With over 72 million cases and 1.6 million deaths worldwide, COVID-19 has emerged as an alarming cause of fear, devastation, grief, paranoia, anxiety, and depression across the glove. A new study from the BRAINCITY Center of Excellence for Neural Plasticity and Brain Disorders at the Nencki Institute of Experimental Biology, Warsaw, Poland and University of Zurich, Switzerland published in the journal Frontiers in Psychiatry has shown that between one half to two-thirds of the patients with pre-existing psychiatric conditions around the world have undergone worsening of their psychological symptoms since the start of COVID-19.

The study is led by Dr. Ali Jawaid, who assembled a team of researchers from several countries across the globe and screened more than 13,000 individuals worldwide for past and current psychological conditions. Using an online questionnaire, the researchers extracted data dealing with only those groups which had a prior history of psychiatric ailment – a total of 2,734 patients. They then looked at those patients who reported a decline in their mental health. At first, they validated the self-report of psychiatric condition worsening through scales screening for symptoms related to depression, anxiety, and post-traumatic stress. They then adjusted the reports of worse psychiatric health to various factors, such as patient demographics, social conditions, satisfaction with their employer or state in dealing with COVID-19, personality factors, family conditions like working at home, home isolation, having pets, how much social contact was present, exercise, prior history of trauma and COVID-19-linked factors like knowing someone nearby at work or home who became sick or died from COVID-19.

The researchers then tested another cohort of 318 patients from an independent practice in Houston consulting psychiatrists during the pandemic to verify their results.

The adjusted analysis showed that the highest odds of worsening of mental health (90%) were linked to a feeling of loss of control. Being female, a lack of interaction with others, and dissatisfaction with state response to the outbreak was linked to a 70%, 56%, and 31% increase in the odds of worsening of the psychiatric condition. Factors that prevented such worsening included the freedom to share concerns with those close to the patient, normal usage (not more or less compared to pre-COVID times) of social media, and having a realistic view of conditions. In the clinical study, about 44% of patients had new clinical symptoms, mostly sleep disturbances. Almost half the patients needed a new mode of treatment or adjustment in the current therapy, according to the clinician’s evaluation.

Overall, the study showed that the pandemic had a substantial effect on psychiatric patients globally, with at least half the patients in 8 of the featured 12 countries in the study reporting that their psychiatric condition had worsened. The study’s strengths include a large sample size, a large number of countries, the use of 11 different languages for generalizability, and validation by an independent clinical study. However, it has certain limitations such as the non-randomized nature of the sample and the online nature of the survey, which could exclude the people who are not well-versed with the internet.

The lead author of the study Dr. Ali Jawaid has remarked that the study could not only aid in helping health systems prioritize their mental health services but also has a message for the masses; that we should look out for the vulnerable population of people with pre-existing psychiatric conditions Checking up on these vulnerable populations, encouraging them to seek psychological support and lending them an ear would be an invaluable support. The co-first authors of the study Susanna Gobbi and Martyna Plomecka noted that working on the study made them realize the importance of fostering global collaborations for conducting studies that could help minimize the impact of human crises situations. Most importantly, they opined that they now pay more attention to the mental health struggles of their colleagues, friends, and family. ‘The study’ Ali Jawaid, Susanna Gobbi, and Martyna Plomecka collectively state ‘already has started to serve its larger purpose’.

Original article:  https://www.frontiersin.org/articles/10.3389/fpsyt.2020.581426/full