Psychiatric and non-psychiatric population vulnerabilities in time of a crisis: the unsuspected aggression factor

In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis.

We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations.

Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group.

New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.