Psycho-social impact of social distancing and isolation due to the COVID-19 containment measures on patients with physical disabilities.

Background While the Covid-19 pandemic was spreading worldwide, the Italian government stated lockdown, with a drastic reorganization in of healthcare systems. The psychological and social effects of the pandemic and to the restrictions of freedom could have had a detrimental impact on people with physical disabilities, for whom well-being depends strongly on their social environment. Aim Our main aim was to describe the overall impact of the pandemic on mental health, social condition and illness perception among patients with disabilities, to provide early interventions for this particularly vulnerable population. For this purpose, we performed a specific screening protocol to detect the prevalence of any psychological distress. Design Cross-sectional observational study. Setting Telephonic interview administered to patients and their caregivers attending the Neurorehabilitation unit of the University Hospital of Pisa. Population 134 patients with physical disability related to neurological disorders, who had their outpatient appointment cancelled, because of the government dispositions, were enrolled. Methods A specific questionnaire (COVID19-q) was designed to test patients' psychosocial state, including a section addressed to the caregiver. Moreover, a standardized psychological evaluation, using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), was also performed. Results Results show a different impact in our study population compared to the general population on psychological aspect. Patients did not manifest any clinically relevant distress, as assessed with CORE-OM. However, patients with higher disability degree reported a statistically lower outcome in the social function and in the well-being domains and an increase in risk behaviour. Results from COVID19-q show that most of our patients reported none or mild change in their psycho-social habits and perception of illness during lockdown. However, reduction of family cohesion and lack of healthcare support are two important aspects that people with disability had to face with during the pandemic emergency. Clinical rehabilitation impact People with physical disabilities surprisingly shown milder effects of the pandemic on their psychological state and good coping skills in facing social isolation, manifesting resilience resources. However, the is a need to give concrete support to healthcare and social care, especially in the management of severe disability. This unexpected and reassuring result may reveal a worrying scenario regarding the social participation and quality of life of people with disabilities: were they already in lockdown?