Telephonic survey and psychological aid for patients with somatic symptom disorders for the impact of lockdown and COVID-19 pandemic

Patients with somatic symptom disorders often indulge in doctor shopping, excessive self-medication, abuse of prescribed medications and frequent request for investigations (Grover et al., 2013; Reid et al., 2001; Sharpe & Mayou, 2004). Lockdown due to COVID-19 has brought down the health care services to stand still. To the extent that outpatient services are closed to a large extent, the investigation facilities are closed, and the medication stores are sparsely opened. Accordingly, the lockdown situation has ruled out the fulfilment of the medical needs of patients with somatoform disorders. Further, the outbreak of COVID-19 has led to significant stress in people of all age groups. Experiencing overwhelming fear and anxiety about the disease or its consequences is supposed to be shared among populations worldwide (Grover et al., 2020). The COVID-19 pandemic and the lockdown make people with somatoform disorders more vulnerable to experience distress. If we look at the needs of the patients with somatoform disorder and the absence of routine healthcare services, it can be expected that it can lead to significant distress among these patients. This study aimed to evaluate the psychosocial impact of lockdown on patients with somatoform disorders. This was a telephonic survey, in which patients diagnosed with somatic symptom disorder as per the DSM-5 criteria, by using MINI-PLUS (Sheehan et al., 1998), as part of a previous project (Naskar et al., 2020) were contacted. A new submission was made to the Ethics Committee for contacting these patients for assessment and single-session intervention. These patients were aged ⩾18 years, had symptoms for at least 1 year, and were educated up to at least Class 5th. Seventy-one (69%) patients participated in the telephonic interview agreed to participate. Patients provided verbal consent for being part of the study. The mean age of the study participants was 40.8 (SD: 9.54; range 21–60 years) with the mean number of years of education being 8.7 (SD: 4.3; range 5–18 years). More than half of the participants were males (57.7%). At the initial assessment on MINI-PLUS, small proportion patients (n = 9) had an additional psychiatric diagnosis in the form of mood disorder in the past (N = 4), dysthymia (N = 2) and panic disorder (N = 2). In terms of the type of symptoms reported spontaneously on the telephonic interview, aches and pains (56.6%) were the most commonly reported symptoms, followed by weakness (26.4%), headache (16.9%), gastrointestinal symptoms (15.1%), sleep disturbances (15.1%) and anxiety (11.3%). When asked about the various other dimensions of life after the beginning of lockdown, about half of the participants reported worsening of anxiety (47.9%), about one-third reported worsening of sleep (33.8%), one-fourth reported worsening of the current level of functioning (29.6%) and about one-fifth reported worsening of mood (18.3%). More than one-third of the participants reported worsening of somatic symptoms since the lockdown (37.6%). In terms of the distress of not being able to visit a doctor, 40.8% said the same to be distressing. Small proportion reported consumption of over-the-counter medications (8.5%) and another small portion reported overdosing themselves with prescribed medications (8.5%). About one-eighth (12.7%) reported self-medicating themselves, and 15.5% reported resorting to faith healing since the beginning of lockdown, and 8.4% reported an increase in religious practices since the onset of lockdown. A small proportion (8.4%) said that lockdown has resulted in discontinuation of the medications. These patients were provided single session psychological aid depending on their needs. The major principles that were followed in providing psychological assistance included reassurance, keeping themselves busy to stay distracted from the symptoms, continuing with the prescribed medications and maintaining a daily routine and sleep Telephonic survey and psychological aid for patients with somatic symptom disorders for the impact of lockdown and COVID-19 pandemic