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Impact of the COVID-19 pandemic on patients with pre-existing mood disorders

Published online by Cambridge University Press:  29 April 2021

James McLoughlin*
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland
Margaret M. O’Grady
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland
Brian Hallahan
Affiliation:
Department of Psychiatry, University Hospital Galway, Galway, Ireland School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
*
Address for correspondence: Dr. James McLoughlin, Department of Psychiatry, Acute Adult Mental Health Unit, University Hospital Galway, Galway, Ireland. (Email: [email protected])

Abstract

Objectives:

To examine the psychological and social impact of the COVID-19 pandemic on patients with established mood disorders during a period of stringent mandated social restrictions.

Methods:

Semi-structured interviews were conducted with 36 individuals attending the Galway–Roscommon Mental Health Services with an International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10) diagnosis of either Bipolar Affective Disorder (BPAD) (n = 20) or Emotionally Unstable Personality Disorder (EUPD) (n = 16) in this cross-sectional study. We determined the impact of the COVID-19 restrictions on anxiety and depressive symptoms, impulsivity, thoughts of self-harm, social and occupational functioning and quality of life.

Results:

The COVID-19 pandemic deleteriously impacted mental health (56.3% v. 15.0%, χ2 = 7.42, p = 0.02), and mood (75.0% v. 20.0%, χ2 = 11.17, p = 0.002) to a greater extent in the EUPD compared to the bipolar disorder cohort, with 43.8% of individuals with EUPD reporting an increase in suicidal ideation. Psychometric rating scales [Beck Anxiety Inventory (BAI), Beck Depression Scale (BDS), Beck Hopelessness Scale (BHS), Barratt Impulsivity Scale (BIS)] and Likert scales for anxiety, mood and quality of life noted significantly higher levels of psychopathology in the EUPD cohort (p < 0.01). Qualitative analysis reflected quantitative data with themes of the employment of maladaptive coping mechanisms and reduced mental health supports notable.

Conclusions:

Individuals with EUPD are experiencing significant mental health difficulties related to the COVID-19 pandemic. The provision and recommencement of therapeutic interventions to this cohort, in particular, are warranted given the significant distress and symptoms being experienced.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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References

Aaronson, CJ, Bender, DS, Skodol, AE, Gunderson, JG (2006). Comparison of attachment styles in borderline personality disorder and obsessive-compulsive personality disorder. Psychiatric Quarterly 77, 6980.CrossRefGoogle ScholarPubMed
Bateman, A, Fonagy, P (2004). Psychotherapy for borderline personality disorder: mentalization-based treatment. Tijdschrift Voor Psychiatrie 46, 872873.Google Scholar
Beck, AT, Epstein, N, Brown, G, Steer, RA (1988a). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893897.CrossRefGoogle ScholarPubMed
Beck, AT, Steer, RA, Carbin, MG (1988b). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review 8, 77100.CrossRefGoogle Scholar
Beck, AT, Steer, RA, Pompili, M (1988c). BHS, Beck Hopelessness Scale: Manual. San Antonio, TX: Psychological Corporation.Google Scholar
Calati, R, Ferrari, C, Brittner, M, Oasi, O, Olié, E, Carvalho, AF, Courter, P et al. (2019). Suicidal thoughts and behaviors and social isolation: a narrative review of the literature. Journal of Affective Disorders 245, 653667.CrossRefGoogle ScholarPubMed
Chan, J, Yuan, S, Kok, K, To, K, Chu, H, Yang, J, Sing, F, Liu, J, Yip, Cc, Poon, RW, Tsoi, HW, Lo, SK, Chan, KH, Poon, VK, Chan, Wm, Ip, JD, Cai, JP, Cheng, VC, Chen, H, Hui, CK, Yuen, KY (2020). A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet 395, 514523. doi: 10.1016/s0140-6736(20)30154-9 CrossRefGoogle ScholarPubMed
Citizens Information Public health measures for COVID-19. (https://www.citizensinformation.ie/en/health/covid19/public_health_measures_for_covid19.html). Accessed 6 January 2021.Google Scholar
Coid, J, Yang, M, Tyrer, P, Roberts, A, Ullrich, S (2006). Prevalence and correlates of personality disorder in Great Britain. The British Journal of Psychiatry 188, 423431.CrossRefGoogle ScholarPubMed
Doyle, M, While, D, Mok, PL, Windfuhr, K, Ashcroft, DM, Kontopantelis, E, Chew-Graham, CA, Appleby, L, Shaw, J, Webb, RT (2016). Suicide risk in primary care patients diagnosed with a personality disorder: a nested case control study. BMC Family Practice 17, 106.CrossRefGoogle ScholarPubMed
Herman, H, Stewart, DE, Diaz-Granados, N, Berger, EL, Jackson, B, Yuen, T (2011). What is resilience? Canadian Journal of Psychiatry 56, 258265.CrossRefGoogle Scholar
Hyland, P, Shevlin, M, McBride, O, Murphy, J, Karatzias, T, Bentall, RP, Martinez, A, Vallieres, F (2020). Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic. Acta Psychiatrica Scandinavica 142, 249256.CrossRefGoogle ScholarPubMed
Korzekwa, MI, Dell, PF, Links, PS, Thabane, L, Webb, SP (2008). Estimating the prevalence of borderline personality disorder in psychiatric outpatients using a two-phase procedure. Comprehensive Psychiatry 49, 380386.CrossRefGoogle ScholarPubMed
Lakeman, R, Crighton, J (2020). The impact of social distancing on people with borderline personality disorder: the views of dialectical behavioural therapists. Issues in Mental Health Nursing 17. doi: 10.1080/01612840.2020.1817208 CrossRefGoogle Scholar
Linehan, MM, Heard, HL, Armstrong, HE (1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry 50, 971974.CrossRefGoogle ScholarPubMed
Nicola, M, Alsafi, A, Sohrabi, C, Kerwan, A, Al-Jabir, A, Iosifidis, C, Agha, M, Agha, R (2020). The socio-economic implications of the coronavirus and COVID-19 pandemic: a review. International Journal of Surgery S1743–9191, 30316–2. doi: 10.1016/j.ijsu.2020.04.018 CrossRefGoogle Scholar
North, CS, Ringwalt, CL, Downs, D, Derzon, J, Galvin, D (2011). Post-disaster course of alcohol use disorders in systematically studied survivors of 10 disasters. Archives of General Psychiatry 68, 173180.CrossRefGoogle Scholar
Patton, JH, Stanford, MS, Barratt, ES (1995). Factor structure of the Barratt impulsiveness scale. Journal of Clinical Psychology 51, 768774.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Pini, S, de Queiroz, V, Pagnin, D, Pezawas, L, Angst, J, Cassano, GB, Wittchen, HU (2005). Prevalence and burden of bipolar disorders in European countries. European Neuropsychopharmacology 15, 425434.CrossRefGoogle ScholarPubMed
Plunkett, R, Costello, S, McGovern, M, McDonald, C, Hallahan, B (2020). Impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders attending secondary care. Irish Journal of Psychological Medicine 19. doi. 10.1017/ipm.2020.75 Google Scholar
Poggi, A, Richetin, J, Preti, E (2019). Trust and rejection sensitivity in personality disorders. Current Psychiatry Reports 21, 69.CrossRefGoogle ScholarPubMed
Simon, NM, Otto, MW, Wisniewski, SR, Fossey, M, Sagduyu, K, Frank, E, Sachs, GS, Nierenberg, AA, Thase, ME, Pollack, MH and STEP-BD Investigators (2004). Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). American Journal of Psychiatry 161, 22222229.CrossRefGoogle ScholarPubMed
Taylor, S (2019). The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease, 1st edn. Newcastle Upon Tyne: Cambridge Scholars Publishing.Google Scholar
Van Rheenen, TE, Meyer, D, Neill, E, Phillipou, A, Tan, EJ, Toh, WL, Rossell, SL (2020). Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: initial results from the COLLATE project. Journal of Affective Disorders 275, 6977.CrossRefGoogle ScholarPubMed
Wang, C, Pan, R, Wan, X, Tan, Y, Xu, L, Ho, CS, Ho, RC (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health 17, 1729.CrossRefGoogle ScholarPubMed
WHO Outbreak Communication Guidelines (2005). Retrieved 6 May 2020, from https://www.who.int/csr/resources/publications/WHO_CDS_2005_28/en/ Google Scholar
Young, JE (1999). Cognitive Therapy for Personality Disorders: A Schema-Focused Approach, 3rd edn. Sarasota, FL: Professional Resource Press/Professional Resource Exchange.Google Scholar
Zimmerman, M, Rothschild, L, Chelminski, I (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. American Journal of Psychiatry 162, 19111918.CrossRefGoogle ScholarPubMed