Perceived Impact of Covid-19 Across Different Mental Disorders: A Study on Disorder-Specific Symptoms, Psychosocial Stress and Behavior

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.

[1]  Zlata Borshchova,et al.  CONSEQUENCES OF COVID-19 , 2020 .

[2]  G. Castellini,et al.  The impact of COVID‐19 epidemic on eating disorders: A longitudinal observation of pre versus post psychopathological features in a sample of patients with eating disorders and a group of healthy controls , 2020, The International journal of eating disorders.

[3]  U. Voderholzer,et al.  Eating disorders in times of the COVID‐19 pandemic—Results from an online survey of patients with anorexia nervosa , 2020, The International journal of eating disorders.

[4]  Steven Taylor,et al.  Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping? , 2020, Journal of Anxiety Disorders.

[5]  D. Meyer,et al.  Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project , 2020, Journal of Affective Disorders.

[6]  Prestia Davide,et al.  The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study , 2020, Psychiatry Research.

[7]  Y. Bao,et al.  Brief Report: Increased Addictive Internet and Substance Use Behavior During the COVID‐19 Pandemic in China , 2020, The American journal on addictions.

[8]  K. Fountoulakis,et al.  University students’ mental health amidst the COVID-19 quarantine in Greece , 2020, Psychiatry Research.

[9]  M. Muñoz,et al.  Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain , 2020, Brain, Behavior, and Immunity.

[10]  Jason P. Rose,et al.  Psychological Outcomes Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life , 2020, Psychiatry Research.

[11]  Kefeng Li,et al.  Anxiety and depression among general population in China at the peak of the COVID‐19 epidemic , 2020, World psychiatry : official journal of the World Psychiatric Association.

[12]  C. Betsch,et al.  German COVID-19 Snapshot Monitoring (COSMO) - Welle 10 (05.05.2020) , 2020 .

[13]  Á. Planchuelo-Gómez,et al.  Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university , 2020, Psychiatry Research.

[14]  S. Francey,et al.  The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research , 2020, Schizophrenia Research.

[15]  D. Siskind,et al.  Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis , 2020, BMJ.

[16]  C. Napoli,et al.  A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors , 2020, International journal of environmental research and public health.

[17]  L. Sanford,et al.  Insomnia and psychological reactions during the COVID-19 outbreak in China. , 2020, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[18]  Yue Wu,et al.  The immediate mental health impacts of the COVID-19 pandemic among people with or without quarantine managements , 2020, Brain, Behavior, and Immunity.

[19]  T. Jiang,et al.  The differential psychological distress of populations affected by the COVID-19 pandemic , 2020, Brain, Behavior, and Immunity.

[20]  Bach Tran,et al.  A longitudinal study on the mental health of general population during the COVID-19 epidemic in China , 2020, Brain, Behavior, and Immunity.

[21]  Shuicheng Tian,et al.  Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19 , 2020, Psychiatry Research.

[22]  Min Zhao,et al.  Clinical characteristics of hospitalised patients with schizophrenia who were suspected to have coronavirus disease (COVID-19) in Hubei Province, China , 2020, General Psychiatry.

[23]  Philip Gorwood,et al.  The consequences of the COVID-19 pandemic on mental health and implications for clinical practice , 2020, European Psychiatry.

[24]  Yi-Feng Xu,et al.  Patients with mental health disorders in the COVID-19 epidemic , 2020, The Lancet Psychiatry.

[25]  R. Ho,et al.  Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China , 2020, International journal of environmental research and public health.

[26]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[27]  Alex H Krist,et al.  Identifying Attrition Phases in Survey Data: Applicability and Assessment Study , 2019, Journal of medical Internet research.

[28]  G. Andersson,et al.  Internet Interventions for Adults with Anxiety and Mood Disorders: A Narrative Umbrella Review of Recent Meta-Analyses , 2019, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[29]  S. Vocks,et al.  Affect and worry during a checking episode: A comparison of individuals with symptoms of obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, body dysmorphic disorder, illness anxiety disorder, and panic disorder , 2019, Psychiatry Research.

[30]  J. Kruschke Rejecting or Accepting Parameter Values in Bayesian Estimation , 2018 .

[31]  B. O’Dea,et al.  e-Therapy in primary care mental health , 2018, Australian journal of general practice.

[32]  T. Lincoln,et al.  Measuring fluctuations across the Continuum of Auditory Hallucinations. Development and validation of a state inventory , 2017, Psychiatry Research.

[33]  J. Chae,et al.  Mental health status of people isolated due to Middle East Respiratory Syndrome , 2016, Epidemiology and health.

[34]  Matthew J. Denwood,et al.  runjags: An R Package Providing Interface Utilities, Model Templates, Parallel Computing Methods and Additional Distributions for MCMC Models in JAGS , 2016 .

[35]  J. Gabry,et al.  Bayesian Applied Regression Modeling via Stan , 2016 .

[36]  C. Essau,et al.  [Depression, anxiety and stress scales: DASS--A screening procedure not only for pain patients]. , 2015, Schmerz.

[37]  J. Sánchez-Meca,et al.  The Yale–Brown Obsessive Compulsive Scale , 2015, Assessment.

[38]  John K. Kruschke,et al.  Doing Bayesian Data Analysis: A Tutorial with R, JAGS, and Stan , 2014 .

[39]  Seena Fazel,et al.  Risks of all‐cause and suicide mortality in mental disorders: a meta‐review , 2014, World psychiatry : official journal of the World Psychiatric Association.

[40]  M. Berk,et al.  Comparison of self-report and structured clinical interview in the identification of depression. , 2014, Comprehensive psychiatry.

[41]  G. Serafini,et al.  Neuroanatomical markers of genetic liability to psychosis and first episode psychosis: A voxelwise meta-analytical comparison , 2014, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[42]  K. Phillips,et al.  Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Treatment Manual , 2012 .

[43]  Anthony F Jorm,et al.  Stigmatizing Attitudes towards People with Mental Disorders: Findings from an Australian National Survey of Mental Health Literacy and Stigma , 2011, The Australian and New Zealand journal of psychiatry.

[44]  M. Pompili,et al.  Stigmatization of schizophrenia as perceived by nurses, medical doctors, medical students and patients. , 2011, Journal of psychiatric and mental health nursing.

[45]  J. Os,et al.  The size and burden of mental disorders and other disorders of the brain in Europe 2010 , 2011, European Neuropsychopharmacology.

[46]  Xinhua Liu,et al.  Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic , 2011, Comprehensive Psychiatry.

[47]  Martin A. Safer,et al.  Functions of remembering and misremembering emotion , 2009 .

[48]  E. Brähler,et al.  Fragebogen körperdysmorpher Symptome (FKS): Ein Screening-Instrument , 2009, Verhaltenstherapie.

[49]  C. Chu,et al.  Long-term psychiatric morbidities among SARS survivors , 2009, General Hospital Psychiatry.

[50]  Ronald C Kessler,et al.  The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys* , 2009, Epidemiologia e Psichiatria Sociale.

[51]  K. Agho,et al.  Factors influencing psychological distress during a disease epidemic: Data from Australia's first outbreak of equine influenza , 2008, BMC public health.

[52]  G. Loewenstein,et al.  Mispredicting and misremembering: patients with renal failure overestimate improvements in quality of life after a kidney transplant. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[53]  M. Martínez-González,et al.  Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I) , 2008, BMC psychiatry.

[54]  Serena J Counsell,et al.  Evidence from in vivo 31-phosphorus magnetic resonance spectroscopy phosphodiesters that exhaled ethane is a biomarker of cerebral n-3 polyunsaturated fatty acid peroxidation in humans , 2008, BMC psychiatry.

[55]  B. Tuschen-Caffier,et al.  Eating Disorder Examination-Questionnaire , 2007 .

[56]  Charlton Cheung,et al.  Stress and Psychological Distress among SARS Survivors 1 Year after the Outbreak , 2007, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[57]  G. Loewenstein,et al.  Misremembering colostomies? Former patients give lower utility ratings than do current patients. , 2006, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[58]  C. Ko,et al.  Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan , 2006, Psychiatry and clinical neurosciences.

[59]  M. Plummer,et al.  CODA: convergence diagnosis and output analysis for MCMC , 2006 .

[60]  Brian P. Henry from Quarantine , 2005 .

[61]  A. Hedley,et al.  Longitudinal assessment of community psychobehavioral responses during and after the 2003 outbreak of severe acute respiratory syndrome in Hong Kong. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[62]  Xilin Yang,et al.  SARS-related Perceptions in Hong Kong , 2005, Emerging infectious diseases.

[63]  K. C. Wong,et al.  Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS) , 2004, Psychological Medicine.

[64]  C. W. Tam,et al.  Severe acute respiratory syndrome (SARS) in Hong Kong in 2003: stress and psychological impact among frontline healthcare workers , 2004, Psychological Medicine.

[65]  S. Zipfel,et al.  Screening psychischer Störungen mit dem "Gesundheitsfragebogen für Patienten (PHQ-D)" Ergebnisse der deutschen Validierungsstudie , 2004 .

[66]  Ya-Mei Bai,et al.  Survey of stress reactions among health care workers involved with the SARS outbreak. , 2004, Psychiatric services.

[67]  S. Galea,et al.  SARS Control and Psychological Effects of Quarantine, Toronto, Canada , 2004, Emerging infectious diseases.

[68]  C. Chu,et al.  Stress and Psychological Impact on SARS Patients during the Outbreak , 2004, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[69]  Clare Jinks,et al.  Patterns of consent in epidemiologic research: evidence from over 25,000 responders. , 2004, American journal of epidemiology.

[70]  F. Jacobi,et al.  Can gender differences in the prevalence of mental disorders be explained by sociodemographic factors? , 2004, Archives of Women’s Mental Health.

[71]  M. Birnbaum Human research and data collection via the internet. , 2004, Annual review of psychology.

[72]  I. Hand,et al.  Reliabilität der deutschen Version der Yale-Brown Obsessive Compulsive Scale , 2003, Verhaltenstherapie.

[73]  M. A. Safer,et al.  Individual differences in misremembering pre-psychotherapy distress: personality and memory distortion. , 2002, Emotion.

[74]  Ellen Frank,et al.  Demographic and clinical characteristics of individuals in a bipolar disorder case registry. , 2002, The Journal of clinical psychiatry.

[75]  D. Carnall,et al.  Eating disorders , 1999, International Journal of Obesity.

[76]  R. Spitzer,et al.  Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. , 1999, JAMA.

[77]  J. Cohn,et al.  Psychological Distress , 1998, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[78]  R. Mattick,et al.  Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. , 1998, Behaviour research and therapy.

[79]  P. Lovibond,et al.  The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. , 1995, Behaviour research and therapy.

[80]  D. Rubin,et al.  Inference from Iterative Simulation Using Multiple Sequences , 1992 .

[81]  I. Hand,et al.  Die Yale-Brown Obsessive Compulsive Scale (Y-BOCS): Ein halbstrukturiertes Interview zur Beurteilung des Schweregrades von Denk- und Handlungszwängen , 1991 .

[82]  W. Goodman,et al.  The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. , 1989, Archives of general psychiatry.

[83]  M. Seligman,et al.  Learned helplessness in humans: critique and reformulation. , 1978, Journal of abnormal psychology.

[84]  I. Pilowsky,et al.  Dimensions of Hypochondriasis , 1967, British Journal of Psychiatry.

[85]  P. Falkai Diagnostisches und Statistisches Manual Psychischer Störungen - DSM-5 ® , 2015 .

[86]  Elementary tutorial overview of the JAGS software for performing Bayesian statistical analysis: Plummer M. Jags: A program for analysis of bayesian graphical models , 2014 .

[87]  Bai-hua Xu,et al.  Is quarantine related to immediate negative psychological consequences during the 2009 H1N1 epidemic? , 2011, General hospital psychiatry.

[88]  Martyn Plummer,et al.  JAGS: A program for analysis of Bayesian graphical models using Gibbs sampling , 2003 .

[89]  E. Brähler,et al.  Hypochondrie in der Allgemeinbevölkerung , 2003 .

[90]  T. Heidenreich,et al.  Die Erfassung sozialer Phobie durch die Social Interaction Anxiety Scale (SIAS) und die Social Phobia Scale (SPS) , 1999 .

[91]  Joachim Stoeber Besorgnis: Ein Vergleich dreier Inventare zur Erfassung allgemeiner Besorgnis [Worry: A comparison of three inventories to assess general worries] , 1995 .

[92]  T J Meyer,et al.  Development and validation of the Penn State Worry Questionnaire. , 1990, Behaviour research and therapy.

[93]  P. Lewinsohn,et al.  A behavioral approach to depression. , 1974 .