Uncorrected Proof
Iran J Psychiatry Behav Sci. In Press(In Press):e103865.
Published online 2020 May 2.
doi: 10.5812/ijpbs.103865.
Letter
Stress Reduction Model of COVID-19 Pandemic
Mohsen Khosravi
1, *
1
Department of Psychiatry and Clinical Psychology, Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
*
Corresponding author: Department of Psychiatry and Clinical Psychology, Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Postal Code: 9813913777,
Zahedan, Iran. Tel: +98-5433522636, Fax: +98-5433518352, Email: dr_khosravi2016@yahoo.com
Received 2020 April 17; Accepted 2020 April 21.
Keywords: COVID-19, Pandemics, Stress
Dear Editor,
Coronavirus disease 2019 (COVID-19), referred to as
2019-nCoV and SARS-CoV2, has attracted global attention
after appearing in Wuhan, China, in the late December
2019, followed by being introduced as a pandemic by the
WHO (1). In recent months, measures taken to identify
the destructive effects of this epidemic on public men-
tal health have failed despite concentrations on epidemi-
ology, clinical features, transmission patterns, and man-
agement of COVID-19 (2). Previous studies have suggested
that pandemics impose a broad spectrum of psychologi-
cal impacts. At the individual level, these adverse effects
can cause new psychiatric symptoms, intensify the pre-
existing mental illnesses, and induce distress in caregivers
of infected patients. Accordingly, in such a condition, so-
ciety members may undergo some negative experiences,
such as fear and anxiety about falling sick or dying and
helplessness, which can potentially cause mental break-
down (3). Likewise, it is believed that the COVID-19 pan-
demic can significantly affect public mental health and
well-being in addition to physical health (4). From a psy-
chopathological viewpoint, the current pandemic can be
assumed as a relatively new form of stressor or trauma for
several reasons. First, unlike natural disasters, the COVID-
19 pandemic is not a temporary emergency limited to a spe-
cific region. In other words, this threat can exist in every
region and be transmitted from person to person (2). Sec-
ond, social isolation programs such as quarantine, physi-
cal distancing, and self-isolation may cause different psy-
chological problems due to limiting normal adaptive cop-
ing strategies, namely social interactions, exercises, and
leisure time. On the other hand, isolated infected patients
cannot see their close ones, which intensifies their suffer-
ing (5). Third, some specific characteristics in COVID-19,
such as uncertain incubation period of the virus, possibly
asymptomatic transmission, a rapidly increasing number
of confirmed cases and deaths, and lack of specific treat-
ment or vaccine against the novel coronavirus, have esca-
lated the fear and anxiety among the general population
(1, 5). The final negative effect is the stigma of disease im-
posed on suspected cases, confirmed patients, and their
families (even after being recovered) by society (1, 6). There-
fore, the psychosocial consequences of the COVID-19 pan-
demic seem to be more severe for several groups of peo-
ple and may put them in need of immediate follow-ups.
These groups include (1) confirmed patients, (2) suspected
cases, (3) susceptible persons, particularly those who are
vulnerable to biopsychosocial stressors, (4) people who are
directly or indirectly in contact with the virus, (5) patients
who refuse to seek care, and (6) health professionals and
healthcare workers (4).
According to the recent experiences, on January 26th,
2020, the National Health Commission of China released a
statement about reducing the negative effects of COVID-19
pandemic on public mental health. The statement clearly
emphasizes the importance of psychological crisis inter-
ventions as part of the public health response to the cur-
rent pandemic (5). However, one of the drawbacks of this
statement is disregarding the mobilization and coordina-
tion of different groups and the undeniable role of the gov-
ernment and society members in providing public mental
health and well-being.
Accordingly, the proposed model of this paper clas-
sifies stress-reduction programs into three subcate-
gories, including individual-level, government-level, and
professional-level implementation strategies, and ad-
dresses the essential roles of these groups in the reduction
of long-term psychological consequences of COVID-19 pan-
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