Elsevier

Brain, Behavior, and Immunity

Volume 87, July 2020, Pages 100-106
Brain, Behavior, and Immunity

Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry

https://doi.org/10.1016/j.bbi.2020.04.069Get rights and content

Highlights

  • Levels of anxiety, depression, stress and insomnia were higher in psychiatric patients.

  • Psychiatric patients had more health concerns, impulsivity and suicidal ideation.

  • More than one-third of psychiatric patients fulfil the diagnostic criteria for PTSD.

  • Poor physical health was associated with higher levels of anxiety, depression and stress.

  • The above findings have service and research implications for immunopsychiatry.

Abstract

This study aimed to assess and compare the immediate stress and psychological impact experienced by people with and without psychiatric illnesses during the peak of 2019 coronavirus disease (COVID-19) epidemic with strict lockdown measures. Seventy-six psychiatric patients and 109 healthy control subjects were recruited from Chongqing, China and completed a survey on demographic data, physical symptoms during the past 14 days and a range of psychiatric symptoms using the Impact of Event Scale-Revised (IES-R), Depression, Anxiety and Stress Scale (DASS-21) and Insomnia Severity Index (ISI). IES-R measures PTSD symptoms in survivorship after an event. DASS-21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. The mean IES-R, DASS-21 anxiety, depression and stress subscale and ISI scores were higher in psychiatric patients than healthy controls (p < 0.001). Serious worries about their physical health, anger and impulsivity and intense suicidal ideation were significantly higher in psychiatric patients than healthy controls (p < 0.05). More than one-third of psychiatric patients might fulfil the diagnostic criteria post-traumatic stress disorder (PTSD). More than one-quarter of psychiatric patients suffered from moderately severe to severe insomnia. Respondents who reported no change, poor or worse physical health status and had a psychiatric illness were significantly more likely to have higher mean IES-R, DASS depression, anxiety and stress subscale scores and ISI scores (p < 0.05). This study confirms the severity of negative psychological impact on psychiatric patients during the COVID-19 epidemic with strict lockdown measures. Understanding the psychological impact on psychiatric patients during the COVID-19 pandemic has the potential to provide insight into how to develop a new immunopsychiatry service. Further research is required to compare pro-inflammatory cytokines between psychiatric patients and healthy controls during the pandemic.

Keywords

Anxiety
COVID-19
Coronavirus
Depression
Epidemic
Immunopsychiatry
Insomnia
Psychiatric illness
Lockdown
Pandemic
PTSD
Stress
Suicide

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