Association between the COVID‐19 pandemic and psychiatric symptoms in people with preexisting obsessive‐compulsive, eating, anxiety, and mood disorders: a systematic review and meta‐analysis of before‐after studies

Abstract

AimTo determine whether, in people with pre‐existing obsessive‐compulsive, eating, anxiety, and mood disorders, the COVID‐19 pandemic was associated with a change in psychiatric symptoms, compared to pre‐pandemic levels.MethodsWe searched MEDLINE, CINAHL, PsychINFO, and EMBASE from inception until February 16th, 2022. Studies were included if they reported pre‐pandemic and during‐pandemic psychiatric symptoms, using validated scales, in people with pre‐existing mood, anxiety, eating, or obsessive‐compulsive disorders. Two reviewers independently screened studies, extracted data, and assessed evidence certainty. Random‐effects meta‐analyses were conducted. Effect sizes were reported as standardized mean differences (SMD) with 95% confidence intervals (CIs).ResultsEighteen studies, from 10 countries, were included. Of the 4465 included participants, 68% were female and the average age was 43. Mood and obsessive‐compulsive disorders were the most studied disorders. During‐pandemic psychiatric measurements were usually collected during nationwide lockdown. Obsessive‐compulsive symptoms worsened among people with obsessive‐compulsive and related disorders, with a moderate effect size (N = 474 [6 studies], SMD = ‐0.45, 95%CI ‐0.82, −0.08, I2 = 83%; very low certainty). We found a small association between the COVID‐19 pandemic and reduced anxiety symptoms in people with mood, anxiety, obsessive‐compulsive, and eating disorders (N = 3738 [6 studies], SMD = 0.11, 95%CI 0.02, 0.19, I2 = 63%; very low certainty). No change in loneliness, depressive or eating symptoms was found.ConclusionPeople with obsessive‐compulsive and related disorders may benefit from additional monitoring during the COVID‐19 pandemic and possibly future pandemics. Other psychiatric symptoms were stable in people with the specific disorders studied. Overall, evidence certainty was very low.This article is protected by copyright. All rights reserved.

Number and nature of psychiatric emergency department visits in a tertiary hospital before, during, and after coronavirus pandemic

“…This was fueled by a context of uncertainty and cumulative macroeconomic losses worldwide ( 4 , 5 ), along with social isolation and its secondary impact on mental health and physical inactivity during this period ( 6 ). Over the months following the onset of the spread of COVID-19, an increased incidence of mental health symptoms were noted among both clinical ( 7 ) and general ( 8 , 9 ) population. A substantial increase in the burden of major depressive disorder and anxiety disorders was noted in 2020, with an increase of their prevalence of around 0.4% worldwide for both disorders ( 10 ) and a prevalence of suicidal ideation among general population of 12.1% ( 11 ), substantially higher than in studies prior to the pandemic.…”