Abstract
The acute phase of the COrona VIrus Disease-19 (COVID-19) emergency determined relevant stressful burdens in psychiatric patients, particularly those with chronic mental disorders such as bipolar disorder (BD), not only for the threat of being infected but also for the strict lock-down and social-distancing measures adopted, the economic uncertainty, and the limited possibilities to access psychiatric services. In this regard, telepsychiatry services represented a new important instrument that clinicians could adopt to monitor and support their patients. The aim of the present study was to investigate acute post-traumatic stress symptoms (PTSS) reported by patients with BD followed in the framework of a telepsychiatry service, set up in the acute phase of the COVID-19 outbreak at the psychiatric clinic of the University of Pisa (Italy). A sample of 100 patients were consecutively enrolled and assessed by the IES-r, GAD-7, HAM-D, and YMRS. Patients reported a mean (±SD) IES-r total score of 18.15 ± 13.67. Further, 17% of the sample reported PTSS (IES-r > 32), 17% depressive symptoms (HAM-D > 17), and 26% anxiety symptoms (GAD-7 > 10). Work and financial difficulties related to the COVID-19 pandemic and anxiety symptoms appeared to be positively associated with the development of acute PTSS. Acute manic symptoms appeared to be protective. The data of the present study suggest the relevance of monitoring patients with BD exposed to the burden related to the COVID-19 outbreak for prompt assessment and treatment of PTSS.
Highlights
Increasing literature suggests how COVID-19 and the related quarantine or social-distancing measures, adopted in the acute phase, may have represented a traumatic experience that could have affected mental health and well-being of exposed individuals [1, 2]
The present study first explored the onset of acute post-traumatic stress symptoms (PTSS), anxiety, and depressive symptoms in a sample of 100 patients with bipolar disorder (BD) evaluated in the framework of a telemedicine service set up in the acute phase of the COVID-19 pandemic in Italy, during the period of national lockdown and ongoing social distancing measures
PTSS rates were lower than those found in the majority of previous studies on patients with BD [9, 10]
Summary
Increasing literature suggests how COVID-19 and the related quarantine or social-distancing measures, adopted in the acute phase, may have represented a traumatic experience that could have affected mental health and well-being of exposed individuals [1, 2]. At the end of April 2020, after 55 days of national lock-down during the so-called first phase of the pandemic, in Italy the number of COVID-19 cases exceeded 200,000 units and the death count 31,000 units. During this period, most of the population lived in home-confinement environments. Liu et al [5] reported a 7% prevalence rate of clinically significant PTSS in the Chinese general population living in the hardest-hit areas during the COVID-19 epidemic Another recent study showed post-traumatic stress disorder (PTSD) and depression rates of 2.7 and 9.0%, respectively, among 2,485 home-quarantined Chinese University students [6]
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