Impact of COVID-19 pandemic related stressors on patients with anxiety disorders: A cross-sectional study

Abstract

The COVID-19 pandemic and related containment measures are affecting mental health, especially among patients with pre-existing mental disorders. The aim of this study was to investigate the effect of the first wave and its aftermath of the pandemic in Germany (March–July) on psychopathology of patients diagnosed with panic disorder, social anxiety disorder and specific phobia who were on the waiting list or in current treatment at a German university-based outpatient clinic. From 108 patients contacted, forty-nine patients (45.37%) completed a retrospective survey on COVID-19 related stressors, depression, and changes in anxiety symptoms. Patients in the final sample (n = 47) reported a mild depression and significant increase in unspecific anxiety (d = .41), panic symptoms (d = .85) and specific phobia (d = .38), while social anxiety remained unaltered. Pandemic related stressors like job insecurities, familial stress and working in the health sector were significantly associated with more severe depression and increases in anxiety symptoms. High pre-pandemic symptom severity (anxiety/depression) was a risk factor, whereas meaningful work and being divorced/separated were protective factors (explained variance: 46.5% of changes in anxiety and 75.8% in depressive symptoms). In line with diathesis-stress models, patients show a positive association between stressors and symptom load. Health care systems are requested to address the needs of this vulnerable risk group by implementing timely and low-threshold interventions to prevent patients from further deterioration.

Health-Promoting Factors and Their Relationships with the Severity of Symptoms in Patients with Anxiety Disorders during the COVID-19 Pandemic

“…Research shows that IU may play a key role in anxiety disorders. In the cognitive model, an individual with anxiety disorders will show intolerance to the state of uncertainty, will have a positive belief about worrying, will use cognitive avoidance and will present a negative orientation to the problem [ 40 ].…”

Mental health improvement after the COVID-19 pandemic in individuals with psychological distress

“…The effect of time was highly significant (F(1.77, 529.13) = 54.54, p < 0.001, η p 2 = 0.15) and is described by a significant rise in strain from pre to peak pandemic (t(306) = 7.07, p < 0.001, d = 0.40 [0.29; 0.52]), which was followed by an even sharper decline from peak to downturn (t(306) = − 16. 23 ). We also found a significant effect of gender (F(1, 299) = 5.50, p = 0.020, η p 2 = 0.02) with higher strain being reported across all assessments by females (z = 0.14) compared to males (z = − 0.20).…”

“…Adverse effects of the COVID-19 pandemic on mental health were particularly pronounced in individuals who already suffered from mental impairments before the outbreak of the pandemic 11,13,15 . For example, a lack of exposure to social situations may have contributed to the maintenance of symptomatology within individuals suffering from social anxiety 19,23,24 . Previous experiences of childhood trauma and other threatening events can also increase an individual's vulnerability for the negative effects of subsequent adverse events 25,26 such as the COVID-19 pandemic 27,28 .…”

Multiple group memberships protect against anticipatory anxiety for social situations

“…Emerging evidence is consistent with this reasoning, with multiple studies reporting increased social anxiety symptoms across the COVID‐19 pandemic (e.g., Arad, Shamai‐Leshem, & Bar‐Haim, 2021; McLeish, Walker, & Hart, 2022; Thompson et al, 2021; cf. Langhammer, Peters, Ertle, Hilbert, & Leuken, 2022). Greater social anxiety symptoms also predict other negative outcomes, such as increased anxiety and stress symptoms (Carlton, Garcia, Andino, Ollendick, & Richey, 2022), and these impacts may be sustained beyond the COVID‐19 pandemic (i.e., after restrictions have eased; Morales et al, 2022).…”