Abstract

The recent outbreak of the coronavirus disease (Covid-19) has plunged countries across the world into crisis. Both in the general population and in specific subgroups such as infected people or health care workers, studies have reported increased symptoms of anxiety, depression and stress. However, the reactions of individuals with mental disorders to Covid-19 have largely been neglected. The present study therefore aimed to investigate the perceived impact of Covid-19 and its psychological consequences on people with mental disorders. In this online survey, participants were asked to evaluate their disorder-specific symptoms, perceived psychosocial stress and behaviors related to Covid-19 in the current situation and retrospectively before the spread of Covid-19. The study included participants with self-identified generalized anxiety disorder (GAD), panic disorder and agoraphobia (PA), illness anxiety disorder (IA), social anxiety disorder (SAD), depression (DP), obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), eating disorders (ED), schizophrenia spectrum and other psychotic disorders (SP), other non-specified mental disorder (other) as well as mentally healthy controls (HC). The results of bayesian parameter estimation suggest that the symptom severity of DP, GAD, IA and BDD has deteriorated as a reaction to Covid-19. Across all mental disorders and HC, self-reported psychosocial stress levels were higher during the outbreak of Covid-19 compared to before. A reduced frequency of social contacts and grocery shopping was found for all participants. People with self-identified mental disorders showed higher personal worries about Covid-19 and a higher fear of contagion with Covid-19 than did HC. According to our findings, Covid-19 may reinforce symptom severity and psychosocial stress in individuals with mental disorders. In times of pandemics, special support is needed to assist people with mental disorders and to prevent symptom deterioration.

Highlights

  • More than a third of the total population of the European Union is affected by a mental disorder (Wittchen et al, 2011)

  • The present study examined potential changes in symptom severity, perceived stress levels, behaviors related to Covid-19, worries, fears and quality of life in individuals with and without mental disorders in an exploratory manner during the initial outbreak of Covid-19

  • Regarding symptom severity, an increase in symptom severity was found for the group of DP, body dysmorphic disorder (BDD), illness anxiety disorder (IA), and generalized anxiety disorder (GAD) during the outbreak of Covid-19 compared to November 2019

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Summary

Introduction

More than a third of the total population of the European Union is affected by a mental disorder (Wittchen et al, 2011). With the recent pandemic of coronavirus disease (Covid-19), people with and without mental disorders are facing profound changes to their lives, such as quarantine and isolation (e.g., Kaparounaki et al, 2020; Li et al, 2020a; Zhu et al, 2020). It is unknown how Covid-19 is impacting the psychological health of people with mental disorders. People living in an infected area may feel negatively affected by the outbreak of an epidemic

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