What Is the Impact of COVID-19 Pandemic on Patients with Pre-Existing Mood or Anxiety Disorder? An Observational Prospective Study.

Background and

Objectives

This observational prospective study aims to examine the psychological and psychopathological impact of the pandemic stress on patients with pre-existing mood, anxiety and obsessive-compulsive disorders. Materials and

Methods

The study includes 386 consecutive patients recruited from 10 March to 30 June 2020 among those being treated at the Institute of Psychopathology in Rome (Italy) with an age ≥18 years and meeting DSM-5 criteria for major depressive disorder (MDD) (35.2%), bipolar I (BD-I) (21.5%) or II (BD-II) (28.8%) disorder, obsessive-compulsive disorder (OCD) (7.5%), panic disorder (PD) (7.0%) or social anxiety (SA). A total of 34.2% had lifetime comorbid Axis I disorders and 15.3% had alcohol/drug abuse disorders. Using a semi-structured interview, we investigated if the impact of COVID-19 stress for patients has been similar, higher or lower than that of their family and friends and, for patients with relapse/symptoms worsening, if there was a relationship between the clinical condition worsening and the pandemic stress.

Results

Compared with that experienced by their family members and friends, the psychological impact of pandemic stress was similar in 52.1% of the sample, better in 37.1% and worse in 10.8%. In 21 patients (5.4%), the stress triggered a recurrence or worsened the symptoms. Patients with OCD had a higher rate of worsening due to pandemic stress compared to patients with MDD (p = 0.033), although, overall, the χ2 test was not significant among primary diagnoses (χ2 = 8.368; p = 0.057).

Conclusions

The psychological and psychopathological consequences of COVID-19 stress in our outpatients were very modest. The continuity of care offered during the lockdown could explain the results.