Toward a cohesive clinical interpretation of mental disorders in SARS-CoV-2 pandemic: An expert opinion

Abstract

As the COVID-19 pandemic progresses, the observed increase in mental health issues requires more and more clinical attention. Mental disorders have become a major cause for disturbances in social adjustment, primarily due to disorders that fall into three clusters: Prolonged fatigue (asthenia) with cognitive impairment; anxiety disorders with sleep disorders; and depression. The last two are also found in individuals who have not contracted SARSCoV- 2; they are seen as a result of their exposure to the stress of the pandemic. Therefore, to successfully manage the consequences of the pandemic, it is necessary to develop a cohesive clinical interpretation of mental disorders related to COVID-19 infection. Our proposed model would encompass all the above manifestations as follows: A) for the general population - by the triad of 'nosogenic reactions' with excessive (hyper-), normal (normo-) or ignoring (hyponosognostic) psychological responses to stress related to the semantics and individual signifi cance of the SARS-CoV-2 diagnosis (nosos); b) for long COVID - by the biopsychosocial model as a typical combination of neurotoxic asthenia with cognitive impairment (Bonhoeff er's neurobiological factor) that exacerbates 'nosogenic' anxiety and sleep disorders (psychological factor) and thus provokes a depressive response (as a social maladaptive factor).