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The Mental Health Consequences of COVID-19 and Physical DistancingThe Need for Prevention and Early Intervention

Educational Objective
To understand how physical distancing can affect the mental health of patients
1 Credit CME

Since the first case of novel coronavirus disease 2019 (COVID-19) was diagnosed in December 2019, it has swept across the world and galvanized global action. This has brought unprecedented efforts to institute the practice of physical distancing (called in most cases “social distancing”) in countries all over the world, resulting in changes in national behavioral patterns and shutdowns of usual day-to-day functioning.

While these steps may be critical to mitigate the spread of this disease, they will undoubtedly have consequences for mental health and well-being in both the short and long term. These consequences are of sufficient importance that immediate efforts focused on prevention and direct intervention are needed to address the impact of the outbreak on individual and population level mental health.

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Article Information

Corresponding Author: Sandro Galea, MD, Office of the Dean, Boston University School of Public Health, 715 Albany St, Talbot 301, Boston, MA 02118 (sgalea@bu.edu).

Published Online: April 10, 2020. doi:10.1001/jamainternmed.2020.1562

Conflict of Interest Disclosures: None reported.

References
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Neria  Y , Nandi  A , Galea  S .  Post-traumatic stress disorder following disasters: a systematic review.   Psychol Med. 2008;38(4):467-480. doi:10.1017/S0033291707001353 PubMedGoogle ScholarCrossref
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Tracy  M , Norris  FH , Galea  S .  Differences in the determinants of posttraumatic stress disorder and depression after a mass traumatic event.   Depress Anxiety. 2011;28(8):666-675. doi:10.1002/da.20838 PubMedGoogle ScholarCrossref
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Galea  S , Ahern  J , Resnick  H ,  et al.  Psychological sequelae of the September 11 terrorist attacks in New York City.   N Engl J Med. 2002;346(13):982-987. doi:10.1056/NEJMsa013404 PubMedGoogle ScholarCrossref
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Vlahov  D , Galea  S , Ahern  J , Resnick  H , Kilpatrick  D .  Sustained increased consumption of cigarettes, alcohol, and marijuana among Manhattan residents after September 11, 2001.   Am J Public Health. 2004;94(2):253-254. doi:10.2105/AJPH.94.2.253 PubMedGoogle ScholarCrossref
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Grattan  LM , Roberts  S , Mahan  WT  Jr , McLaughlin  PK , Otwell  WS , Morris  JG  Jr .  The early psychological impacts of the Deepwater Horizon oil spill on Florida and Alabama communities.   Environ Health Perspect. 2011;119(6):838-843. doi:10.1289/ehp.1002915 PubMedGoogle ScholarCrossref
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Lee  AM , Wong  JG , McAlonan  GM ,  et al.  Stress and psychological distress among SARS survivors 1 year after the outbreak.   Can J Psychiatry. 2007;52(4):233-240. doi:10.1177/070674370705200405PubMedGoogle ScholarCrossref
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Mental Health UK. Managing your mental health during the coronavirus outbreak. https://mentalhealth-uk.org/help-and-information/covid-19-and-your-mental-health/. Accessed March 31, 2020.
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Merchant  RM , Lurie  N .  Social media and emergency preparedness in response to novel coronavirus  [published online March 23, 2020].  JAMA. doi:10.1001/jama.2020.4469 PubMedGoogle Scholar
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Cohen  GH , Tamrakar  S , Lowe  S ,  et al.  Comparison of simulated treatment and cost-effectiveness of a stepped care case-finding intervention vs usual care for posttraumatic stress disorder after a natural disaster.   JAMA Psychiatry. 2017;74(12):1251-1258. doi:10.1001/jamapsychiatry.2017.3037 PubMedGoogle ScholarCrossref
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List of services payable under the Medicare Physician Fee Schedule when furnished via telehealth. https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes Accessed April 1, 2020.
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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