Information-seeking on pandemic health threats for persons with schizophrenia.

Dear Sir,

With the recent bushfires and ongoing COVID-19 pandemic, the Australian community has been subjected to serious threats. Repeated waves of widespread SARS-CoV-2 outbreaks have been described as the biggest threat of the 21st Century, heightened by the recent emergence of the highly infectious Delta variant.[1] Therefore, it is useful to explore factors which may influence how people deal with health threats, including innate levels of optimism, cognitive style and access to a support person (https://www.blackdoginstitute.org.au/news/10-tips-for-managing-anxiety-during-covid-19/). We explored these issues in patients with schizophrenia, and general practice attendees, as part of a larger study on risk perception during the 2009 swine influenza pandemic.[2] We are not aware of a similar study during the current COVID-19 pandemic.

The sample included 48 patients with a diagnosis of schizophrenia (Scz) recruited from inpatient and community health care settings in the Australian Capital Territory, matched (age, gender, and employment status) with a sample of 48 patients from general practice (GP) settings without a diagnosis of schizophrenia. The mean age in both groups was 35 (SD =11; range = 19–65). Each group comprised 27 males. This study was ethically approved.

There were no statistically significant differences between the Scz and GP groups for: optimism; having a support person to turn to; and having a tendency to avoiding thinking about threats when faced with them (Table 1). However, there were significantly fewer people with schizophrenia who reported seeking more information when faced with, and in order to deal with, a threat, compared with the GP group.

Table 1.

Survey items and responses (n = 96)

	(1) None of the time (%)		(2) A little of the time (%)		(3) Some of the time (%)		(4) A lot of the time (%)		(5) All of the time (%)		Statistic#
	Scz	GP	Scz	GP	Scz	GP	Scz	GP	Scz	GP
Generally, are you an optimistic person?	8.9.	0.0	11.1	17.4	37.8	21.7	26.7	47.8	15.6	13.0	χ2 = 0.07p = 0.79
Do you have someone you can turn to for support in times of need?	6.5	6.5	15.2	13.0	19.6	17.4	28.3	26.1	30.4	37.0	χ2 = 0.07p = 0.80
	(1) Not at all (%)		(2) A little (%)		(3) Moderately well (%)		(4) Very well (%)		(5) Extremely well (%)
	Scz	GP	Scz	GP	Scz	GP	Scz	GP	Scz	GP
When confronted with some kind of new health threat or difficulty I like to find out more information about it so that I can work out the best way to deal with it. How well does this statement describe you?	8.7	6.5	32.6	15.2	28.3	43.5	17.4	17.4	13.0	17.4	χ 2 = 4.08 p < 0.04
When confronted with some kind of new health threat or difficulty I tend to push it aside and try not to think about it. How well does this statement describe you?	19.6	26.1	47.8	30.4	19.6	15.2	8.7	10.9	4.3	6.5	χ2 = 1.15p = 0.28

Scz = schizophrenia; GP = general practice.

# Chi square statistic: 2 × 2 table comparing Scz with GP for (1) + (2) versus (3) + (4) + (5) i.e. none or a little versus substantive amount of each item.

One in five people in both groups reported feeling optimistic none or only a little of the time. However, 61% of the people in the GP group saw themselves as being optimistic all or a lot of the time compared with only about 42% of people in the schizophrenia group. Approximately one in three responders in each group viewed themselves as having a tendency to push aside thoughts about new health threats confronting them. Only 58.7% of people with schizophrenia reported seeking to gather more information about a new health threat in order to work out the best way to deal with it, compared with 78.3% in the GP group. The majority (80%) of people in both groups reported having access to a support person some, a lot, or all of the time.

People with schizophrenia, already at greater risk from SARS-CoV-2 due to comorbidity, might benefit from encouragement and/or assistance from their psychiatrist, GP, and carers to seek information and advice on how to deal with new health threats. This should include guidance related to public health messaging, including vaccination hesitancy, related to the COVID-19 pandemic.