Mental health in individuals with severe mental disorders during the covid-19 pandemic: a longitudinal investigation

Alex Hofer,Josef Marksteiner,Martin Schmidt,Silvia Pardeller,Martin Fronthaler,Beatrice Frajo-Apor,Barbara Plattner,Christian Haring,Roger Pycha,Anna Chernova,Verena Perwanger,Andreas Conca,Carl Miller,Bernhard Holzner,Barbara Sperner-Unterweger,Franziska Tutzer,Markus Huber,Timo Kachel

doi:10.1038/s41537-022-00225-z

Abstract

Research on the long-term mental health impact of the COVID-19 pandemic across mental disorders is limited, and information on the impact of public health policy measures with varying strictness is missing. This study therefore aimed at investigating psychological distress among residents of Tyrol (Austria) and South Tyrol (Italy) at the early stages of the pandemic and 5 months thereafter and examined how sociodemographic, protective, and risk factors relate to change over time. One hundred and fifteen people with severe mental illness (SMI; schizophrenia spectrum disorder, bipolar disorder, major depressive disorder with psychotic features) or major depressive disorder without psychotic features (MDD) and 481 community controls without mental disorders participated in an online survey. Next to the collection of sociodemographic and COVID-19 related variables, the Brief Symptom Checklist, the Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Three-Item Loneliness Scale, and the Multidimensional State Boredom Scale-Short Form were used to assess psychological distress, resilience, perceived social support, loneliness, and boredom. Levels of psychological symptoms and the prevalence of psychological distress were significantly higher in individuals with MDD compared to the other two groups, and Italian participants were more prone to anxiety than those from Austria. Psychological distress was predicted by a lower degree of both resilience and perceived social support as well as loneliness and boredom. Notably, the prevalence of clinically relevant psychological symptoms remained unchanged among each group over time. These results underscore the relevance of tailored prevention and mitigation strategies to meet the specific needs of people both with and without mental disorders.

Highlights

The COVID-19 pandemic and related public health policy measures including quarantine, lockdown, and physical distancing are largely affecting mental health worldwide
Despite a considerable overlap in terms of symptoms, familial patterns, risk genes, and outcome, it remains unclear whether the levels and changes in COVID-19-related psychological distress differ between individuals suffering from severe mental illnesses (SMI) as defined by Kessler et al.[18] (SSD, bipolar disorder (BD), major depressive disorder without psychotic features (MDD) with psychotic features) and those with MDD without psychotic features
We report psychological distress at the early stages of the pandemic and 5 months thereafter in (1) individuals suffering from SMI or (2) MDD and (3) community controls with no self-reported mental health disorders

Summary

Introduction

The COVID-19 pandemic and related public health policy measures including quarantine, lockdown, and physical distancing are largely affecting mental health worldwide. Previous studies have consistently detected a high prevalence of anxiety, depressive symptomatology, and psychological distress among the general population[1], the pandemic has been suggested to have an even more detrimental effect on individuals with a pre-existing psychiatric disorder[2] and in particular, those with severe mental illnesses (SMI) such as schizophrenia or bipolar disorder (BD). They may be more susceptible to infection and to suffer complications of COVID-19 but may experience symptom exacerbations or worsening of the illness course due to increased stress, reduced social interactions, and disruptions in treatment delivery and availability[3].

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