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Comparação entre o impacto na saúde mental de (1) medidas de saúde pública de confinamento e (2) encarceramento em serviços prisionais
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INTRODUÇÃO: Durante a pandemia de COVID-19, têm sido utilizadas medidas de Saúde Pública, como a quarentena, o isolamento, o distanciamento social e a contenção comunitária. Estas medidas podem causar efeitos deletérios na Saúde Mental da população em geral. Nos serviços prisionais, a restrição da liberdade e os consequentes efeitos na Saúde Mental estão presentes de forma permanente. A presente revisão pretende aferir o impacto na Saúde Mental destas duas medidas de restrição de liberdade e concluir com algumas recomendações sobre como minimizar o mesmo.
MÉTODOS: Pesquisa, na base de dados PubMed®, de artigos que aferiram o impacto das medidas de confinamento ou do encarceramento na Saúde Mental, até abril de 2021. Foram encontrados 1340 artigos e selecionados 135 para inclusão nesta revisão.
DISCUSSÃO: As medidas de confinamento provocaram uma disrupção da rotina diária e variados efeitos a nível emocional. Constatou-se um aumento da prevalência de ansiedade, depressão, perturbações associadas ao stress, insónia e sofrimento psicológico. A nível comportamental, registaram-se efeitos prejudiciais significativos em diversas áreas. Foram encontrados vários fatores de risco e identificadas populações de particular vulnerabilidade, assim como fatores protetores relativamente a este impacto psicológico. Sugerem-se algumas medidas que podem mitigar o efeito deletério das medidas de confinamento.
Relativamente ao encarceramento em serviços prisionais, discutem-se os vários fatores que podem explicar a elevada prevalência de perturbações psiquiátricas, particularmente o efeito do ambiente prisional, tendo-se identificado fatores protetores que diminuem o seu efeito potencialmente patogénico. Verificou-se que este impacto se mantém após a libertação, com dificuldades na reintegração e alta mortalidade. Sugerem-se algumas medidas com o objetivo de reduzir o efeito nocivo do encarceramento.
INTRODUCTION: During the COVID-19 pandemic, public health measures such as quarantine, isolation, social distancing, and community containment have been implemented. These restrictions may have deleterious effects on the mental health of the general population. In prisons, the restriction of freedom and its effects on mental health are a given. This review aims to assess the impact on mental health of these two environments created by the restriction of freedom. METHODS: The PubMed® database was searched from inception to April 2021 for articles assessing the impact of the lockdown measures or incarceration on mental health. 1340 studies were found and 135 were included in this review. DISCUSSION: The lockdown measures caused a disruption of daily routine and several emotional effects. There was an increase in the prevalence of anxiety, depression, stress-related disorders, insomnia, and psychological distress. There was significant behavioral impact on several areas. Risk and protective factors were identified, as well as particularly vulnerable populations. Some recommendations are made that can mitigate the previously mentioned deleterious effects. Regarding incarceration in prisons, many factors were identified that contribute to the high prevalence of psychiatric disorders, particularly the effect of the prison environment. Protective factors that reduce the effect of this environment were recognized. This effect lingers even after release from prison, resulting in a challenging community reentry and high mortality. Recommendations are suggested with the aim of reducing the harmful effect of incarceration.
INTRODUCTION: During the COVID-19 pandemic, public health measures such as quarantine, isolation, social distancing, and community containment have been implemented. These restrictions may have deleterious effects on the mental health of the general population. In prisons, the restriction of freedom and its effects on mental health are a given. This review aims to assess the impact on mental health of these two environments created by the restriction of freedom. METHODS: The PubMed® database was searched from inception to April 2021 for articles assessing the impact of the lockdown measures or incarceration on mental health. 1340 studies were found and 135 were included in this review. DISCUSSION: The lockdown measures caused a disruption of daily routine and several emotional effects. There was an increase in the prevalence of anxiety, depression, stress-related disorders, insomnia, and psychological distress. There was significant behavioral impact on several areas. Risk and protective factors were identified, as well as particularly vulnerable populations. Some recommendations are made that can mitigate the previously mentioned deleterious effects. Regarding incarceration in prisons, many factors were identified that contribute to the high prevalence of psychiatric disorders, particularly the effect of the prison environment. Protective factors that reduce the effect of this environment were recognized. This effect lingers even after release from prison, resulting in a challenging community reentry and high mortality. Recommendations are suggested with the aim of reducing the harmful effect of incarceration.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Confinamento Encarceramento COVID-19 Saúde mental