Domestic violence and substance abuse during COVID19: A systematic review

INTRODUCTION: As COVID-19 develops around the world, numerous publications have described the psychiatric consequences of this pandemic. Although clinicians and healthcare systems are mainly focused on managing critically ill patients in an attempt to limit the number of casualties, psychiatric disease burden is increasing significantly. In this scenario, increased domestic violence and substance abuse have been recently reported. OBJECTIVE: The objective of this study is to perform a systematic review of the literature regarding the consequences of severe acute respiratory syndrome-CoV-2 infection in terms of domestic violence and substance abuse, and compare incidences found. MATERIALS AND METHODS: We conducted a literature search using the preferred reporting items for systematic reviews and meta-analyses guidelines. The keywords included “domestic violence,” “substance abuse” AND “COVID-19,” including multiple variants from December 2019 through June 2020. An extensive bibliographic search was carried out in different medical databases: Pubmed, EMBASE, LILACS, medRxiv, and bioRxiv. Titles and abstracts were reviewed according to the eligibility criteria. The risk of bias in the retrieved articles was assessed by the Joanna Briggs Institute's critical assessment instrument. RESULTS: A total of 1505 papers were initially retrieved after consulting the selected databases. After browsing through titles and abstracts, 94 articles were initially included considering the predefined eligibility criteria. After a more detailed analysis, only six scientific articles remained in our selection. Of these, three were evaluating domestic violence against children, while the other three were about substance abuse. CONCLUSION: There is not enough evidence to support the concept that COVID-19 has led to an increase in the rates of domestic violence and substance abuse. The initial decrease in violence reports might not translate into a real reduction in incidence but in accessibility. Apparently, there has been a slight increase in alcohol and tobacco abuse, especially by regular users, which also requires confirmatory studies. The inconsistency between expert opinon articles and the actual published data could be a result of the limited time since the beginnging of the crisis, the fact that psychitaric patients have been chronically exposed to stressful situatons, and a possible stimulated increase in demand for psychatric consultations.