COVID-19 and mental health
The COVID-19 pandemic has led to the death of more than 6 million people worldwide (WHO, 2019). There has been a psychological toll as well, with a global increase in the prevalence of mental health problems in the general population (Georgieva et al., 2021, Mortier et al., 2021, Zhang et al., 2022). Although some studies found no effect of the pandemic on psychotic symptom levels (Pinkham et al., 2020), distress (Grossman-Giron et al., 2022), or OCD symptoms (Moreira-de-Oliveira et al., 2022), most have shown a general worsening in anxiety and depression levels (Gobbi et al., 2020, Lewis et al., 2022, Quittkat et al., 2020); distress (Van Rheenen et al., 2020); obsessive-compulsive disorder (OCD) symptoms (Benatti et al., 2020, Tükel et al., 2022); psychotic symptoms and suicidal ideation (Muruganandam et al., 2020, Strauss et al., 2022, Szmulewicz et al., 2021) in people with pre-existing mental disorders. This may be due to direct effects of the pandemic including increased risk of acquiring COVID-19 or having a worse prognosis once infected (De Hert et al., 2022), which can be attributed to reduced risk-awareness and non-compliance with preventive measures (Chevance et al., 2020, Wang et al., 2021), or to having additional medical comorbidities known to be associated with worse prognosis (Wang et al., 2021, Tzur Bitan et al., 2021). Reduced access to services due to lockdowns also likely contributed to symptom worsening; as well indirect effects of the pandemic (lockdowns and other mandates, high uncertainty, etc.) on mental patients may have been more severe compared to the general population (Solé et al., 2021).