# The impact of the prolonged COVID-19 pandemic on the practice of psychosomatic medicine in Japan: a nationwide physician survey

## TL;DR

This study examines how the long-term effects of the COVID-19 pandemic have changed the practice of psychosomatic medicine in Japan, including shifts in patient care and mental health trends.

## Contribution

This paper provides a one-year follow-up survey revealing evolving mental health impacts and shifts in psychosocial factors affecting patients in psychosomatic medicine during the pandemic.

## Key findings

- Outpatient numbers partially recovered but 28% of physicians reported ongoing declines compared to pre-pandemic levels.
- Telemedicine remained widely used (62% of institutions), but 70% of physicians reported challenges in assessing patient symptoms.
- Fear of infection was a key factor for anxiety disorders, while activity restrictions influenced other mental health conditions.

## Abstract

The prolonged COVID-19 pandemic has significantly affected the clinical care and the mental health of patients in psychosomatic medicine. Between late 2021 and early 2022, the Japanese Society of Psychosomatic Medicine (JSPM) and the Japanese Society of Psychosomatic Internal Medicine (JSPIM) conducted a nationwide physician survey to assess these effects. The survey identified difficulties in outpatient and inpatient care, increased use of telemedicine, and rises in patient numbers and symptom severity. Due to inconsistent findings in prior studies on long-term mental health effects of the pandemic, a follow-up survey was needed.

This study is the one-year follow-up survey conducted by JSPM and JSPIM. A cross-sectional, web-based survey was conducted among physicians of the two societies from December 21, 2022, to February 14, 2023. The questionnaire examined trends in outpatient and inpatient care, telemedicine use, and changes in the mental health of patients with psychosomatic disorders, eating disorders, adjustment disorders, mood disorders, and anxiety disorders. Descriptive statistical analyses were performed.

A total of 251 physicians responded. While outpatient numbers showed partial recovery, 28% of the respondents reported persistent declines compared to pre-pandemic levels. Telemedicine remained in use at 62% of their institutions, but 70% of the respondents reported difficulties in symptom assessment. Compared to the previous year, more respondents reported an increase in the number of patients across all surveyed disorders. Regarding the psychosocial factors that affected patients, fear of infection was the predominant factor for anxiety disorders, as in the previous survey, whereas restrictions on daily and social activities were the most influential for psychosomatic disorders, mood disorders, and adjustment disorders.

The COVID-19 pandemic has had a lasting effect on patients receiving psychosomatic treatment. Outpatient numbers are gradually recovering, and telemedicine has contributed to the continuity of care. However, concerns about patient assessment in telemedicine persist. The impact of the prolonged pandemic on mental health appears to have evolved, with shifts in the psychosocial factors that influence different aspects of mental health deterioration. Future studies that incorporate clinical data will provide valuable insights into the long-term consequences of the pandemic and help guide future clinical practice.

The online version contains supplementary material available at 10.1186/s13030-025-00333-z.