Abstract
The impact of the COVID-19 pandemic on clinically stable older patients with psychiatric disorders is unclear. This study examined the prevalence of depressive and anxiety symptoms, and their associations with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. This was a multicenter, cross-sectional study. Depressive and anxiety symptoms, insomnia, pain, and QOL were assessed with standardized instruments. A total of 1063 patients were included. The prevalence of depressive and anxiety symptoms, and combined depressive and anxiety symptoms were 62.3% (95%CI = 59.4–65.2%), 52.4% (95%CI = 49.3–55.4%), and 45.9% (95%CI = 42.9–48.9%), respectively. Patients with depressive and anxiety symptoms had significantly lower QOL than those without (P < 0.01). Binary logistic regression analyses revealed that having depressive symptoms was positively associated with more severe insomnia (OR = 1.29, P < 0.01) and pain (OR = 1.14, P < 0.01), and was negatively associated with other psychiatric diagnoses (except for major depressive disorder, schizophrenia, and organic mental disorder; OR = 0.50, P < 0.01), while having anxiety symptoms was positively associated with severe physical diseases (OR = 1.57, P = 0.02), poor adherence to treatment (OR = 1.50, P < 0.01), and more severe insomnia (OR = 1.15, P < 0.01) and pain (OR = 1.11, P < 0.01). Having combined depression and anxiety symptoms was positively associated with poor adherence to treatment (OR = 1.42, P = 0.02) and more severe insomnia (OR = 1.19, P < 0.01) and pain (OR = 1.15, P < 0.01), and was negatively associated with the diagnosis of schizophrenia (OR = 0.50, P = 0.04) and others (OR = 0.53, P < 0.01). Depressive and anxiety symptoms were common in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. Considering the negative impact of these symptoms on QOL, regular screening and appropriate treatment are recommended for this population.
Highlights
As of late July 2020, the Coronavirus Disease 2019(COVID-19) pandemic has caused ~1 million deaths out of >39 million confirmed cases[1]
The prevalence of depression (62.3%) and anxiety (52.4%) in this study were higher than the corresponding figures in adolescents[43] and in the general population
(depression: 27.9%; anxiety: 31.6%%)[24] in China, using the same measurements during the COVID-19 pandemic. This high prevalence of depression and anxiety in older psychiatric patients could be partly due to the fear of high mortality rate and poor prognosis in older people infected with COVID-193–5, which leads to considerable psychological distress in older population
Summary
As of late July 2020, the Coronavirus Disease 2019(COVID-19) pandemic has caused ~1 million deaths out of >39 million confirmed cases[1]. Li et al Translational Psychiatry (2021)11:75 exacerbate fear and psychological distress due to COVID-19. Of older adults, those with preexisting psychiatric disorders need greater attention due to the high risk of mental health problems during the COVID-19 pandemic[6,7]. To reduce the risk of disease transmission, some preventive measures, such as quarantine and travel restriction, could trigger or worsen mental health status in older persons with psychiatric problems[7]. Clinically stable older patients with psychiatric disorders usually require long-term maintenance pharmacotherapy. As a result of quarantine and travel restriction, patients had difficulties attending hospitals, which may trigger mental health problems, such as depression and anxiety. Limited access to health services could result in deterioration of their physical diseases and increase their risk of mental health problems
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