rates of PTSD in three particular populations:
- Survivors of severe COVID-19: The researchers found recent studies from Italy showing that between 10 and 30 per cent of survivors of severe COVID-19 developed PTSD symptoms. Older studies following the similar severe acute respiratory syndrome (SARS) epidemic showed that the frequency of PTSD in survivors is likely to increase over time; nearly 55 per cent of hospitalized SARS survivors had PTSD approximately 4 years after discharge.
- Family members of people who have survived severe cases or died from COVID-19: Individuals who experience the sudden or unexpected death of a family member can be considered to be at risk of both PTSD and prolonged grief disorder (PGD). In the case of COVID-19, emotions around the death or near death of a loved one are further complicated by pandemic-related restrictions such as quarantine requirements, delayed funerals and capacity restrictions at hospitals and places of mourning.
- Frontline healthcare providers who have witnessed life-threatening cases and deaths from COVID-19: In addition to witnessing the trauma of major illness and death related to COVID-19, individuals working in hospitals and long-term care homes are likely to have experienced fear of contagion or death. This fear may have been worse in cases where medical equipment was insufficient or inadequate.
To prepare for this increase in patients with PTSD symptoms, the researchers suggest that mental health professionals should:
- increase awareness and understanding of PTSD and its symptoms among care providers, patients and their families
- implement routine screening for PTSD in primary care settings for the high-risk groups noted above 1 to 6 months after a traumatic event (where follow up by a mental health specialist is available)
- begin screening bereaved families for PGD 12 months after the loss of a loved one to COVID-19
- prepare to provide evidence-based interventions for PTSD by:
- increasing training in effective therapeutic approaches, such as exposure therapy and cognitive processing therapy
- adapting interventions to the current local context, such as by enabling online delivery of interventions
- explore psychological support needed for children of parents experiencing PTSD
- consider prevention strategies and other risks associated with PTSD (e.g., suicide).
How can this information be used?
Both mental health and primary care clinicians can use this information to monitor and improve the mental health of individuals who have survived or been exposed to severe cases of COVID-19.
What future research is recommended?
The researchers recommend that, in the months and years following the end of the COVID-19 pandemic, research be dedicated to fully exploring the prevalence of pandemic-related PTSD across the population.
About the researchers
Marcin Sekowski1, Małgorzata Gambin2, Karolina Hansen2, Paweł Holas2, Sylwia Hyniewska3, Julia Wyszomirska4, Agnieszka Pluta2, Marta Sobańska2 and Emilia Łojek2
- Department of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
- Department of Experimental Psychology, University College London, London, U.K.
- Department of Psychology, Medical University of Silesia, Katowice, Poland