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Carmassi C, Tosato S, Pedrinelli V, Bertelloni CA, Abbate-Daga G, Albert U, Castellini G, Luciano M, Menchetti M, Pompili M, Sampogna G, Signorelli M, Massimetti G, Fiorillo A. Longitudinal trajectories of anxiety and depression in subjects with different mental disorders after one year in the COVID-19 pandemic. Psychiatry Res 2024; 334:115680. [PMID: 38368843 DOI: 10.1016/j.psychres.2023.115680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 02/20/2024]
Abstract
The aim of this study was to prospectively assess the development and trajectories of anxiety and depressive symptoms among subjects with different mental disorders, during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and after 3 months (T1, June-July 2021), with reduced restrictive measures. A sample of 527 subjects, with different DSM-5 diagnoses, was enrolled at nine Italian psychiatric outpatient services. Assessments at T0 and T1 included the Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, and the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms. Differences in anxiety and depressive symptoms rates emerged across different mental disorders and a general improvement at T1 was detected for all of them in both the GAD-7 and PHQ-9 scores, except for Psychosis and Obsessive-Compulsive Disorder (OCD). Patients with Feeding and Eating Disorders (FED) reported statistically significantly higher: GAD-7 scores than those with Bipolar Disorder (BD), at both times, and Anxiety Disorders at baseline; PHQ-9 scores than all other diagnostic categories, at both times. Unemployment, no COVID-19 infection, OCD were predictive variables related to GAD-7 scores at T1, while being unmarried, BD or FED related to PHQ-9 scores at T1. Subjects with mental disorders reported anxiety and depressive symptoms during the third pandemic wave and most of patients showed an improvement over a 3-month follow-up, despite differences emerged among diagnostic categories and for the variables involved. Further studies are needed to deepen knowledge on pandemic impact on patients with mental disorders.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Carlo A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | - Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Firenze, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Roma "La Sapienza", Roma, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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2
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Nazemi M, Kiani S, Zakerabasali S. Tele-mental health during the COVID-19 pandemic: A systematic review of the literature focused on technical aspects and challenges. Health Sci Rep 2023; 6:e1637. [PMID: 37916142 PMCID: PMC10617983 DOI: 10.1002/hsr2.1637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/09/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023] Open
Abstract
Introduction Mental disorders are the leading cause of disability and the second leading cause of death worldwide, which leads to the death of more than 9 million people annually. The global impact of the Coronavirus epidemic on mental health includes insomnia, anxiety, and depression. Therefore, given the current situation, innovations such as telemedicine to provide prevention and treatment services for people with mental disorders seem necessary. Methods A literature review was performed according to the preferred items to report in systematic reviews and meta-analyses (PRISMA). Covering a period from January 2020 to July 2023, we conducted a systematic literature search on five electronic databases (PubMed-Mesh, Scopus, Web of Science, Science direct, and PsycInfo). The search strategy included three categories of keywords: Mental health, Tele, COVID-19. Results A total of 112 articles were identified by searching the databases of published articles, 13 articles met our inclusion criteria. A total of 76.2% of them were related to patients with stress, anxiety, and depression issues. We found that the real-time method has been the most common method used to communicate between the physician and the patient (92.3%). The communication technologies used also included telephone, video call, video conference, and E-mail. During these communications, data was exchanged in text, voice, and video formats. In three studies (27%), interoperability with other systems was mentioned. In addition, 69.2% of the studies reported challenges, the most important of which were access to electronic and communication devices, network connection problems, audio and video problems, and privacy issues. Conclusions Considering the many advantages of telemedicine technology in the field of mental health, the need to use this technology in developing countries, including our country, is obvious. But the application of these technologies requires the investigation of technical aspects and challenges related to them as much as possible, which have been seen in few studies.
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Affiliation(s)
- Maryam Nazemi
- Department of Health Information Management, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
| | | | - Somayyeh Zakerabasali
- Department of Health Information Management, Clinical Education Research Center, Health Human Resources Research Center, School of Health Management and Information SciencesShiraz University of Medical SciencesShirazIran
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Carmassi C, Tosato S, Bertelloni CA, Pedrinelli V, Cappelli A, Abbate-Daga G, Albert U, Castellini G, Luciano M, Menchetti M, Pompili M, Sampogna G, Signorelli MS, Massimetti G, Fiorillo A. PTSD trajectories across different mental disorders in the second year of the COVID-19 pandemic in Italy: a naturalistic, longitudinal, multicenter study. Int Rev Psychiatry 2022; 34:797-808. [PMID: 36546718 DOI: 10.1080/09540261.2022.2145184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The potentially traumatic impact of the COVID-19 pandemic in subjects with pre-existing mental disorders is still unclear, especially regarding its long-term consequences. The aim of this study was to prospectively assess post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms (PTSS) in patients with mental disorders, during the 3rd wave of the infection (T0, March-April 2021) while strict containment measures were applied in Italy, and after 3 months (T1, June-July 2021), with reduced restrictive measures. A total sample of 527 subjects, with different DSM-5 diagnoses, was consecutively enrolled at nine Italian psychiatric outpatient services. Assessments at T0 included: the Trauma and Loss Spectrum-Self Report (TALS-SR), the Impact of Event Scale-Revised (IES-R) and the Work and Social Adjustment Scale (WSAS). These two latter were repeated at T1. Results showed that at T0, 43.6% of the sample reported symptoms of PTSD, with females (p = .004), younger subjects (p = .011), unemployed/students (p = .011), and living with their parental families (p = .017), resulting more affected. Differences in PTSD rates emerged across diagnostic groups ranging from 10% in patients with psychoses up to 59% in those with feeding and eating disorders. An improvement at T1 emerged in all diagnostic groups for the IES-R scores, while WSAS scores improved only in subjects with mood disorders. In conclusions, subjects with mental disorders presented relevant rates of PTSD and PTSS at 1-year into the pandemic. Further long-term studies are needed to follow-up the course of pandemic traumatic burden especially in patients with severe mental disorders.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | | | - Mario Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Rome "La Sapienza", Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
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4
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Del Casale A, Lai C, Iannuccelli A, Ciacchella C, Veneziani G, Ali M, Zocchi C, Bilotta I, Pompili M. Pandemic experiences and psychopathological aspects in individuals with mood disorders and other mental disorders. Front Psychiatry 2022; 13:1039072. [PMID: 36311495 PMCID: PMC9614274 DOI: 10.3389/fpsyt.2022.1039072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022] Open
Abstract
Individuals with different personality traits, temperaments, and psychological symptoms have different attitudes toward the pandemic experiences and restrictive measures. The aim of the present study was to evaluate the associations between the psychological factors and the attitudes toward COVID-19, experienced during the third pandemic wave in Italy, in a sample of individuals with psychiatric disorders. Between March and September 2021, 53 patients with mood disorders and other mental disorders completed a survey composed of self-report questionnaires that assessed sleep quality, depressive and hypomanic symptoms, and temperament and personality traits. Positive and negative attitudes toward the pandemic experience were assessed using an ad hoc questionnaire. The results showed that individuals with more severe depressive symptoms were less prone to adhere to government guidelines, and were more convinced that the pandemic was not a real problem. Reduced sleep quality was associated with increased skepticism toward official explanations concerning the causes of COVID-19. Lastly, negative affect and cyclothymic temperament predicted the disposition toward COVID-19 vaccines. In conclusion, these findings highlighted that some psychological aspects and psychiatric symptoms could influence the beliefs about COVID-19 and compliance with government recommendations. Further research is needed to provide indications on how to improve the current healthcare policies.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Carlo Lai
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Alessia Iannuccelli
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Chiara Ciacchella
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Giorgio Veneziani
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Mohamed Ali
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Clarissa Zocchi
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Irene Bilotta
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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5
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Kølbæk P, Gil Y, Schmidt FCL, Speed M, Østergaard SD. Symptom severity and well-being of patients with mental illness during the COVID-19 pandemic: a two-wave survey. Nord J Psychiatry 2022; 77:293-303. [PMID: 35834531 DOI: 10.1080/08039488.2022.2099581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE OF THE ARTICLE To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness. MATERIALS AND METHODS In February 2021, we conducted a follow-up questionnaire-based survey among adults with mental illness, who responded to a similar survey on mental health in June 2020. The participants completed the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in mental health using the pre-pandemic period as reference. The survey data were merged with sociodemographic and clinical data from the medical records of all invitees to the first survey, enabling analysis of attrition and weighting of the results. RESULTS A total of 613 of 992 (62%) invitees participated in the follow-up wave of the survey. The weighted mean WHO-5 and BSI-18 scores were 38 and 27, respectively, and did not differ statistically significantly from the first wave. Multivariate logistic regression showed that having a vocational education (skilled worker/craftsman) was positively associated with reporting deterioration in psychological well-being (OR: 2.95, 95%CI: 1.14-7.81), while being unemployed was negatively associated with reporting deterioration in psychological well-being (OR: 0.20, 95%CI: 0.07-0.56) from the first to the second survey wave. The most common reason for self-reported deterioration in mental health was loneliness (70%). CONCLUSIONS Approximately one year into the COVID-19 pandemic, the level of symptoms remained high, whereas the level of psychological well-being remained low among patients with mental illness.
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Affiliation(s)
- Pernille Kølbæk
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Yael Gil
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
| | | | - Maria Speed
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Søren Dinesen Østergaard
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Intimate Relationships during COVID-19 across the Genders: An Examination of the Interactions of Digital Dating, Sexual Behavior, and Mental Health. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11070297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The COVID-19 pandemic has resulted in economic hardship, psychological stress, anxiety, and depression in a significant proportion of the global population. However, the bidirectional effects of social isolation and pre-existing or developed psychological stress could inform sexual behaviors and affect digital dating outcomes. Additionally, it is unknown whether intimate behaviors and relationships have been equally affected across the genders during the COVID-19 pandemic. The purpose of this study is to contrast the course of intimate relationships pre-and post-COVID-19, with a focus on diverse genders, digital dating, mental health, and behavior. A review of the dating landscape during COVID-19 is developed in this study, encompassing themes including diverse genders, sexual orientation, demographic characteristics, sexual behavior, the state of psychological wellbeing, and interactions with digital dating apps. The authors reviewed the trends and challenges of digital romance. Dating before and during the pandemic is explored, discussing how COVID-19 experiences may inform future romantic partnerships. Mobile dating applications saw a surge in downloads and usage across popular platforms, including Tinder (3 billion swipes in March 2020) and Ok Cupid (700% increase in dates), with the top 20 dating apps gaining 1.5 million daily users. Cross-sectionally, being younger, single, and having higher levels of stress was a predictor of higher dating-app usage during the COVID-19 lockdowns. Risky sexual behavior and having multiple sexual partners were reduced during social distancing as there was an increased worry of contracting the virus. Heightened incidents of domestic/intimate partner abuse have caught the headlines in several countries. COVID-19 during lockdown has also posed barriers to accessing support and help from sexual and mental health services.
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7
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Pedruzo B, Catalan A, Aymerich C, Bordenave M, Estevez O, Gómez DA, Herrero J, Laborda M, Mancebo G, Martínez A, Pacho M, Paniagua A, Pérez JL, González-Torres MÁ. Psychological impact of COVID-19 lockdown on a population with serious mental illness. A prospective cohort study. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 16:59-67. [PMID: 35755489 PMCID: PMC9212956 DOI: 10.1016/j.rpsm.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022]
Abstract
Introduction COVID-19 has spread worldwide since its appearance at the end of 2019. In Spain, 99-day long home confinement was set from March 15th 2020. Previous studies about events requiring situations of isolation suggested that mental health problems may occur among the general population and, more specifically, vulnerable groups such as individuals with serious mental illness (SMI). This study aims to assess the psychological effect of confinement in patients with mental illness admitted to an inpatient psychiatric unit. Method In this longitudinal study, IDER (State-Trait Depression Inventory) and STAI (State-Trait Anxiety Inventory) questionnaires were used at two different times (at the beginning and after the lockdown) of the pandemic to evaluate the depression and anxiety symptoms, respectively, in a population of patients who had been previously admitted to the Psychiatry Unit of the Basurto University Hospital. Results 95 participants completed the IDER questionnaire in the first measurement, with a mean score of 24.56 (SD = 8.18) for state and 23.57 (SD = 8.14) for trait. In the case of STAI, the mean score was 27.86 (SD = 15.19) for the state and 30.49 (SD = 14.71) for the trait. No differences between the first and the second time were found in anxiety and depression levels. People with personality disorders presented high levels of anxiety. Conclusions Individuals with a personality disorder showed the highest scores in anxiety and depression. Nevertheless, strict confinement did not affect this population, despite the literature that evidences that the pandemic has worsened people's mental health with SMI.
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Affiliation(s)
- Borja Pedruzo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neuroscience Department, University of the Basque Country, UPV/EHU, Leioa, Spain.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Marta Bordenave
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Olatz Estevez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | | | - Jon Herrero
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - María Laborda
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Gonzalo Mancebo
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ania Martínez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Malein Pacho
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Ana Paniagua
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - José Luis Pérez
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital, Bilbao, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,Neuroscience Department, University of the Basque Country, UPV/EHU, Leioa, Spain
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Carvalho S, Coelho CG, Kluwe-Schiavon B, Magalhães J, Leite J. The Acute Impact of the Early Stages of COVID-19 Pandemic in People with Pre-Existing Psychiatric Disorders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095140. [PMID: 35564538 PMCID: PMC9104538 DOI: 10.3390/ijerph19095140] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/09/2022] [Accepted: 04/21/2022] [Indexed: 01/27/2023]
Abstract
People with pre-pandemic health conditions are more vulnerable and more likely to suffer greater psychosocial impact due to the current COVID-19 pandemic and the lockdown measures. Thus, the objective of this work was to systematically review the impact of the early stages COVID-19 pandemic on people with pre-existing psychiatric disorders. The search was performed between 23 January and 2 September 2021 in PubMed, PsycINFO, and EMBASE. A total of 4167 published results were identified; however, only 49 were included in this review. Results show that there was considerable heterogeneity among studies, which resulted in a low consensus. However, it seems that the impact of the first stage of the COVID-19 pandemic on psychiatric disorders was two-fold: (1) an overall effect, in which people suffering from psychiatric disorders in general experienced more psychological distress and anxiety when compared to people who had no psychiatric diagnosis, and (2) a condition-specific effect, namely in people suffering from eating disorders and obsessive compulsive disorders. Moreover, the current work highlights that there were also some external factors that were related to worsening symptoms. For instance, unemployment or experiencing work and financial difficulties can be a trigger for greater distress during the pandemic for people with mood disorders, and being alone and in social isolation during the COVID-19 pandemic may actually increase substance use and relapse rates. Further studies are needed to prospectively investigate the long-term effects of the current COVID-19 pandemic on people with (pre)-existing psychiatric conditions and on the onset or deterioration of psychiatric-related symptoms in a larger number of participants, as well as exploring the long-term effects of the current pandemic on mental health.
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Affiliation(s)
- Sandra Carvalho
- Translational Neuropsychology Laboratory, William James Center for Research, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
| | - Catarina G. Coelho
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal; (C.G.C.); (B.K.-S.); (J.M.)
| | - Bruno Kluwe-Schiavon
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal; (C.G.C.); (B.K.-S.); (J.M.)
| | - Juliana Magalhães
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, 4710-057 Braga, Portugal; (C.G.C.); (B.K.-S.); (J.M.)
| | - Jorge Leite
- Portucalense Institute for Human Development (INPP), Portucalense University, 4200-072 Porto, Portugal;
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Carmassi C, Pacciardi B, Gravina D, Fantasia S, De Pascale G, Cutuli SL, Bertelloni CA, Dell’Osso L. Pharmacological Treatment of Acute Psychiatric Symptoms in COVID-19 Patients: A Systematic Review and a Case Series. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4978. [PMID: 35564372 PMCID: PMC9099660 DOI: 10.3390/ijerph19094978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023]
Abstract
Delirium and psychomotor agitation are relevant clinical conditions that may develop during COVID-19 infection, especially in intensive care unit (ICU) settings. The psychopharmacological management of these conditions is receiving increasing interest in psychiatry, considering hyperkinetic delirium as one of the most common neuropsychiatries acute consequences in COVID-19 recovery patients. However, there are no actual internationally validated guidelines about this topic, due to the relatively newly introduced clinical condition; in addition, a standardized psychopharmacologic treatment of these cases is a complex goal to achieve due to the risk of both drug-drug interactions and the vulnerable conditions of those patients. The aim of this systematic review and case series is to evaluate and gather the scientific evidence on pharmacologic handling during delirium in COVID-19 patients to provide practical recommendations on the optimal management of psychotropic medication in these kinds of patients. The electronic databases PubMed, Embase and Web of Science were reviewed to identify studies, in accordance with the PRISMA guidelines. At the end of the selection process, a total of 21 studies (n = 2063) were included. We also collected a case series of acute psychomotor agitation in COVID-19 patients hospitalized in ICU. Our results showed how the symptom-based choice of the psychotropic medication is crucial, and even most of the psychotropic drug classes showed good safety, one must not underestimate the possible drug interactions and also the possible decrease in vital functions which need to be strictly monitored especially during treatment with some kinds of molecules. We believe that the evidence-based recommendations highlighted in the present research will enhance the current knowledge and could provide better management of these patients.
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Affiliation(s)
- Claudia Carmassi
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Bruno Pacciardi
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Davide Gravina
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Sara Fantasia
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Gennaro De Pascale
- Department of Emergency, Catholic University of the Sacred Heart, 00168 Rome, Italy; (G.D.P.); (S.L.C.)
| | - Salvatore Lucio Cutuli
- Department of Emergency, Catholic University of the Sacred Heart, 00168 Rome, Italy; (G.D.P.); (S.L.C.)
| | - Carlo Antonio Bertelloni
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
| | - Liliana Dell’Osso
- Psychiatric Unit, Department of Clinical and Experimental Medicine, AOUP, University of Pisa, 56126 Pisa, Italy; (C.C.); (B.P.); (S.F.); (C.A.B.); (L.D.)
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Carmassi C, Dell'Oste V, Bui E, Foghi C, Bertelloni CA, Atti AR, Buselli R, Di Paolo M, Goracci A, Malacarne P, Nanni MG, Gesi C, Cerveri G, Dell'Osso L. The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence. J Affect Disord 2022; 298:209-216. [PMID: 34728285 PMCID: PMC8556686 DOI: 10.1016/j.jad.2021.10.128] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) deployed to the frontline during the COVID-19 pandemic are at risk for developing mental disorders, with a possible impact on their wellbeing and functioning. The present study aimed at investigating post-traumatic stress symptoms (PTSS), anxiety and depressive symptoms and their relationships with impairment in the functioning impairment among frontline HCWs from three Italian regions differently exposed to the first wave of the COVID-19 emergency: Tuscany (low), Emilia-Romagna (medium) and Lombardy (high). METHODS 514 frontline HCWs were consecutively enrolled in hospital units devoted to the treatment of COVID-19 patients. They completed the IES-R, PHQ-9 and GAD-7 to assess PTSS, depressive and anxiety symptoms respectively, and the WSAS to investigate functioning impairment. RESULTS A total of 23.5% of HCWs reported severe PTSS, 22.4% moderate-severe anxiety symptoms, 19.3% moderate-severe depressive symptoms and 22.8% impairment in global functioning. HCWs from the higher-exposure regions reported significantly higher scores in all instruments than those from lower-exposure regions. In a multiple linear regression model, PTSS, depressive and anxiety symptoms presented a significant positive association with the functioning impairment. Both PTSS and depression resulted to be independently related to functioning impairment. LIMITATIONS The cross-sectional design and the use of self-report instruments. CONCLUSIONS Depressive and PTSS appear to be the greatest contributors to functioning impairment in HCWs exposed to a massive stressful sanitary event as the COVID-19 pandemic. A more accurate assessment of work-related mental health outcomes in such population could help planning effective prevention strategies and therapeutic interventions.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
| | - Eric Bui
- Department of Psychiatry, Caen University and Caen University Hospital, Caen, France
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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11
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Carmassi C, Cordone A, Bertelloni CA, Cappelli A, Pedrinelli V, Sampogna G, Massimetti G, Dell'Oste V, Dell'Osso L. A longitudinal study of post-traumatic stress, depressive and anxiety symptoms trajectories in subjects with Bipolar Disorder during the COVID-19 pandemic. Eur Psychiatry 2022; 65:e8. [PMID: 35022099 PMCID: PMC8853854 DOI: 10.1192/j.eurpsy.2021.2247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Bipolar disorder (BD) is recognized to be at high risk for developing negative psychopathological sequelae to potentially traumatic events. Nevertheless, scant data are still available about the effects of the COVID-19 emergency on the clinical course of BD. The present study examined prospectively the development and trajectories of post-traumatic stress, depressive, and anxiety symptoms among subjects with BD that were followed in an outpatient psychiatric clinic at the time of pandemic onset. Methods A cohort of 89 subjects with BD was enrolled during the first wave of the COVID-19 pandemic, and assessed at baseline (T0), 2-months (T1), and 6-months (T2) follow-up. A K-means cluster analysis was used to identify distinct trajectories of depressive, anxiety, and post-traumatic stress symptoms during the three time points. Results We identified three trajectories: the Acute reaction (13.5%); the Increasing severity (23.6%); and the Low symptoms (62.9%) groups, respectively. In the Acute reaction group a significant prevalence of female gender was reported with respect to the Low symptoms one. Subjects in the Increasing severity group reported significantly lower employment rate, and higher rate of relatives at risk for COVID-19 medical complications. Subjects in the Increasing Severity group reported higher rates of previous hospitalization and manic symptoms at baseline than those included in the Low symptoms one. Conclusions Our results describe three distinct symptom trajectories during the COVID-19 emergency in a cohort of subjects suffering from BD, suggesting the need of a long-term follow-up for detecting the impact of the COVID-19 pandemic in this vulnerable population.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Cappelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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12
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Hogg B, Valiente-Gómez A, Redolar-Ripoll D, Gardoki-Souto I, Fontana-McNally M, Lupo W, Jiménez E, Madre M, Blanco-Presas L, Reinares M, Cortizo R, Massó-Rodriguez A, Castaño J, Argila I, Castro-Rodríguez JI, Comes M, Doñate M, Herrería E, Macias C, Mur E, Novo P, Rosa AR, Vieta E, Radua J, Padberg F, Pérez-Solà V, Moreno-Alcázar A, Amann BL. High incidence of PTSD diagnosis and trauma-related symptoms in a trauma exposed bipolar I and II sample. Front Psychiatry 2022; 13:931374. [PMID: 36339849 PMCID: PMC9632656 DOI: 10.3389/fpsyt.2022.931374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II. OBJECTIVE (1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse. METHODS This multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (https://clinicaltrials.gov; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes. RESULTS The majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity. CONCLUSION Trauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients.
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Affiliation(s)
- Bridget Hogg
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Alicia Valiente-Gómez
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Diego Redolar-Ripoll
- Neuromodulation Unit, Institut Brain, Barcelona, Spain.,Cognitive NeuroLab, Faculty of Psychology and Educational Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Itxaso Gardoki-Souto
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,PhD Programme, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Fontana-McNally
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Walter Lupo
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Esther Jiménez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, L'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mercè Madre
- Addictive Behaviours Unit, Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Laura Blanco-Presas
- Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.,Programa TEPT-AGRESX, Instituto de Neurociencias (ICN), Hospital Clinic, Barcelona, Spain
| | - María Reinares
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, L'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Romina Cortizo
- Centro Salud Mental Adultos Ciutat Vella, Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,Centro Salud Mental Adultos (CSMA), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Anna Massó-Rodriguez
- Centro de Salud Mental Infantil y Juvenil (CSMIJ), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Juan Castaño
- Centro Salud Mental Adultos (CSMA), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Isabel Argila
- Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - José Ignacio Castro-Rodríguez
- Centro Salud Mental Adultos (CSMA), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Mercè Comes
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, L'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Doñate
- Centro Salud Mental Adultos (CSMA), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain.,Parc Sanitari Sant Joan de Deu, Sant Boi de Llobegrat, Spain
| | - Elvira Herrería
- Hospital Benito Menni-CASM, Sant Boi de Llobregat, Barcelona, Spain
| | - Cristina Macias
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,Centre Emili Mira, Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Estanislao Mur
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro Salud Mental Adultos (CSMA), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Patricia Novo
- Centro de Salud Mental Infantil y Juvenil (CSMIJ), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain.,Day Hospital, Centro de Psicoterapia de Barcelona (CPB), Barcelona, Spain
| | - Adriane R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Departamento de Farmacologia, Instituto de Ciéncias Básicas de Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande doSul (UFRGS), Porto Alegre, Brazil
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, L'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Joaquim Radua
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, L'Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Clinical Neuroscience, Karolinska Institutet (KI), Solna, Sweden.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Frank Padberg
- Clinic for Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Victor Pérez-Solà
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Centro Salud Mental Adultos (CSMA), Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain.,Departamento de Medicina y Ciencias de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
| | - Ana Moreno-Alcázar
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Benedikt L Amann
- Centre Fòrum Research Unit, Institute of Neuropsychiatry and Addiction (INAD), Parc de Salut Mar, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain.,Clinic for Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.,Departamento de Medicina y Ciencias de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
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13
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Fleischmann E, Dalkner N, Fellendorf FT, Reininghaus EZ. Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature. World J Psychiatry 2021; 11:1387-1406. [PMID: 35070784 PMCID: PMC8717042 DOI: 10.5498/wjp.v11.i12.1387] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/27/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is having a great impact on individuals from all over the world, particularly on individuals with mental disorders. Several studies found more pronounced psychiatric symptoms, notably symptoms of depression and anxiety.
AIM To assess the situation of patients with serious mental illness (SMI: Affective disorders and schizophrenia) regarding their mental health outcome during the pandemic.
METHODS A systematic search using the databases PubMed and MEDLINE was conducted, employing the key words “COVID-19”, “SARS-CoV-2”, “psychiatric/mental disorder/illness”, “affective/mood disorder”, “bipolar disorder”, “(major) depression”, “schizoaffective disorder”, and “schizophrenia”. Studies that had been published up until January 9, 2021 were included. Information of studies in languages other than English and German was mostly taken from their English abstracts.
RESULTS The literature search concluded in the finding of 36 studies containing relevant clinical data. A general impairment of the mental health of individuals with SMI could be detected, particularly in individuals with affective disorders, as compared to those with schizophrenia. Compared to healthy controls, symptoms of anxiety, depression, and stress were more pronounced in individuals with SMI. Relevant factors found that impacted their mental health were age, resilience, and socioeconomic environment, especially the shortage of mental health services, lack of social support, and inadequate information about COVID-19.
CONCLUSION In light of these results, mental health services should be reinforced, notably the use of telemental health services. Furthermore, supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is important. When researching the impact of the COVID-19 pandemic on individuals with SMI, standardization as well as follow-up studies are needed to enable better comparability and understanding.
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Affiliation(s)
- Eva Fleischmann
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Frederike T Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
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14
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Carmassi C, Dell'Oste V, Bertelloni CA, Pedrinelli V, Barberi FM, Malacarne P, Dell'Osso L. Gender and occupational role differences in work-related post-traumatic stress symptoms, burnout and global functioning in emergency healthcare workers. Intensive Crit Care Nurs 2021; 69:103154. [PMID: 34895972 DOI: 10.1016/j.iccn.2021.103154] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/01/2021] [Accepted: 09/08/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To explore gender and occupational role impact on work-related Post-Traumatic Stress Symptoms, Post-Traumatic Stress Disorder, burnout and global functioning in a sample of emergency healthcare workers. DESIGN A cross-sectional study. PARTICIPANTS/SETTING 126 healthcare workers of the Emergency Department, including Intensive Care Unit, Emergency Room and Emergency Medicine, of a major University Hospital in central Italy were recruited. MAIN OUTCOME MEASURES Participants were assessed by means of the: Trauma and Loss Spectrum-Self Report (TALS-SR) to explore Post-Traumatic Stress Spectrum Symptoms, Professional Quality of Life (ProQOL) Scale to assess Compassion Satisfaction, Burnout and Compassion Fatigue and Work and Social Adjustment Scale (WSAS) to measure global functioning. RESULTS The present findings showed females were more prone to develop Post-Traumatic Stress Symptoms, particularly re-experiencing (p = .010) and hyperarousal (p = .026) symptoms and medical doctors reporting higher Burnout (p < .001) and lower Compassion Satisfaction (p = .009) mean scores than nurses. Higher levels of functioning impairment emerged amongst medical doctors rather than nurses, in both social (p = .029) and private (p = .020) leisure activities. Linear correlations highlighted relationships between the TALS-SR, ProQOL and WSAS scores. Finally, medical doctor status was significantly associated with lower Compassion Satisfaction (p = .029) and higher Burnout (p = .015). CONCLUSION Our results highlight high post-traumatic stress symptoms and burnout levels in emergency healthcare workers with a relevant impact of female gender and occupational role, supporting the need for preventive strategies, also in light of the current COVID-19 pandemic.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | | | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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15
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P.0798 Acute peritraumatic distress predicts post-traumatic stress disorder at 6 months in patients with bipolar disorder followed during the COVID-19 pandemic. Eur Neuropsychopharmacol 2021. [PMCID: PMC8716266 DOI: 10.1016/j.euroneuro.2021.10.860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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16
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Fornaro M, De Prisco M, Billeci M, Ermini E, Young AH, Lafer B, Soares JC, Vieta E, Quevedo J, de Bartolomeis A, Sim K, Yatham LN, Bauer M, Stein DJ, Solmi M, Berk M, Carvalho AF. Implications of the COVID-19 pandemic for people with bipolar disorders: A scoping review. J Affect Disord 2021; 295:740-751. [PMID: 34517248 PMCID: PMC8416293 DOI: 10.1016/j.jad.2021.08.091] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/26/2021] [Accepted: 08/30/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The COVID-19 (coronavirus disease 2019)-related pandemic represents a global source of societal and health burden. Yet, the impact of the pandemic on people with severe mental illness, including bipolar disorder (BD), remains unclear, warranting scoping review on the matter. METHODS The MEDLINE and EMBASE databases were systematically searched from inception up to April 24, 2021, adopting broad inclusion criteria to assess a variety of clinical and public health themes related to people with a primary diagnosis of BD during the COVID-19 pandemics. The present work complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) registered in the Open Science Framework (OSF) repository (https://osf.io/7evpx/). RESULTS Fourteen papers informed the present scoping review. Four major themes were identified: (i) impact of COVID-19-related stressors on BD; (ii) impact of COVID-19 on mental health service utilization among people with BD; (iii) impact of BD on the risk of acquiring SARS-CoV-2 infection; (iv) engagement in preventative behaviors among people with BD. Additional themes warranting further research were nonetheless detected. LIMITATIONS Further original studies are needed. CONCLUSION The present study confirmed the high-vulnerability hypothesis concerning people with BD versus the general population, reinforcing the need for further research related to the COVID-19 pandemic. Additional information is warranted to compare the impact of the pandemic period among BD people against pre-pandemic records, the general population, and other severe mental illnesses, namely people with schizophrenia or major depressive disorder, to inform the public health and the delivery of patient-tailored interventions.
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Affiliation(s)
- Michele Fornaro
- Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy
| | - Michele De Prisco
- Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy
| | - Martina Billeci
- Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy
| | - Eleonora Ermini
- Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy
| | - Allan H Young
- Department of Psychological Medicine, Psychology and Neuroscience, Institute of Psychiatry, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK
| | - Beny Lafer
- Bipolar Research Program, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Eduard Vieta
- Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia 08036, Spain
| | - Joao Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Department of Psychiatry and Behavioral Sciences, Translational Psychiatry Program, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Center of Excellence On Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Neuroscience Graduate Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Andrea de Bartolomeis
- Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy; Laboratory of Molecular and Translational Psychiatry and Unit of Treatment-Resistant Psychosis, University of Naples Federico II, Italy; Staff of Unesco Chair for Health Education and Sustainable Development, Naples, Italy
| | - Kang Sim
- Institute of Mental Health Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Dan J Stein
- Department of Psychiatry and Neuroscience Institute, SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia; Department of Psychiatry, Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia
| | - Andre F Carvalho
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia.
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17
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Scattoni ML, Starace F, de Girolamo G, Xia J. An Italy-China Collaboration for Promoting Public Mental Health Recommendations During the COVID-19 Pandemic. Front Public Health 2021; 9:640205. [PMID: 34485211 PMCID: PMC8414581 DOI: 10.3389/fpubh.2021.640205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/20/2021] [Indexed: 12/02/2022] Open
Abstract
The rapid evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergency involved Italy as the first European country. Meanwhile, China was the only other country to experience the emergency scenario, implementing public health recommendations and raising concerns about the mental health of the population. The Italian National Institute of Health [Istituto Superiore di Sanità (ISS)] reviewed relevant scientific literature in mental health to evaluate the best clinical practices and established the collaboration with the WHO, World Psychiatry Association, and China to support the public health system in a phase of acute emergency. This process permitted the definition of organizational and practical-operational Italian guidelines for the protection of the well-being of healthcare workers. These guidelines have been extensively disseminated within the Italian territory for maximum stakeholder utilization.
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Affiliation(s)
- Maria Luisa Scattoni
- Istituto Superiore di Sanità, Research Coordination and Support Service, Rome, Italy
| | - Fabrizio Starace
- AUSL Modena, Department of Mental Health and Drug Abuse, Modena, Italy
- Italian Society of Epidemiological Psychiatry (SIEP), Modena, Italy
| | - Giovanni de Girolamo
- Saint John of God Clinical Research Center, Psychiatric Epidemiology and Evaluation Unit, Brescia, Italy
| | - Jun Xia
- University of Nottingham Ningbo, Nottingham Ningbo GRADE Centre, Nottingham, China
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18
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Broche-Pérez Y, Fernández-Fleites Z, Fernández-Castillo E, Jiménez-Puig E, Ferrer-Lozano DM, Vizcaíno- Escobar AE, Martínez-Rodríguez L, Martín-González R, Rodríguez-Martín BC. Female gender and knowing a person positive for COVID-19 significantly increases fear levels in the Cuban population. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1952739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Yunier Broche-Pérez
- Psychology Department, Universidad Central “Marta Abreu” de Las Villas, Santa Clara, Cuba
- CognitiON (Cuban Iniciative on Cognitive Health), Santa Clara, Cuba
| | - Zoylen Fernández-Fleites
- Psychology Department, Universidad Central “Marta Abreu” de Las Villas, Santa Clara, Cuba
- CognitiON (Cuban Iniciative on Cognitive Health), Santa Clara, Cuba
| | - Evelyn Fernández-Castillo
- Psychology Department, Universidad Central “Marta Abreu” de Las Villas, Santa Clara, Cuba
- CognitiON (Cuban Iniciative on Cognitive Health), Santa Clara, Cuba
| | - Elizabeth Jiménez-Puig
- Psychology Department, Universidad Central “Marta Abreu” de Las Villas, Santa Clara, Cuba
- CognitiON (Cuban Iniciative on Cognitive Health), Santa Clara, Cuba
| | - Dunia M. Ferrer-Lozano
- Psychology Department, Universidad Central “Marta Abreu” de Las Villas, Santa Clara, Cuba
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19
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Dalkner N, Wagner-Skacel J, Ratzenhofer M, Fellendorf F, Lenger M, Maget A, Tmava-Berisha A, Pilz R, Queissner R, Hamm C, Bengesser S, Platzer M, Birner A, Reininghaus E. Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation. Int J Bipolar Disord 2021; 9:16. [PMID: 34059980 PMCID: PMC8166528 DOI: 10.1186/s40345-021-00222-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) pandemic, a global health crisis, has resulted in widespread socioeconomic restrictions including lockdown, social distancing, and self-isolation. To date, little is known about the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder as a particularly vulnerable group. METHODS An online survey was conducted in Austria at two points of measurement (T1 April 2020 during the first lockdown vs. T2 May 2020 at post-lockdown). The sample comprises 20 patients with bipolar disorder (mean age = 49.4 ± 15.6 years) and 20 healthy controls (mean age = 32.7 ± 9.6 years). A 2 × 2 factorial design to compare two time points (T1 vs. T2) and two groups (patients vs. healthy controls) was used. Main outcome measures included the Brief Symptom Inventory-18 (BSI-18) and a (non-validated and non-standardized) assessment to determine COVID-19 fears and emotional distress due to social distancing. Multiple linear regression analyses were used to assess the longitudinal association of COVID-19 fears/emotional distress due to social distancing during lockdown (T1) and psychological symptoms after lockdown (T2). RESULTS At T1, results demonstrated higher scores in BSI-18 subscales depression, anxiety and global severity index as well as emotional distress due to social distancing in bipolar patients compared to controls. There was a significant time x group interaction in the BSI-18 subscale somatization showing a decreasing trend in patients with BD compared to controls. No time effects in BSI-18 subscales or COVID-19 fears/emotional distress due to social distancing were observed. Regression analyses showed that COVID-19 fears during lockdown predicted somatization, only in patients. CONCLUSIONS There was a connection between the lockdown measures and somatization symptoms observed in patients. When the first steps of easing the social restrictions in May 2020 took place, somatization decreased only in the bipolar compared to the control group. Higher COVID-19 fears during lockdown predicted later symptoms at post-lockdown. Long-term impacts of the COVID-19 pandemic need further investigations to improve current therapeutic approaches and prevent fears and distress during lockdown in individuals with bipolar disorder in times of crisis.
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Affiliation(s)
- Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Jolana Wagner-Skacel
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Auenbruggerplatz 3, 8036, Graz, Austria.
| | - Michaela Ratzenhofer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Frederike Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Alexander Maget
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Adelina Tmava-Berisha
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - René Pilz
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Robert Queissner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Carlo Hamm
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Martina Platzer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria
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20
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Mahmoudi H, Saffari M, Movahedi M, Sanaeinasab H, Rashidi-Jahan H, Pourgholami M, Poorebrahim A, Barshan J, Ghiami M, Khoshmanesh S, Potenza MN, Lin CY, Pakpour AH. A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19. Brain Behav 2021; 11:e02138. [PMID: 33811451 PMCID: PMC8119851 DOI: 10.1002/brb3.2138] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/07/2021] [Accepted: 03/16/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep. METHODS Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. RESULTS Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life. CONCLUSION Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
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Affiliation(s)
- Hosein Mahmoudi
- Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahmoud Movahedi
- Behavioral Sciences Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hormoz Sanaeinasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hojat Rashidi-Jahan
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Morteza Pourgholami
- Health Education and Health Promotion unit, Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Poorebrahim
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jalal Barshan
- Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Milad Ghiami
- Health, Safety and Environment Management, Expert of Occupational Health of Health Center, Rasht, Iran
| | - Saman Khoshmanesh
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, Department of Occupational Therapy, Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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21
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Increases in distress during stay-at-home mandates During the COVID-19 pandemic: A longitudinal study. Psychiatry Res 2021; 298:113821. [PMID: 33662840 PMCID: PMC7901303 DOI: 10.1016/j.psychres.2021.113821] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 02/20/2021] [Indexed: 12/18/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has contributed to over 500,000 deaths, and hospitalization of thousands of individuals worldwide. Cross-sectional data indicate that anxiety and depression levels are greater during the pandemic, yet no known prospective studies have tested this assertion. Further, individuals with elevated trait anxiety prior to a global pandemic may theoretically be more apt to experience greater pandemic-related anxiety and/or impairment. The current study tested whether anxiety and depression increased from the month before the state's Stay-At-Home order to the period of the Stay-At-Home order among 120 young adults in Louisiana, a state with especially high rates of COVID-19 related infections and deaths. We also tested whether pre-pandemic social anxiety was related to greater pandemic related anxiety, depression, and COVID-related worry and impairment. Depression but not anxiety increased during the Stay-At-Home order. Further, pre-pandemic trait anxiety, social anxiety, and depression were statistically significant predictors of anxiety and depression during the Stay-At-Home order, although only social anxiety was robustly related to COVID-related worry and impairment. Emotional distress increased during the COVID-19 pandemic Stay-At-Home order and this is especially the case among individuals with pre-pandemic elevations in trait anxiety (especially social anxiety) and depression.
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22
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Chen W, Ju Y, Liu B, Huang M, Yang A, Zhou Y, Wang M, Liao M, Shu K, Liu J, Zhang Y. Negative Appraisals of the COVID-19 Social Impact Associated With the Improvement of Depression and Anxiety in Patients After COVID-19 Recovery. Front Psychiatry 2021; 12:585537. [PMID: 33935820 PMCID: PMC8081962 DOI: 10.3389/fpsyt.2021.585537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Little is known about the factors affecting the recovery of mental health in COVID-19 patients. The purpose of this study is to look into the change of psychological distress and to explore the role of negative appraisals in the improvement of psychological distress in COVID-19 patients after they recovered from the infection. Methods: We conducted a longitudinal survey on patients with COVID-19 infection in Changsha. The 9-item Patient Health scale, the 7-item Generalized Anxiety Disorder scale, and a newly developed measure, the COVID-19 Impact Scale (CIS) were applied to assess patients' depression, anxiety, and negative appraisal toward COVID-19 infection during their hospitalization and 1 month post-discharge. Results: Seventy-two patients were included in the analysis. A significant decrease in anxiety and depression levels was observed after patients were discharged from hospital. Two meaningful factors of the CIS were extracted based on factor analysis, namely "health impact," and "social impact." The change of social impact explained the 12.7 and 10.5% variance in the depression and anxiety symptom improvement, respectively. Conclusions: Change in negative appraisals, especially the appraisals related to COVID-19 social impact may play a vital role in the relief of psychological distress of infected patients. Therefore, a cognitive and social care perspective might be considered when promoting the mental health recovery and readjustment to society among COVID-19 patients.
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Affiliation(s)
- Wentao Chen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
| | - Yumeng Ju
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
| | - Bangshan Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
| | - Mei Huang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
| | - Aiping Yang
- Department of Obstetrics & Gynecology, The First Hospital of Changsha, Changsha, China
| | - Yun Zhou
- Department of Orthopedics, The First Hospital of Changsha, Changsha, China
| | - Mi Wang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
| | - Mei Liao
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
| | - Kongliang Shu
- Department of Neurology, The First Hospital of Changsha, Changsha, China
| | - Jiyang Liu
- Administrative Office, The First Hospital of Changsha, Changsha, China
| | - Yan Zhang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute, Central South University, Changsha, China
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23
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Ma J, Jiang T, Huang H, Li R, Zhang L, Liu L, Liu X. Mental Symptoms and Stress of Hospitalized Schizophrenia Patients With 2019 Novel Coronavirus Disease: An Observation Study. Front Psychiatry 2021; 12:557611. [PMID: 33897476 PMCID: PMC8062770 DOI: 10.3389/fpsyt.2021.557611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 03/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The 2019 novel coronavirus disease (COVID-19) is an extremely rapidly spreading respiratory infection caused by SARS-CoV-2. Many schizophrenic patients were infected with COVID-19 in Wuhan City, Hubei Province. This study took hospitalized schizophrenia patients with COVID-19 as the research subjects and observed the changes in psychopathology and stress of patients with COVID-19 and the accompanying social isolation. Methods: To sort and isolate potential COVID-19-infected patients, an isolated ward was set up from January 30, 2020, to March 30, 2020. Schizophrenia patients with COVID-19 were referred to this ward, and long-term hospitalized cases were included in this study. The Positive and Negative Syndrome Scale and Perceived Stress Scale were used to evaluate the severity of mental symptoms and psychological stress in the early stage of the outbreak of COVID-19, after the diagnosis of COVID-19 and after recovery. At the time of diagnosis, we also extracted the patient's routine blood, biochemical and other indicators and asked the patient's perception of COVID-19. Results: 21 hospitalized schizophrenia patients with COVID-19 were recruited in this study. The changes in PANSS scores were not significant (p = 0.225 baseline vs. diagnosed, p = 0.399 cured vs. diagnosed). The CPSS scores increased significantly after diagnosis and transfer to the isolation ward (p < 0.001 baseline vs. diagnosed, p < 0.001 cured vs. diagnosed). The course of schizophrenia was a protective factor of stress levels to cases (t = -3.25, p = 0.006), and patients' perception of COVID-19 was a risk factor (t = 2.48, p = 0.038). The final multiple linear regression model was statistically significant (F = 8.16, p < 0.001). Conclusion: Hospitalized schizophrenia patients with COVID-19 had increased stress levels and negative symptoms but alleviated positive symptoms after medical isolated treatment. This reminds us that in the face of major epidemics, we must specifically alleviate the psychological burden at the peak of the epidemic and improve the prognosis of patients after the epidemic.
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Affiliation(s)
- Jun Ma
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Tao Jiang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Hanjun Huang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Ruihua Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Zhang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Lianzhong Liu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Xuebing Liu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
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24
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Di Lorenzo R, Frattini N, Dragone D, Farina R, Luisi F, Ferrari S, Bandiera G, Rovesti S, Ferri P. Psychiatric Emergencies During the Covid-19 Pandemic: A 6-Month Observational Study. Neuropsychiatr Dis Treat 2021; 17:1763-1778. [PMID: 34113107 PMCID: PMC8184244 DOI: 10.2147/ndt.s307128] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/22/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The new SARS-CoV-2 has caused an ongoing pandemic. Health prevention measures to contain the outbreak are profoundly affecting the physical and mental health as well as personal freedom of the population. AIM To evaluate psychiatric emergencies in a 6-month period during the COVID-19 pandemic in 2020 compared to those of the corresponding period of the previous year. METHODS This monocentric observational study preliminarily collected variables of the urgent psychiatric consultations (UPCs) carried out in emergency room (ER) from 1-3-2020 to 31-8-2020 and the socio-demographic and clinical characteristics of patients who required UPCs in the 6-month period, comparing these data with those collected from 1-3-2019 to 31-8-2019. The data, collected in alpha-numeric code, were statistically analyzed through STATA 12-2011. RESULTS This research reported a reduction of both UPCs and hospital psychiatric admissions. Concomitantly, we observed an increase of UPCs required by people already being treated by psychiatric and other health services, residents in psychiatric facilities and non-Italians. In 2020, differently from 2019, the most frequent reasons for urgent psychiatric consultations were aggressive behavior and adjustment disorders with anxiety and depressive mood. CONCLUSION This preliminary study suggests that, during the COVID-19 epidemic, urgent psychiatric consultations in ER were reduced, except for the most vulnerable people due to their clinical and/or social conditions.
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Affiliation(s)
- Rosaria Di Lorenzo
- Psychiatric Intensive Treatment Facility, Mental Health and Drug Abuse Department of AUSL-Modena, Modena, Italy
| | - Nicoletta Frattini
- Department of Biomedical, Metabolic and Neural Sciences, School of Nursing, University of Modena and Reggio Emilia, Modena, Italy
| | - Diego Dragone
- Department of Biomedical, Metabolic and Neural Sciences, School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Farina
- Department of Biomedical, Metabolic and Neural Sciences, School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Filippa Luisi
- Department of Biomedical, Metabolic and Neural Sciences, School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, School of Psychiatry, University of Modena and Reggio Emilia, Modena, Italy
| | - Geminiano Bandiera
- Emergency Room and Emergency Medicine Unit, General Hospital of Baggiovara, AOU of Modena, Modena, Italy
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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