The COVID-19 pandemic is associated with several psychiatric manifestations leaving undoubtedly psychological consequences. However by escaping death ,do COVID-19 survivors present a higher risk for suicide ?

In this study, we aimed to explore suicidal risk among recovering COVID 19 patients .

Our literature review was based on the PubMed interface and adapted for 2 databases: Science Direct and Google Scholar using the following combination ( suicide [MeSH terms]) AND (COVID-19 survivors[MeSH terms]).

Recovering COVID 19 patients are at risk for developping posttraumatic stress disorder , anxiety , depression and sleep abnormalities , especially in severe forms. Added to that ,cognitive impairment was largely described in COVID 19 causing judgment and reasoning decline. These manifestations would partially explain the suicidiality among survivors regardless to their medical hisotry. Nonetheless,many COVID-19 survivors experience persistent physical symptoms and psychiatric disorders leading to post-COVID syndrome which is associated with increased suicidal ideation and behavior In addition , social factors are considered as a suicide risk factor such as isolation ,loss of loved ones ,loss of job and economic instability .

Over the course of illness , COVID 19 survivors may suffer from psychiatric and medical conditions leading to serieous suicide risk. Therefore ,suicide prevention interventions and appropriate medical management need to be provided to keep survivors alive .

No significant relationships.

Suicide is a phenomenon that is increasing in prevalence. Exposure to suicide by a loved one can be experienced as a traumatic event, capable of precipitating or aggravating preexisting psychiatric conditions. As much as we are clinically aware of gravity situation experienced by suicide survivors, there is a marked lack of studies on psychotherapeutic interventions in this population group.

The present work aims to review the literature on the psychodynamic treatment of suicide survivors, considering their theoretical and technical aspects.

Narrative review of psychiatric and psychoanalytic literature.

The initial reaction described on becoming aware of the suicide of someone close to you is of disbelief, shock and helplessness. This is followed by ambivalent feelings of hate and guilt, shame and hopelessness. Sometimes, a chronic depressive state expressed by the survivor’s guilt can emerge. The mourning work will initially encounter resistance to face the loss of the object, through mechanisms such as denial, repression and psychotic fantasies. The lost suicide has a traumatic impact, modifying relational patterns and it is commonly associated with important isolation. The survivor will be able to transfer via fear the death of the therapist and even fantasize that he will also kill himself.

Psychodynamic psychotherapy with suicide survivors finds theoretical and practical foundations in the literature, mainly through discussions of reports clinical and theoretical reviews on the topic. Through transfer and therapeutic alliance, new patterns of object relation can be sketched, in a context of mourning so often complicated by shutdown pressures and loneliness.

No significant relationships.

Psychological distress is a common symptom after natural disasters. Although musculoskeletal pain also increases after natural disasters, its relation to psychological distress is not known. This study aimed to examine the association of musculoskeletal pain with new-onset psychological distress among survivors of the Great East Japan Earthquake.

A panel study was conducted with survivors at 2 and 3 years after the Great East Japan Earthquake. New-onset psychological distress was defined as psychological distress absent at 2 years and present at 3 years after the disaster. The number of musculoskeletal pain sites at 2 years after the disaster was divided into 3 categories (0, 1, and ≥2). Multivariate logistic regression models were used to calculate the odds ratio and 95% confidence interval for new-onset psychological distress according to the number of musculoskeletal pain sites.

The rate of new-onset psychological distress was 6.7%. Musculoskeletal pain was associated with new-onset psychological distress. Using “0” as a reference, the adjusted odds ratios (95% confidence interval) were 1.65 (0.92-2.95) in “1” and 2.12 (1.24-3.64) in “≥2” (P for trend=.02).

Musculoskeletal pain is associated with new-onset psychological distress among survivors of the Great East Japan Earthquake. (Disaster Med Public Health Preparedness. 2019;13:295–300)

Sleep can affect quality of life (QoL) during cancer survivorship, and symptoms related to poor sleep can be exacerbated. We examined the prevalence, severity, and nature of subjective sleep complaints in women surviving stage I–III breast cancer who were 1–10 years posttreatment. We also examined the demographic, medical, physical, and psychosocial correlates of poor sleep in these women in order to identify the subgroups that may be most in need of intervention.

A total of 200 patients at a comprehensive cancer center who were 1–10 years posttreatment for primary stage I–III breast cancer with no evidence of disease at the time of enrollment completed a battery of questionnaires on demographics, sleep, physical symptoms, mood, cancer-specific fears, and QoL.

The women had a mean age of 57 years (SD = 10.0), with a mean of 63.3 months (SD = 28.8) of post-cancer treatment. Some 38% of these patients were identified as having poor-quality sleep. Women with poor sleep took longer to fall asleep, had more awakenings, and acquired 2 hours less sleep per night than those with good sleep. They also had a lower QoL, greater severity of pain, more concerns about health and recurrence, and increased vasomotor symptoms (p < 0.05). Daytime sleepiness and depression were found to be not significantly correlated with sleep quality.

Many breast cancer survivors had severe subjective insomnia, and several breast cancer survivor subgroups were identified as having members who might be most in need of sleep-improvement interventions. Addressing physical symptoms (e.g., vasomotor symptoms and pain) and providing education about the behavioral, social, environmental, and medical factors that affect sleep could result in substantial improvement in the life course of breast cancer survivors.