Psychiatric symptoms during the COVID‐19 outbreak in older adults with bipolar disorder

Abstract

Objectives Older adults with bipolar disorder (OABD) are vulnerable for a COVID‐19 infection via multiple pathways. It is essential for OABD to adhere to the COVID‐19 measures, with potential consequences for the psychiatric symptoms. This situation offers the unique opportunity to investigate factors of vulnerability and resilience that are associated with psychiatric symptoms in OABD. Methods This study included 81 OABD patients aged over 50 years. Factors measured at baseline in patients that participated in 2017/2018 were compared with factors measured during the COVID‐19 outbreak. Results Participants experienced less psychiatric symptoms during COVID‐19 than (67.9% euthymic) than at baseline (40.7% euthymic). There was no difference in loneliness between COVID‐19 and baseline. Not having children, more feelings of loneliness, lower mastery, passive coping style and neuroticism were associated with more psychiatric symptoms during COVID‐19 measures. Conclusions Participants experienced less psychiatric symptoms during COVID‐19 measures when compared to baseline. Our results indicate promising targets for psychological interventions aimed at curing and preventing recurrence in OABD and improving quality of life in this growing vulnerable group.

Effects of the COVID‐19 pandemic in a preexisting longitudinal study of patients with recently diagnosed bipolar disorder: Indications for increases in manic symptoms

“…In all these cases, the stress and daily rhythm disruptions of lockdowns and/or quarantine were presumed to be a trigger for the (first) onset of manic episodes. The fact that a previous study (Orhan et al, 2020) among older patient with BD found a decrease in manic symptoms, while in our younger-aged cohort we found an increase might be explained by the fact that younger people with BD are more vulnerable to life stressors than older adults. According to this inoculation-hypothesis, older adults are better able to deal with life-stressors because they simply have more experience with this (Knight et al, 2000).…”

“…In the study by Orhan et al. ( 2020 ), among older (over age 50) patients with BD comparable results with the study we previously mentioned were found: No worsening of symptom levels were observed among these patients. Actually, symptom levels significantly decreased among these patients.…”

“…Although cross‐sectional studies have suggested that an increase in depressive symptoms was associated with the start of the pandemic (e.g., Hao et al., 2020 ), results from prospective, repeated measures, studies showed that participants with mental illness had higher levels of depressive and anxiety symptoms, but these symptoms decreased in the subsequent weeks of lockdown (Fancourt et al., 2020 ; Pan et al., 2021 ). For bipolar patients specifically, cross‐sectional studies again indicated an increase in depressive symptomatology compared to comparison groups (Carta et al., 2021 ; Van Rheenen et al., 2020 ), but prospective studies showed no substantial increases in depressive symptomatology compared to prepandemic measures (Orhan et al., 2021 ; Yocum et al., 2021 ). Possible explanations are that most patients have previously dealt with stressful events and social isolation caused by their mental illness and therefore have learned how to cope with stressful situations, and that the lockdown measures induced some sense of relaxation as their world and habits became more in sync with the quarantined society.…”

The Intersection Between Childhood Trauma, the COVID-19 Pandemic, and Trauma-related and Psychotic Symptoms in People With Psychotic Disorders

“…Studies thus far have reported that individuals with SMI have poorer sleep, 25 more difficulty coping, 26 , 27 and higher levels of (and slower recovery from 25 ) COVID-19-related stress, 25 , 26 , 28–30 anxiety, 25–30 depression, 25–30 loneliness, 26 and psychotic experiences 27 , 28 compared to individuals without psychiatric illness. However, there have been mixed findings, as some studies found no exacerbation of mood or psychotic symptoms in patients, 31 , 32 but rather an increase in self-reported well-being. 31 …”

Factors of Negative Affect in Elderly Patients With Substance Use Disorders During COVID-19 Pandemic

“…As mentioned above, the psychological vulnerability had led to more NA for the elderlies during the pandemic ( 15 ). In particular, clinicians have conducted extensive studies on elderly patients with mood disorder ( 16 , 17 ) and dementia ( 18 ) during the pandemic, as these illnesses are often identified as severe mental disorders ( 19 ). Undoubtedly, these studies provided guidance for clinicians to treat such patients in a more targeted manner, thus helped them positively cope with their NA.…”