Digital Therapeutic to Treat Adjustment Disorders during COVID-19

Digital Therapeutic to Treat Adjustment Disorders during Coronavirus covid-19 Pandemic
Digital Therapeutic to Treat Adjustment Disorders during Coronavirus covid-19 Pandemic


Rational

Among public health measures to control the spread of coronavirus during COVID-19 pandemic in the absence of a vaccine, lockdown, quarantine and isolation have proven to be effective.

To be forced to stay home for a long time may represent a difficult and stressing experience to manage (1,2).

Separation from loved ones, loss of freedom, uncertainty about the evolution of the pandemic, fear of infection, boredom, fear of economic consequences can have negative effects on the mental health of the population, whose dimension is, for the moment, only conceivable.

Exposure to these stressors can give rise to symptoms of depression or anxiety, more intense than normally expected and which provide the elements to diagnose an Adjustment Disorder.

Adjustment Disorders occur when a subject who has recently been exposed to one or more sources of stress cannot “adapt” to the experience, but develops an abnormal emotional and behavioural response.

Onset of generic manifestations of anger and aggression, increased quarrelsomeness and interpersonal conflicts (3), increased cases of suicide (4), compromised intra-family relationships following the imposition of movement restriction, quarantine and isolation (1,2) are reported in the literature  from previous epidemics.

All these psychological and behavioural aspects should be carefully assessed as symptoms of possible Adjustment Disorders with depressed, anxious or mixed mood, or as part of past psychopathologies exacerbated by the intense stress related to the pandemic.

In view of the current situation and evolution of the COVID-19 pandemic, there is an urgent need for action to counteract adverse mental health effects in the population as a consequence of lockdown, quarantine and isolation and to promote the mental well-being of the population.

Digital Therapeutics, in the form of an application for mobile devices delivering evidence – based health care may be used by the whole population and offer a personalized treatment at low cost (5,6, 7).

The availability of a Digital Therapeutic will also allow the collection of real time data on the psychological impact of pandemic on the population, that may be used to plan the best actions for subsequent pandemics.

Objectives

  1. To research, design and develop a Digital Therapeutic for adult citizens as a smartphone, tablet or PC application, to treat Adjustment Disorders as a cosequnce of quarantine and isolation associated with the coronavirus pandemic emergency
  2. To collect data on the adverse mental health effects of the current pandemic

References

  1. Samantha K Brooks, Rebecca K Webster, Louise E Smith, Lisa Woodland, Simon Wessely, Neil Greenberg, Gideon James Rubin. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet, Published online February 26, 2019
  2. Kimberley Smith. The association between loneliness, social isolation and inflammation: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, in press 2020
  3. Miles SH. Kaci Hickox: public health and the politics of fear. 2014.
    http://www.bioethics.net/2014/11/kacihickoxpublichealthandthepoliticsoffear/
  4. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep 2015; 9: 547–53.
  5. NHSX tech funding to support people in isolation from coronavirus
    https://www.digitalhealth.net/2020/03/nhsx-tech-funding-to-support-people-in-isolation-fromcoronavirus/
  6. Digital Therapeutics Alliance. Finding Value in Digital Therapeutics During COVID-19. https://dtxalliance.org/2020/03/19/finding-value-in-dtx-products-during-covid-19/
  7. Damir Huremović Editor. Psychiatry of Pandemics. A Mental Health Response to Infection Outbreak. Springer Nature Switzerland AG 2019

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