Mental health during COVID-19 pandemic/Baghdad Al-Karkh

Psychological disturbances among Al-Karkh PHCs clients

In the current study we can notice that in one hand comprehensive view to the total numbers of mental health problems during 2020 up to August reflect decrement in the frequency of Al-Karkh health centers clients than 2019. This might be due to lock down and home confinement strategies in the months preceding August that prohibit patients with psychological disturbances to attend health centers, even public transport in many regions has been suspended to lower the risk of disease transmission in addition to unstable security situations before that date. This is similar to previous outbreaks have reported that psychological impact of quarantine can vary from immediate effects, like irritability, fear of contracting and spreading infection to family members, anger, confusion, frustration, loneliness, denial, anxiety, depression, insomnia, despair, to extremes of consequences, including suicide (Dubey et al., 2020).

On the other hand the percentages of psychological disturbances among clients attending Al-Karkh Health Directorate’s PHCs significantly hiked up during August 2020 more than in August 2019, this mostly attributed to the dependence of the strategy of (containment of the epidemic) so no more lockdown and the clients can easily attend the health centers, especially with existence of the miss interpretation of the removal of lockdown as the end of COVID-19 pandemic and returning back to normal life, in addition long term lockdown causes unavailability of community services and collapse of many industries, consequently negative impact on local and national economic stabilities. Furthermore, the affected people with COVID-19 were subjected to social rejection, discrimination and stigmatization making them more vulnerable to get psychological problems. Also, more people bereaved from the death of dear friends, colleagues, and loved ones due to COVID-19 can result psychological trauma and long-term psychiatric problems. Other possible reason for hiking up of number of clients in August 2020 was that psychiatric patients were more prone to develop recurrences or deterioration of the preexisting signs and symptoms. Therefore because of the above enlisted causes, immediately after removal of lockdown the number of clients attending mental health unit hiked up. This is consistent with the results of study conducted in Spain revealed that about 36% of the participants reported moderate to severe psychological impact, 25% showed mild to severe levels of anxiety, 41% reported depressive symptoms, and 41% felt stressed (Rodríguez-Rey et al., 2020).

Depression among Al-Karkh PHCs attendants

The least number of depressive clients during 2020 was in April this might be attributed to fueling of this period by an infodemic spread via different platforms of social media and outburst of myths that the COVID-19 virus will fade out immediately after Ramadan in addition to absence of universities and schools consequently no stress of courses and no exams, since lockdown was persistent during this period. The number of cases started to increase abruptly in August this might be attributed to the prolonged effect of lockdown in the previous months intensifying the negative emotions experienced by the general population during the COVID-19 pandemic.

A study conducted in India by Chakraborty and Chatterjee (2020) about the psychological impact of COVID-19 pandemic on general population noted that the majority of the responders felt worried about financial restraint during lockdown.

General anxiety disorder among Al-Karkh PHCs’s clients

The greatest number of general anxiety disorder among Al-Karkh PHC’s clients was in January, this is similar to the results of study conducted in China by Li et al. (2020) determined that anxiety have been increased after declaration of COVID-19 on January 20, 2020.

The number of general anxiety disorder cases among Al-Karkh health centers’ clients gradually increased abruptly in August. This might be due to prolonged period of lockdown with their uncertainty about their health status in addition considerable number of clients developed obsessive-compulsive symptoms, such as repeated temperature checks and hands sterilization, those are more likely to misinterpret harmless bodily symptoms and feelings as the evidence of acquiring COVID-19. This, in turn, imposing unnecessary burden to public health care. (Chen et al., 2020)

Post traumatic stress disorder among Al-Karkh PHCs clients

The mass fear of COVID-19, rightly termed as ‘coronaphobia’, in our study the cases of PTSD abruptly increase in August, his might be due to the increased numbers of death, and rapid acceleration in the number of new cases with expansive media attention about the uncertain character of the virus, unpredictable course of the disease can heighten people’s fears and stress.

Psychosis and behavioral abnormalities among clients/Al-Karkh PHCs

In our study both Psychosis and behavioral abnormalities showed remarkable decrease in cases during months preceding August this could be attributed to regulations regarding transport and quarantine can abruptly discontinue the therapeutic counseling schedules and impose utmost difficulties upon access of prescribed psychiatric medications.

Gender and mental health problems among Al-Karkh PHCs clients

In our study there was significant difference between male and female clients in (mental disturbances, depression, violence, anxiety, post-traumatic stress disorders).

Women and girls face specific and often disproportionate economic, health, and social risks due to deeply entrenched inequalities, social norms and unequal power relations. Understanding the gender – differentiated impacts of the COVID-19 crisis through gender disaggregation data is fundamental to strengthen women’s agency and building a more just and resilient world (Rivera et al., 2020).