key: cord-0965294-w3ajpaxo authors: Yıldız, Erman title: What can be said about lifestyle and psychosocial issues during the coronavirus disease pandemic? first impressions date: 2020-07-06 journal: Perspect Psychiatr Care DOI: 10.1111/ppc.12560 sha: ea26c7425f3bca477fc5ae10b9d5b7d98bb4c702 doc_id: 965294 cord_uid: w3ajpaxo nan What can be said about lifestyle and psychosocial issues during the coronavirus disease pandemic? first impressions To the Editor, The disease caused by the coronavirus disease (COVID- 19) which shows involvement mainly in the respiratory tract was declared as a pandemic on 11 March 2020 by the World Health Organization (WHO). 1 Everything regarding COVID-19 started with cases detected in the city of Wuhan in China 2 and became a public even that concerns the entire world in a short time due to the disease's high contagiousness. 3, 4 According to the official website of WHO, it was confirmed globally that more than 6 100 000 people had COVID-19 infection by 2 June 2020, and the number of cases is increasing day by day. 5 Although the methods used by countries to take the COVID-19 pandemic under control show a diversity, it is seen that the strategy that is common in the world involves calls for staying home. 6, 7 Without a doubt, it is a necessity in terms of slowing down the spreading speed of the pandemic for governments to recommend people to self-isolate and self-quarantine, that is, deliberate social isolation. 8, 9 Nevertheless, these restrictions mean reduced physical activity, and this is known as an unhealthy lifestyle. It is a known fact that regular physical activity helps prevent and treat noncontagious diseases such as cardiac diseases, paralysis, diabetes and breast and colon cancer. Regular physical activity not only helps prevent hypertension, overweight and obesity but also has the potential to increase mental health, quality of life and prosperity. 10, 11 In addition to this, restrictions that have been issued in the period of the COVID-19 pandemic prohibited a large proportion of these open and social activities (eg, going to the gym) and led to a reduction in physical activity. Additionally, while people are encouraged to exercise at home during quarantine, there are questions regarding the functionality of this. Another important area regarding lifestyle involves changing dietary habits and difficulties experienced in effective weight management in connection with the availability of food products and transition to unhealthy foods. That is, due to the concerns on food availability problems in the future, individuals have a tendency to purchase packaged and long-lasting foods rather than fresh foods. 12 Such unhealthy dietary behaviors and ineffective weight management carry the potential of causing several noncontagious diseases, such as obesity, diabetes, cardiovascular disease, cancer, chronic kidney disease and osteoarthritis. 13 Furthermore, in the long term, negative effects of some behaviors that may be used in coping with problems in the pandemic process may also be experienced. In this context, usage of cigarettes, alcohol and other addictive substances which is defined among ineffective coping styles may present another unhealthy lifestyle. 14 Considering the multifaceted nature of healthy lifestyles, applying transdiagnostic approaches can contribute to achieving pragmatic results. 15 Indeed, unhealthy lifestyle behaviors encountered in the pandemic period are not just related to noncontagious diseases, but these behaviors are also closely in interacting with the mental health of individuals. Considering that unhealthy lifestyle behaviors due to quarantine, such as physical limitation and ineffective weight management are frequently comorbid with stress, anxiety, and depression, the mental health of individuals should not be neglected. 16 For all these reasons, from the perspectives of public health and protective care, there is an emergent need to provide information and interventions to individuals, communities and healthcare institutions for them to continue the healthiest lifestyle under quarantine. 17 Although governments encourage people to work from home in the period of the COVID-19 pandemic, working from home does not seem to be suitable and sufficiently functional for the entire population, especially tradespeople. As this situation will inevitably have serious effects on mental health by increasing unemployment, lack of financial security and poverty, it is clear that pandemic management requires socioeconomic policies. The sense of loss experienced in the society in the pandemic process may be caused by losing direct social contact, and this loss may be in multiple forms (eg, loved ones, employment, education opportunities, recreation, loss of freedoms, and social support). 14 Moreover, since the losses experienced are known as important risk factors for depression and suicide, 18 they require more careful observation and approach. Under quarantine conditions, individuals not only get away from the sources of social support, but they may also need social support more than ever. If these individuals cannot receive sufficient social support from their children, spouses, relatives or surroundings, it is likely for their psychosocial adaptation to be affected negatively. It seems rational to consider the pandemic as a psychological crisis and accept that the uncertainty and unpredictability in the nature of this crisis will have social, psychological and behavioral effects. 6, 7 In pandemics, uncertainty and the anxiety related to this have strongly remained since the past. 19, 20 Although it is argued that uncertainty is an experience that is always existent in the world of people, this may be felt more than ever in a period of a pandemic. [19] [20] [21] While the speed of spread of the infection seems fast, 22 it is observed that the uncertainty, fear and anxiety caused by the virus spread more rapidly. Especially paranoia feelings related to hygiene may be largely affected by anxiety and show themselves as symptoms of obsessive WHO characterizes COVID-19 as a pandemic Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China Covid-19: surge in cases in Italy and South Korea makes pandemic look more likely Coronavirus disease (COVID-19) situation dashboard Mental health and psychosocial aspects of coronavirus outbreak in Pakistan: psychological intervention for public mental health The psychological impact of quarantine and how to reduce it: rapid review of the evidence Quarantine, isolation and the duty of easy rescue in public health Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19 Lifestyle modification with physical activity promotion on leptin resistance and quality of life in metabolic syndrome-a systematic review with meta-analysis Lifestyle indices and cardiovascular disease risk: a meta-analysis Lifestyle at time of COVID-19: how could quarantine affect cardiovascular risk Ineffectiveness of commercial weight-loss programs for achieving modest but meaningful weight loss: systematic review and meta-analysis Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry The effects of acceptance and commitment therapy on lifestyle and behavioral changes: a systematic review of randomized controlled trials (Article in press) The relation of anxiety, depression, and stress to binge eating behavior Lifestyle behaviours during the COVID-19-time to connect The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis Managing and reducing uncertainty in an emerging influenza pandemic Intolerance of uncertainty, appraisals, coping, and anxiety: the case of the 2009 H1N1 pandemic The relationship between uncertainty and affect The novel coronavirus, 2019-nCoV, is highly contagious and more infectious than initially estimated COVID-19 and mental health: a review of the existing literature China adopts non-contact free consultation to help the public cope with the psychological pressure caused by new coronavirus pneumonia Coronavirus disease 2019 (COVID-19): reducing stigma Stigma in the time of influenza: social and institutional responses to pandemic emergencies Influenza stigma during the 2009 H1N1 pandemic Influenza: the once and future pandemic