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Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up
Nina Dalkner1, Jolana Wagner-Skacel2, Michaela Ratzenhofer1
1Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Auenbruggerplatz 31, Graz, 8036, Austria.
Insights
The COVID-19 pandemic lockdown increased psychological distress and fears in bipolar disorder patients. Higher COVID-19 fears during lockdown predicted later somatization symptoms in these patients.
Area of Science:
- Psychiatry
- Psychology
- Public Health
Background:
- The COVID-19 pandemic necessitated global socioeconomic restrictions, including lockdowns and social distancing.
- Bipolar disorder patients are a vulnerable group, yet the psychological impact of the pandemic on them remains understudied.
- Understanding these impacts is crucial for developing targeted interventions during health crises.
Purpose of the Study:
- To investigate the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder.
- To assess COVID-19-related fears and emotional distress due to social distancing in bipolar patients versus healthy controls.
- To examine the longitudinal association between lockdown-related distress and post-lockdown psychological symptoms.
Main Methods:
- An online survey was conducted in Austria with 20 bipolar disorder patients and 20 healthy controls during and after the first lockdown (April-May 2020).
- A 2x2 factorial design compared two time points (lockdown vs. post-lockdown) and two groups (patients vs. controls).
- Measures included the Brief Symptom Inventory-18 (BSI-18), COVID-19 fears, and emotional distress due to social distancing, analyzed using multiple linear regression.
Main Results:
- Bipolar patients reported higher depression, anxiety, global severity, and emotional distress during lockdown compared to controls.
- A significant time x group interaction was observed for somatization, decreasing in bipolar patients post-lockdown.
- COVID-19 fears during lockdown predicted somatization symptoms exclusively in bipolar disorder patients.
Conclusions:
- Lockdown measures were linked to somatization symptoms in bipolar patients, which decreased post-lockdown.
- Elevated COVID-19 fears during lockdown predicted subsequent psychological symptoms in this vulnerable group.
- Further research is needed to understand long-term impacts and improve therapeutic strategies for individuals with bipolar disorder during crises.
Background:
The coronavirus disease (COVID-19) pandemic, a global health crisis, has resulted in widespread socioeconomic restrictions including lockdown, social distancing, and self-isolation. To date, little is known about the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder as a particularly vulnerable group.
Methods:
An online survey was conducted in Austria at two points of measurement (T1 April 2020 during the first lockdown vs. T2 May 2020 at post-lockdown). The sample comprises 20 patients with bipolar disorder (mean age = 49.4 ± 15.6 years) and 20 healthy controls (mean age = 32.7 ± 9.6 years). A 2 × 2 factorial design to compare two time points (T1 vs. T2) and two groups (patients vs. healthy controls) was used. Main outcome measures included the Brief Symptom Inventory-18 (BSI-18) and a (non-validated and non-standardized) assessment to determine COVID-19 fears and emotional distress due to social distancing. Multiple linear regression analyses were used to assess the longitudinal association of COVID-19 fears/emotional distress due to social distancing during lockdown (T1) and psychological symptoms after lockdown (T2).
Results:
At T1, results demonstrated higher scores in BSI-18 subscales depression, anxiety and global severity index as well as emotional distress due to social distancing in bipolar patients compared to controls. There was a significant time x group interaction in the BSI-18 subscale somatization showing a decreasing trend in patients with BD compared to controls. No time effects in BSI-18 subscales or COVID-19 fears/emotional distress due to social distancing were observed. Regression analyses showed that COVID-19 fears during lockdown predicted somatization, only in patients.
Conclusions:
There was a connection between the lockdown measures and somatization symptoms observed in patients. When the first steps of easing the social restrictions in May 2020 took place, somatization decreased only in the bipolar compared to the control group. Higher COVID-19 fears during lockdown predicted later symptoms at post-lockdown. Long-term impacts of the COVID-19 pandemic need further investigations to improve current therapeutic approaches and prevent fears and distress during lockdown in individuals with bipolar disorder in times of crisis.
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