Impact of the COVID-19 pandemic on psychosocial health and well-being in South-Asian (World Psychiatric Association zone 16) countries: A systematic and advocacy review from the Indian Psychiatric Society

Abstract
Background: Coronavirus disease 2019 (COVID-19) has emerged as a global health threat. The South-Asian (SA) countries have witnessed both the initial brunt of the outbreak as well as the ongoing rise of cases. Their unique challenges in relation to mental health during the pandemic are worth exploring. Materials and Methods: A systematic review was conducted for all the original studies on the impact of COVID-19 and lockdown on psychological health/well-being in the SA countries of the World Psychiatric Association Zone 16. PubMed, Google Scholar, PSYCHINFO, EMBASE, and SCOPUS were searched till June 2020. Studies conducted in the age group of 18-60 years with a minimum sample size of 10, and statistically significant results were included. Results: Thirteen studies were included in the review. They showed increase prevalence in nonpsychotic depression, anxiety, somatic concerns, alcohol-related disorders, and insomnia in the general population. Psychological symptoms correlated more with physical complaints of fatigue and pain in older adults and were directly related to social media use, misinformation, xenophobia, and social distancing. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination. One study validated the Coronavirus anxiety scale in the Indian population while another explored gaming as a double-edged sword during the lockdown in adolescents. Another study from Bangladesh explored psychosexual health during lockdown. Most studies were cross-sectional online surveys, used screening tools and had limited accessibility. Conclusion: The ongoing COVID-19 crisis and its impact serve as an important period for adequate mental healthcare, promotion, research, and holistic biopsychosocial management of psychiatric disorders, especially in vulnerable groups. Mental healthcare and research strategies during the pandemic and preparedness for postpandemic aftermath are advocated subsequently.