Medium-term and peri-lockdown course of psychosocial burden during the ongoing COVID-19 pandemic: a longitudinal study on patients with pre-existing mental disorders.
Adjustment disorder
Coronavirus
Mental health
Psychosocial stress
SARS-CoV-2
Journal
European archives of psychiatry and clinical neuroscience
ISSN: 1433-8491
Titre abrégé: Eur Arch Psychiatry Clin Neurosci
Pays: Germany
ID NLM: 9103030
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
26
07
2021
accepted:
08
11
2021
pubmed:
27
11
2021
medline:
16
7
2022
entrez:
26
11
2021
Statut:
ppublish
Résumé
While the COVID-19 pandemic continues, patients with pre-existing mental disorders are increasingly recognized as a risk group for adverse outcomes. However, data are conflicting and cover only short time spans so far. Here, we investigate the medium-term and peri-lockdown-related changes of mental health outcomes in such patients in a longitudinal study. A cohort of 159 patients comprising all major mental disorders (ICD-10 F0-F9) were interviewed twice with the Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) to evaluate psychosocial burden, psychiatric symptoms and resilience at the end of the first (April/May 2020) and the second lockdown in Germany (November/December 2020). For the primary outcome "psychosocial burden" ratings also comprised retrospective pre-pandemic (early 2020) and very early states during the pandemic (March 2020). For all diagnostic groups, psychosocial burden varied significantly over time (p < 0.001) with an increase from the pre-pandemic to the initial phase (p < 0.001), followed by a steady decrease across both lockdowns, normalizing in November/December 2020. Female gender, high adjustment disorder symptom load at baseline and psychiatric comorbidities were risk factors for higher levels and an unfavorable course of psychosocial burden. Most psychiatric symptoms changed minimally, while resilience decreased over time (p = 0.044 and p = 0.037). The longitudinal course of psychosocial burden indicates an initial stress response, followed by a return to pre-pandemic levels even under recurrent lockdown conditions, mimicking symptoms of an adjustment disorder. Strategies for proactive, specific and continuous treatment have to address resilience capacities before their depletion in the pandemic aftermath, especially for patients with additional risk factors.
Identifiants
pubmed: 34825249
doi: 10.1007/s00406-021-01351-y
pii: 10.1007/s00406-021-01351-y
pmc: PMC8614217
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
757-771Subventions
Organisme : bundesministerium für bildung und forschung
ID : #01KX2021
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s).
Références
Kesner L, Horáček J (2020) Three challenges that the COVID-19 pandemic represents for psychiatry. Br J Psychiatry 217:475–476. https://doi.org/10.1192/bjp.2020.106
doi: 10.1192/bjp.2020.106
pubmed: 32412401
Wang C, Pan R, Wan X et al (2020) A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav Immun 87:40–48. https://doi.org/10.1016/j.bbi.2020.04.028
doi: 10.1016/j.bbi.2020.04.028
pubmed: 32298802
pmcid: 7153528
Qiu J, Shen B, Zhao M et al (2020) A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psych 33:e100213. https://doi.org/10.1136/gpsych-2020-100213
doi: 10.1136/gpsych-2020-100213
Li J, Yang Z, Qiu H et al (2020) Anxiety and depression among general population in China at the peak of the COVID-19 epidemic. World Psychiatry 19:249–250. https://doi.org/10.1002/wps.20758
doi: 10.1002/wps.20758
pubmed: 32394560
pmcid: 7214959
Rossi R, Socci V, Talevi D et al (2020) COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Front Psychiatry. https://doi.org/10.3389/fpsyt.2020.00790
doi: 10.3389/fpsyt.2020.00790
pubmed: 33343407
pmcid: 7738432
Huang Y, Zhao N (2020) Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res 288:112954. https://doi.org/10.1016/j.psychres.2020.112954
doi: 10.1016/j.psychres.2020.112954
pubmed: 32325383
pmcid: 7152913
McGinty EE, Presskreischer R, Han H, Barry CL (2020) Psychological distress and loneliness reported by US adults in 2018 and April 2020. JAMA 324:93. https://doi.org/10.1001/jama.2020.9740
doi: 10.1001/jama.2020.9740
pubmed: 32492088
pmcid: 7270868
Gilan D, Röthke N, Blessin M et al (2020) Psychomorbidity, resilience, and exacerbating and protective factors during the SARS-CoV-2 pandemic. Dtsch Arztebl Online. https://doi.org/10.3238/arztebl.2020.0625
doi: 10.3238/arztebl.2020.0625
Boden M, Zimmerman L, Azevedo KJ et al (2021) Addressing the mental health impact of COVID-19 through population health. Clin Psychol Rev 85:102006. https://doi.org/10.1016/j.cpr.2021.102006
doi: 10.1016/j.cpr.2021.102006
pubmed: 33714167
pmcid: 7934657
Kola L, Kohrt BA, Hanlon C et al (2021) COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry 8:535–550. https://doi.org/10.1016/S2215-0366(21)00025-0
doi: 10.1016/S2215-0366(21)00025-0
pubmed: 33639109
Li S, Zhang Y (2020) Mental healthcare for psychiatric inpatients during the COVID-19 epidemic. Gen Psych 33:e100216. https://doi.org/10.1136/gpsych-2020-100216
doi: 10.1136/gpsych-2020-100216
Norris FH, Friedman MJ, Watson PJ et al (2002) 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry 65:207–239. https://doi.org/10.1521/psyc.65.3.207.20173
doi: 10.1521/psyc.65.3.207.20173
pubmed: 12405079
Yao H, Chen J-H, Xu Y-F (2020) Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry 7:e21. https://doi.org/10.1016/S2215-0366(20)30090-0
doi: 10.1016/S2215-0366(20)30090-0
pubmed: 32199510
pmcid: 7269717
Toubasi AA, AbuAnzeh RB, Tawileh HBA et al (2021) A meta-analysis: the mortality and severity of COVID-19 among patients with mental disorders. Psychiatry Res 299:113856. https://doi.org/10.1016/j.psychres.2021.113856
doi: 10.1016/j.psychres.2021.113856
pubmed: 33740483
pmcid: 7927594
Mohan M, Perry BI, Saravanan P, Singh SP (2021) COVID-19 in people with schizophrenia: potential mechanisms linking schizophrenia to poor prognosis. Front Psychiatry 12:666067. https://doi.org/10.3389/fpsyt.2021.666067
doi: 10.3389/fpsyt.2021.666067
pubmed: 34079487
pmcid: 8166317
Lee SW, Yang JM, Moon SY et al (2020) Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study. Lancet Psychiatry 7:1025–1031. https://doi.org/10.1016/S2215-0366(20)30421-1
doi: 10.1016/S2215-0366(20)30421-1
pubmed: 32950066
pmcid: 7498216
Wang Q, Xu R, Volkow ND (2021) Increased risk of COVID-19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States. World Psychiatry 20:124–130. https://doi.org/10.1002/wps.20806
doi: 10.1002/wps.20806
pubmed: 33026219
Fiorillo A, Sampogna G, Giallonardo V et al (2020) Effects of the lockdown on the mental health of the general population during the COVID-19 pandemic in Italy: results from the COMET collaborative network. Eur Psychiatry 63:E87. https://doi.org/10.1192/j.eurpsy.2020.89
doi: 10.1192/j.eurpsy.2020.89
pubmed: 32981568
Bäuerle A, Steinbach J, Schweda A et al (2020) Mental health burden of the COVID-19 outbreak in Germany: predictors of mental health impairment. J Prim Care Community Health 11:2150132720953682. https://doi.org/10.1177/2150132720953682
doi: 10.1177/2150132720953682
pubmed: 32865107
pmcid: 7457643
Castellini G, Rossi E, Cassioli E et al (2021) A longitudinal observation of general psychopathology before the COVID-19 outbreak and during lockdown in Italy. J Psychosom Res 141:110328. https://doi.org/10.1016/j.jpsychores.2020.110328
doi: 10.1016/j.jpsychores.2020.110328
pubmed: 33316632
Robillard R, Daros AR, Phillips JL et al (2021) Emerging new psychiatric symptoms and the worsening of pre-existing mental disorders during the COVID-19 pandemic: a Canadian multisite study: nouveaux symptômes psychiatriques émergents et détérioration des troubles mentaux préexistants durant la pandémie de la COVID-19: une étude canadienne multisite. Can J Psychiatry. https://doi.org/10.1177/0706743720986786
doi: 10.1177/0706743720986786
pubmed: 34378420
pmcid: 9065494
Yocum AK, Zhai Y, McInnis MG, Han P (2021) Covid-19 pandemic and lockdown impacts: a description in a longitudinal study of bipolar disorder. J Affect Disord 282:1226–1233. https://doi.org/10.1016/j.jad.2021.01.028
doi: 10.1016/j.jad.2021.01.028
pubmed: 33601700
Plunkett R, Costello S, McGovern M et al (2021) Impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders attending secondary care. Ir J Psychol Med 38:123–131. https://doi.org/10.1017/ipm.2020.75
doi: 10.1017/ipm.2020.75
pubmed: 32507119
Pan K-Y, Kok AAL, Eikelenboom M et al (2021) The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. Lancet Psychiatry 8:121–129. https://doi.org/10.1016/S2215-0366(20)30491-0
doi: 10.1016/S2215-0366(20)30491-0
pubmed: 33306975
Hamm ME, Brown PJ, Karp JF et al (2020) Experiences of American older adults with pre-existing depression during the beginnings of the COVID-19 pandemic: a multicity, mixed-methods study. Am J Geriatr Psychiatry 28:924–932. https://doi.org/10.1016/j.jagp.2020.06.013
doi: 10.1016/j.jagp.2020.06.013
pubmed: 32682619
pmcid: 7305766
Pinkham AE, Ackerman RA, Depp CA et al (2020) A longitudinal investigation of the effects of the COVID-19 pandemic on the mental health of individuals with pre-existing severe mental illnesses. Psychiatry Res 294:113493. https://doi.org/10.1016/j.psychres.2020.113493
doi: 10.1016/j.psychres.2020.113493
pubmed: 33038789
pmcid: 7528831
Hennigan K, McGovern M, Plunkett R et al (2021) A longitudinal evaluation of the impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders. Ir J Psychol Med. https://doi.org/10.1017/ipm.2021.32
doi: 10.1017/ipm.2021.32
pubmed: 33818322
pmcid: 8365043
Castellini G, Cassioli E, Rossi E et al (2020) The impact of COVID-19 epidemic on eating disorders: a longitudinal observation of pre versus post psychopathological features in a sample of patients with eating disorders and a group of healthy controls. Int J Eat Disord 53:1855–1862. https://doi.org/10.1002/eat.23368
doi: 10.1002/eat.23368
pubmed: 32856333
pmcid: 7461528
Fernández-Aranda F, Casas M, Claes L et al (2020) COVID-19 and implications for eating disorders. Eur Eat Disord Rev 28:239–245. https://doi.org/10.1002/erv.2738
doi: 10.1002/erv.2738
pubmed: 32346977
pmcid: 7267370
Monteleone AM, Marciello F, Cascino G et al (2021) The impact of COVID-19 lockdown and of the following “re-opening” period on specific and general psychopathology in people with eating disorders: the emergent role of internalizing symptoms. J Affect Disord 285:77–83. https://doi.org/10.1016/j.jad.2021.02.037
doi: 10.1016/j.jad.2021.02.037
pubmed: 33636674
Breaux R, Dvorsky MR, Marsh NP et al (2021) Prospective impact of COVID-19 on mental health functioning in adolescents with and without ADHD: protective role of emotion regulation abilities. J Child Psychol Psychiatry. https://doi.org/10.1111/jcpp.13382
doi: 10.1111/jcpp.13382
pubmed: 33543486
pmcid: 8014657
Brown S, Opitz M-C, Peebles AI et al (2021) A qualitative exploration of the impact of COVID-19 on individuals with eating disorders in the UK. Appetite 156:104977. https://doi.org/10.1016/j.appet.2020.104977
doi: 10.1016/j.appet.2020.104977
pubmed: 32991945
Kim JU, Majid A, Judge R et al (2020) Effect of COVID-19 lockdown on alcohol consumption in patients with pre-existing alcohol use disorder. Lancet Gastroenterol Hepatol 5:886–887. https://doi.org/10.1016/S2468-1253(20)30251-X
doi: 10.1016/S2468-1253(20)30251-X
pubmed: 32763197
pmcid: 7403133
Robinson E, Sutin AR, Daly M, Jones A (2021) A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic. Prepr Available Medrxiv. https://doi.org/10.1101/2021.03.04.21252921
doi: 10.1101/2021.03.04.21252921
Belz M, Hessmann P, Vogelgsang J et al (2021) Evolution of psychosocial burden and psychiatric symptoms in patients with psychiatric disorders during the Covid-19 pandemic. Eur Arch Psychiatry Clin Neurosci. https://doi.org/10.1007/s00406-021-01268-6
doi: 10.1007/s00406-021-01268-6
pubmed: 34825249
pmcid: 8614217
Einsle F, Köllner V, Dannemann S, Maercker A (2010) Development and validation of a self-report for the assessment of adjustment disorders. Psychol Health Med 15:584–595. https://doi.org/10.1080/13548506.2010.487107
doi: 10.1080/13548506.2010.487107
pubmed: 20835968
Lorenz L, Bachem RC, Maercker A (2016) The adjustment disorder–new module 20 as a screening instrument: cluster analysis and cut-off values. Int J Occup Environ Med (The IJOEM) 7:215–220. https://doi.org/10.15171/ijoem.2016.775
doi: 10.15171/ijoem.2016.775
Fancourt D, Steptoe A, Bu F (2021) Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study. Lancet Psychiatry 8:141–149. https://doi.org/10.1016/S2215-0366(20)30482-X
doi: 10.1016/S2215-0366(20)30482-X
pubmed: 33308420
O’Connor RC, Wetherall K, Cleare S et al (2021) Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 mental health and wellbeing study. Br J Psychiatry 218:326–333. https://doi.org/10.1192/bjp.2020.212
doi: 10.1192/bjp.2020.212
pubmed: 33081860
Quervain D de, Aerni A, Amini E et al (2020) The Swiss corona stress study. OSF Preprints. April 24. https://doi.org/10.31219/osf.io/jqw6a
Bendau A, Plag J, Kunas S et al (2021) Longitudinal changes in anxiety and psychological distress, and associated risk and protective factors during the first three months of the COVID-19 pandemic in Germany. Brain Behav 11:e01964. https://doi.org/10.1002/brb3.1964
doi: 10.1002/brb3.1964
pubmed: 33230969
Daly M, Robinson E (2021) Psychological distress and adaptation to the COVID-19 crisis in the United States. J Psychiatr Res 136:603–609. https://doi.org/10.1016/j.jpsychires.2020.10.035
doi: 10.1016/j.jpsychires.2020.10.035
pubmed: 33138985
Van Rheenen TE, Meyer D, Neill E et al (2020) Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: initial results from the COLLATE project. J Affect Disord 275:69–77. https://doi.org/10.1016/j.jad.2020.06.037
doi: 10.1016/j.jad.2020.06.037
pubmed: 32658826
pmcid: 7331562
Liu CH, Stevens C, Conrad RC, Hahm HC (2020) Evidence for elevated psychiatric distress, poor sleep, and quality of life concerns during the COVID-19 pandemic among U.S. young adults with suspected and reported psychiatric diagnoses. Psychiatry Res 292:113345. https://doi.org/10.1016/j.psychres.2020.113345
doi: 10.1016/j.psychres.2020.113345
pubmed: 32745794
pmcid: 7387248
Meaklim H, Junge MF, Varma P et al (2021) Pre-existing and post-pandemic insomnia symptoms are associated with high levels of stress, anxiety and depression globally during the COVID-19 pandemic. J Clin Sleep Med. https://doi.org/10.5664/jcsm.9354
doi: 10.5664/jcsm.9354
pubmed: 33985647
Vissink CE, van Hell HH, Galenkamp N, van Rossum IW (2021) The effects of the COVID-19 outbreak and measures in patients with a pre-existing psychiatric diagnosis: a cross-sectional study. J Affect Disord Rep 4:100102. https://doi.org/10.1016/j.jadr.2021.100102
doi: 10.1016/j.jadr.2021.100102
pubmed: 33558866
pmcid: 7848531
Kwong ASF, Pearson RM, Adams MJ et al (2020) Mental health before and during the COVID-19 pandemic in two longitudinal UK population cohorts. Br J Psychiatry. https://doi.org/10.1192/bjp.2020.242
doi: 10.1192/bjp.2020.242
pmcid: 7844173
Casey P (2009) Adjustment disorder: epidemiology, diagnosis and treatment. CNS Drugs 23:927–938. https://doi.org/10.2165/11311000-000000000-00000
doi: 10.2165/11311000-000000000-00000
pubmed: 19845414
MacKenzie M, Daviskiba S, Dow M et al (2021) The impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare workers with pre-existing psychiatric conditions. Psychiatr Q. https://doi.org/10.1007/s11126-020-09870-y
doi: 10.1007/s11126-020-09870-y
pubmed: 33411127
pmcid: 7788543
Murphy D, Williamson C, Baumann J et al (2020) Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties. BMJ Mil Health. https://doi.org/10.1136/bmjmilitary-2020-001622
doi: 10.1136/bmjmilitary-2020-001622
pubmed: 33243764
pmcid: 7692021
Chen S, She R, Qin P et al (2020) The medium-term impact of COVID-19 lockdown on referrals to secondary care mental health services: a controlled interrupted time series study. Front Psychiatry 11:585915. https://doi.org/10.3389/fpsyt.2020.585915
doi: 10.3389/fpsyt.2020.585915
pubmed: 33324258
pmcid: 7726266
Bendau A, Kunas SL, Wyka S et al (2021) Longitudinal changes of anxiety and depressive symptoms during the COVID-19 pandemic in Germany: the role of pre-existing anxiety, depressive, and other mental disorders. J Anxiety Disord 79:102377. https://doi.org/10.1016/j.janxdis.2021.102377
doi: 10.1016/j.janxdis.2021.102377
pubmed: 33662702
Sheridan Rains L, Johnson S, Barnett P et al (2021) Early impacts of the COVID-19 pandemic on mental health care and on people with mental health conditions: framework synthesis of international experiences and responses. Soc Psychiatry Psychiatr Epidemiol 56:13–24. https://doi.org/10.1007/s00127-020-01924-7
doi: 10.1007/s00127-020-01924-7
pubmed: 32804258
Asmundson GJG, Paluszek MM, Landry CA et al (2020) Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping? J Anxiety Disord 74:102271. https://doi.org/10.1016/j.janxdis.2020.102271
doi: 10.1016/j.janxdis.2020.102271
pubmed: 32673930
pmcid: 7342169
Tsamakis K, Tsiptsios D, Ouranidis A et al (2021) COVID-19 and its consequences on mental health (Review). Exp Ther Med 21:244. https://doi.org/10.3892/etm.2021.9675
doi: 10.3892/etm.2021.9675
pubmed: 33603852
pmcid: 7851613
Methfessel I, Besse M, Belz M, Zilles-Wegner D (2021) Effectiveness of maintenance electroconvulsive therapy—evidence from modifications due to the COVID-19 pandemic. Acta Psychiatr Scand. https://doi.org/10.1111/acps.13314
doi: 10.1111/acps.13314
pubmed: 33960406
pmcid: 8212113