Tele-Psychiatry Assessment of Post-traumatic Stress Symptoms in 100 Patients With Bipolar Disorder During the COVID-19 Pandemic Social-Distancing Measures in Italy

Abstract

The acute phase of the COrona VIrus Disease-19 (COVID-19) emergency determined relevant stressful burdens in psychiatric patients, particularly those with chronic mental disorders such as bipolar disorder (BD), not only for the threat of being infected but also for the strict lock-down and social-distancing measures adopted, the economic uncertainty, and the limited possibilities to access psychiatric services. In this regard, telepsychiatry services represented a new important instrument that clinicians could adopt to monitor and support their patients. The aim of the present study was to investigate acute post-traumatic stress symptoms (PTSS) reported by patients with BD followed in the framework of a telepsychiatry service, set up in the acute phase of the COVID-19 outbreak at the psychiatric clinic of the University of Pisa (Italy). A sample of 100 patients were consecutively enrolled and assessed by the IES-r, GAD-7, HAM-D, and YMRS. Patients reported a mean (±SD) IES-r total score of 18.15 ± 13.67. Further, 17% of the sample reported PTSS (IES-r > 32), 17% depressive symptoms (HAM-D > 17), and 26% anxiety symptoms (GAD-7 > 10). Work and financial difficulties related to the COVID-19 pandemic and anxiety symptoms appeared to be positively associated with the development of acute PTSS. Acute manic symptoms appeared to be protective. The data of the present study suggest the relevance of monitoring patients with BD exposed to the burden related to the COVID-19 outbreak for prompt assessment and treatment of PTSS.

Increases in distress during stay-at-home mandates During the COVID-19 pandemic: A longitudinal study

“…It may be that clinical samples may be more vulnerable to the adverse mental health effects of COVID-19, as has been found in other disasters ( Zvolensky et al, 2015 ). In fact, individuals receiving outpatient telehealth services during the Stay-At-Home order and those who were diagnosed with psychiatric disorders endorsed elevated levels of posttraumatic stress during Stay-At-Home orders compared to individuals who did not have pre-existing mental health conditions ( Carmassi et al, 2020 ; Hao et al, 2020 ), and these symptoms were especially elevated among women with Bipolar disorder ( Carmassi et al, 2020 ). Third, data were collected via self-reports.…”

A mediating role for mental health in associations between COVID‐19‐related self‐stigma, PTSD, quality of life, and insomnia among patients recovered from COVID‐19

“…Therefore, specific attention should be paid to this vulnerable population. Indeed, recent research has found that patients with psychiatric problems had high levels of mental health burden (including PTSD and insomnia) when they were exposed to lockdowns and spatial distancing (Carmassi, Bertelloni, et al., 2020).…”

Negative Appraisals of the COVID-19 Social Impact Associated With the Improvement of Depression and Anxiety in Patients After COVID-19 Recovery

“…Although patients have recovered from the infection and finished quarantine for medical observation, they are suffering from social isolation and economic problems or unemployment because of the diagnosis (37). Consistently, a recent study also reported that COVID-19-related financial and social difficulties or concerns were a major risk factor for psychological distress in subjects (38). Therefore, disturbing social problems may be more strongly linked to psychological distress in patients.…”