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; Tozzo et al., 2020). This group is also more vulnerable to the infection of SARS-CoV-2, as prisons tend to be overcrowded, have poorly ventilated environments and low compliance to hygiene rules (Tozzo et al., 2020). In light of this scenario, prisoners are more likely to suffer from anger, depression, anxiety, irritability, frustration, paranoia, fear of contamination, psychosis, exacerbation of underlying mental illness and suicidal behavior (Fovet et al., 2020; Hewson et al., 2020; Tozzo et al., 2020). Rural Communities The individuals living in rural communities experience more loneliness, lack of belonging and perceived burdensomeness than those living in urban centers. They are, therefore, at elevated risk for unsatisfactory mental health and even suicide (Monteith et al., 2020). During the COVID-19 pandemic, the social distancing measures, often not accompanied by virtual connections due to diminished access to the Internet, may exacerbate mental health symptoms and increase suicide behavior in this population (Monteith et al., 2020). Furthermore, intimate partner violence tends to be more intense in rural communities, whereas access to mental healthcare tends to be deficient. All of these circumstances may exacerbate during the pandemic and might result in poorer mental health outcomes and increased suicide rates (Monteith et al., 2020). Psychiatric Patients In psychiatric patients, the COVID-19 pandemic might trigger an even worse outcome regarding mental health. As previously discussed, the uncertainty, fear and social distancing may exacerbate pre-existing psychiatric diseases and precipitate its symptomatology (Holmes et al., 2020; Vindegaard and Benros, 2020; Yao et al., 2020). Added to their higher vulnerability to many stressors (Yao et al., 2020), they face worsen medical follow-up due to the suspension of some elective appointments and redirection of health professionals to face the pandemic (Holmes et al., 2020). Furthermore, they tend to have more severe forms of COVID-19 due to comorbidities, immunosuppression (Fontenelle and Miguel, 2020; Yao et al., 2020) and, possibly, worst access to medical care because of discrimination (Yao et al., 2020). Depression and Anxiety When performed several scales to assess the psychological impact of COVID-19 pandemic in China on 76 psychiatric patients (with major depressive disorder, anxiety disorders and mixed anxiety and depressive disorder patients) and 109 healthy controls, the patients group had worst outcomes on almost all variables addressing depression, anxiety, stress and insomnia (Hao et al., 2020). As for other psychiatric symptoms referred during the survey, the patients group had more worries about their physical health, more moderate to severe anger and impulsivity and more suicidal ideation (Hao et al., 2020). However, it is important to mention that the control group was evaluated simultaneously to the patients group. Control group was composed of individuals without psychiatric disorders that were evaluated before COVID-19 pandemic. For this reason, results of the study can be contestable. Moreover, patients with generalized anxiety have increased health anxiety. As a result, they are more prone to confound normal feelings with COVID-19 symptoms, generating even more anxiety and distress (Dubey et al., 2020).Obsessive-Compulsive Disorder Many patients with obsessive-compulsive disorder (OCD) already excessively worry about having a disease or contaminating others.
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