Authors
Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract
Coronavirus disease 2019 (COVID‑19) has caused different kinds of psychological consequences.
Identifying and providing psychological plans and protocols can be effective in promoting patients’
mental health. The study was conducted to investigate the effect of psychological interventions in
response to stress, anxiety, and depression in COVID‑19 patients. The present study was performed
based on a systematic review. The studies were done by using different combinations of keywords
in databases such as Science Direct, ProQuest, PubMed, and Google scholar search engines and
in Persian databases such as Magiran, SID, Iranmedex from July 25 to September 7, 2020. Out
of 4533 articles that were found after extensive search, 9 articles were evaluated and qualitatively
analyzed for data extraction with the 2010 consort checklist. The final articles were from different
countries of China, the USA, France, Italy, and Iran and were about COVID‑19 patients and their
health‑care providers. Interventions ranged from relaxation, music therapy to mental health and
extensive psychological skills including adaptation methods, mindfulness and self‑care, and crisis
management. Anxiety was the highest and then stress and depression were the next indicators. The
results showed a positive effect of these interventions on stress, anxiety, depression, and even the
quality of life, sleep and family and child function. The number of studies in this field is increasing. We
see a variety of psychological and educational interventions every day. It is hoped that by designing
standard protocols for psychological intervention, effective steps can be taken to improve the mental
health of patients and health‑care providers.
Keywords
- Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan,
China. Glob Health Res Policy 2020;5:6.
2. OrganizationWH. Iran (Islamic Republic of) Situation 2020/10/17.
Available from: https://covid19.who.int/region/emro
/country/ir.
3. Organization WH. Rolling updates on coronavirus
disease (COVID‑19 25 May 2020. Available from: https://www.
who.int/emergencies/diseases/novel‑coronavirus‑2019/eventsas-they-happen.
4. Liu D, Ren Y, Yan F, Li Y, Xu X, Yu X, et al., Psychological
Impact and Predisposing Factors of the Coronavirus Disease
2019 (COVID‑19) Pandemic on General Public in China. 2020.
5. Bo HX, Li W, Yang Y, Wang Y, Zhang Q, Cheung T, et al.
Posttraumatic stress symptoms and attitude toward crisis mental
health services among clinically stable patients with COVID‑19
in China. Psychol Med 2021;51:1052‑3.
6. LimaCK, CarvalhoPM, Lima IA, Nunes JV, Saraiva JS, de SouzaRI,
et al. The emotional impact of coronavirus 2019‑nCoV (new
coronavirus disease). Psychiatry Res 2020;287:112915.
7. Yao H, Chen JH, Xu YF. Patients with mental health disorders in
the COVID‑19 epidemic. Lancet Psychiatry 2020;7:e21.
8. Karim l, khalili R, Sirati Nir M. Prevalence of various psychological
disorders during the COVID‑19 pandemic: Systematic review.
J Mil Med 2020;22:648‑62.
9. Salari N, Hosseinian‑FarA, JalaliR, Vaisi‑RayganiA, Rasoulpoor S,
Mohammadi M, et al. Prevalence of stress, anxiety, depression
among the general population during the COVID‑19 pandemic:
A systematic review and meta‑analysis. Global Health 2020;16:57.
10. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide
survey of psychological distress among Chinese people in the
COVID‑19 epidemic: Implications and policy recommendations.
Gen Psychiatr 2020;33:e100213.
11. Yang L, Danjuan Wu, Yanbin Hou, Xunqiang Wang, Ni Dai,
Guanjun Wang, et al. Analysis of psychological state and clinical
psychological intervention model of patients with COVID‑19.
medRxiv 2020;1‑8.
12. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated
with mental health outcomes among health care workers exposed
to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.
13. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate
psychological responses and associated factors during the initial
stage of the 2019 coronavirus disease (COVID‑19) epidemic
among the general population in China. Int J Environ Res Public
Health 2020;17:E1729.
14. Liu S, Yang L, Zhang C, Xiang YT, Liu Z, Hu S, et al. Online mental
health services in China during the COVID‑19 outbreak. Lancet
Psychiatry 2020;7:e17‑8.
15. Qi J, Xu J, Li BZ, Huang JS, Yang Y, Zhang ZT, et al. The evaluation
of sleep disturbances for Chinese frontline medical workers under
the outbreak of COVID‑19. Sleep medicine. 2020 Aug 1;72:1‑4.
16. Kwok KO, Li KK, Chan HH, Yi YY, Tang A, Wei WI, et al.
Community responses during the early phase of the COVID‑19
epidemic in Hong Kong: Risk perception, information exposure
and preventive measures. medRxiv preprint 2020.
17. Jiang Y. Psychological impact and coping strategies of frontline
medical staff in Hunan between January and March 2020 during
the outbreak of coronavirus disease 2019 (COVID19) in Hubei,
China. Med Sci Monit 2020;26:e924171.
18. Xiao H, Zhang Y, Kong D, Li S, Yang N. Social capital and sleep
quality in individuals who self‑isolated for 14 days during the
coronavirus disease 2019 (COVID‑19) outbreak in January 2020
in China. Med Sci Monit 2020;26:e923921.
19. 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;17:E2032.
20. Pieh C, Budimir S, Probst T. Mental health during COVID‑19
lockdown: A comparison of Austria and the UK SSRN Electron.
J. 2020;. 10.2139/ssrn. 3592372. [Epub ahead of print].
21. Huang Y, Zhao N. Generalized anxiety disorder, depressive
symptoms and sleep quality during COVID‑19 epidemic in China:
A web‑based cross‑sectional survey. medRxiv 2020; 288:112954.
22. Ying Y, Ruan L, Kong F, Zhu B, Ji Y, Lou Z et al. Mental health
status among family members of health care workers in Ningbo,
China during the coronavirus disease 2019 (COVID‑19) outbreak:
A Cross‑sectional Study. BMC psychiatry. 2020 Dec;20(1):1‑10.
23. Hall RC, Hall RC, Chapman MJ. The 1995 Kikwit Ebola outbreak:
Lessons hospitals and physicians can apply to future viral
epidemics. General hospital psychiatry. 2008 Sep 1;30(5):446‑52.
24. Valencia-Garcia D, Simoni JM, Alegría M, Takeuchi DT. Social
capital, acculturation, mental health, and perceived access to
services among Mexican American women. Journal of consulting
and clinical psychology. 2012 Apr;80(2):177.
25. Eisazadeh F, Dehkordi MA, Aghajanbigloo S. Psychological
consequences of patients with coronavirus (COVID‑19):
A qualitative study. Biquarterly Iran J Health Psychol 2020;2:9‑20. - 26. Li C, Jiang S, Fang X. Effects of multi‑dimensional social capital
on mental health of children in poverty: An empirical study in
Mainland China. J Health Psychol 2020;25:853‑67.
27. Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma AS,
Muana AT, et al. Psychosocial effects of an Ebola outbreak at
individual, community and international levels. Bull World
Health Organ 2016;94:210‑4.
28. Xiao H, ZhangY, KongD, Li S, Yang N. The effects of social support
on sleep quality of medical staff treating patients with coronavirus
disease 2019(COVID‑19) in January and February 2020 in China. Med
Sci Monit 2020;26:e923549.‑1.
29. Wei N, Huang BC, Lu SJ, Hu JB, Zhou XY, Hu CC, et al. Efficacy
of internet‑based integrated intervention on depression and
anxiety symptoms in patients with COVID‑19. J Zhejiang Univ
Sci B 2020;21:400‑4.
30. XiaoCX, LinYJ, LinRQ, LiuAN, ZhongGQ, LanCF. Effects of progressive
muscle relaxation training on negative emotions and sleep quality in
COVID‑19patients: Aclinical observational study. Medicine(Baltimore)
2020;99:e23185.
31. James Riegler, L., Raj, S. P., Moscato, E. L., Narad, M. E.,
Kincaid, A., & Wade, S. L. Pilot trial of a telepsychotherapy
parenting skills intervention for veteran families: Implications
for managing parenting stress during COVID‑19. Journal of
Psychotherapy Integration 2020:30(2); 290–303.
32. Weiner L, Berna F, Nourry N, Severac F, Vidailhet P, Mengin AC.
Efficacy of an online cognitive behavioral therapy program
developed for healthcare workers during the COVID‑19
pandemic: The REduction of STress (REST) study protocol for a
randomized controlled trial. Trials 2020;21:870.
33. Pizzoli SM, Marzorati C, Mazzoni D, Pravettoni G. An
internet‑based intervention to alleviate stress during social
isolation with guided relaxation and meditation: Protocol for a
randomized controlled trial. JMIR Res Protoc 2020;9:e19236.
34. Giordano F, Scarlata E, Baroni M, Gentile E, Puntillo F, Brienza N,
et al. Receptive music therapy to reduce stress and improve
wellbeing in Italian clinical staff involved in COVID‑19 pandemic:
A preliminary study. Arts Psychother 2020;70:101688.
35. Gharaati Sotoudeh H, Alavi SS, Akbari Z, Jannatifard F,
Artounian V. The effect of brief crisis intervention package on
improving quality of life and mental health in patients with
COVID‑19. Iran J Psychiatry 2020;15:205‑12.
36. Thombs BD, Kwakkenbos L, Carrier ME, Bourgeault A, Tao L,
Harb S, Gagarine M, Rice D, Bustamante L, Ellis K, Duchek D.
Protocol for a partially nested randomised controlled trial to
evaluate the effectiveness of the scleroderma patient‑centered
intervention network COVID‑19 home‑isolation activities
together (SPIN‑CHAT) program to reduce anxiety among
at‑risk scleroderma patients. Journal of psychosomatic research.
2020 Aug 1;135:110‑132.
37. Li W, Yang Y, Liu ZH, Zhao YJ, Zhang Q, Zhang L, et al.
Progression of mental health services during the COVID‑19
outbreak in China. Int J Biol Sci 2020;16:1732‑8.
38. Chew QH, Wei KC, Vasoo S, Chua HC, Sim K. Narrative synthesis
of psychological and coping responses towards emerging
infectious disease outbreaks in the general population: practical
considerations for the COVID-19 pandemic. Singapore medical
journal. 2020 Jul;61(7):350.
39. Cheng SK, Wong CW. Psychological intervention with sufferers
from severe acute respiratory syndrome (SARS): Lessons learnt
from empirical findings. Clin Psychol Psychother 2005;12:80‑6.
40. Ho CS, Chee CY, Ho RC. Mental health strategies to combat the
psychological impact of COVID‑19 beyond paranoia and panic.
Ann Acad Med Singapore 2020;49:1‑3.
41. Wilczyńska D, Łysak-Radomska A, Podczarska-Głowacka M, Zajt
J, Dornowski M, Skonieczny P. Evaluation of the effectiveness of
relaxation in lowering the level of anxiety in young adults‑a pilot
study. Int J Occup Med Environ Health 2019;32:817‑24.
42. Aksu NT, Erdogan A, Ozgur N. Effects of progressive muscle
relaxation training on sleep and quality of life in patients with
pulmonary resection. Sleep Breath 2018;22:695‑702.
43. Fallek R, Corey K, Qamar A, Vernisie SN, Hoberman A,
Selwyn PA, et al. Soothing the heart with music: A feasibility study
of a bedside music therapy intervention for critically ill patients
in an urban hospital setting. Palliat Support Care 2020;18:47‑54.
44. Warren FC, KuykenW, TaylorRS, Whalley B, Crane C, Bondolfi G,
et al. Efficacy and moderators of mindfulness‑based cognitive
therapy in prevention of depressive relapse: An individual patient
data meta‑analysis from randomized trials. JAMA Psychiatry 2016
E1‑E10.
45. Carlson LE. Mindfulness‑based interventions for physical
conditions: A narrative review evaluating levels of evidence.
ISRN Psychiatry 2012:1‑21.
46. Bushell W, Castle R, Williams MA, Brouwer KC, Tanzi RE,
Chopra D et al. Meditation and yoga practices as potential
adjunctive treatment of SARS‑CoV‑2 infection and COVID‑19:
A brief overview of key subjects. The Journal of Alternative and
Complementary Medicine. 2020 Jul 1;26(7):547‑56.
47. Main A, Zhou Q, Ma Y, Luecken LJ, Liu X. Relations of
SARS‑related stressors and coping to Chinese college students’
psychological adjustment during the 2003 Beijing SARS epidemic.
J Couns Psychol 2011;58:410.
48. Wong TW, Yau JK, Chan CL, Kwong RS, Ho SM, Lau CC, et al.
The psychological impact of severe acute respiratory syndrome
outbreak on healthcare workers in emergency departments and
how they cope. Eur J Emerg Med 2005;12:13‑8.
49. Raven J, Wurie H, Witter S. Health workers’ experiences of
coping with the Ebola epidemic in Sierra Leone’s health system:
A qualitative study. BMC Health Serv Res 2018;18:51.