Abstract
Background: Bipolar disorder (BD) is recognized to be at high risk for developing negative psychopathological sequelae to potentially traumatic events. Nevertheless, scant data are still available about the effects of the COVID-19 emergency on the clinical course of BD. The present study examined prospectively the development and trajectories of post-traumatic stress, depressive, and anxiety symptoms among subjects with BD that were followed in an outpatient psychiatric clinic at the time of pandemic onset.
Methods: A cohort of 89 subjects with BD was enrolled during the first wave of the COVID-19 pandemic, and assessed at baseline (T0), 2-months (T1), and 6-months (T2) follow-up. A K-means cluster analysis was used to identify distinct trajectories of depressive, anxiety, and post-traumatic stress symptoms during the three time points.
Results: We identified three trajectories: the Acute reaction (13.5%); the Increasing severity (23.6%); and the Low symptoms (62.9%) groups, respectively. In the Acute reaction group a significant prevalence of female gender was reported with respect to the Low symptoms one. Subjects in the Increasing severity group reported significantly lower employment rate, and higher rate of relatives at risk for COVID-19 medical complications. Subjects in the Increasing Severity group reported higher rates of previous hospitalization and manic symptoms at baseline than those included in the Low symptoms one.
Conclusions: Our results describe three distinct symptom trajectories during the COVID-19 emergency in a cohort of subjects suffering from BD, suggesting the need of a long-term follow-up for detecting the impact of the COVID-19 pandemic in this vulnerable population.
Keywords: Anxiety; COVID-19; PTSD; bipolar disorder; depression.
【저자키워드】 COVID-19, Anxiety, Depression, PTSD, Bipolar disorder, 【초록키워드】 pandemic, Depression, Stress, PTSD, Hospitalization, COVID-19 pandemic, severity, risk, Symptom, Prevalence, Cohort, Clinical course, Cluster, complications, trajectory, Bipolar disorder, Follow-up, cluster analysis, First wave, post-traumatic, Analysis, Long-term follow-up, employment, high risk, vulnerable population, anxiety symptoms, Trajectories, Post-traumatic stress symptoms, Psychiatric, subject, female gender, depressive, disorder, bipolar, COVID-19 emergency, significantly lower, Effect, anxiety symptom, manic, Psychiatric clinic, enrolled, identify, was used, examined, reported, events, groups, Increasing, baseline, post-traumatic stress symptom, 【제목키워드】 Stress, trajectory, Bipolar disorder, post-traumatic, subject, disorder, anxiety symptom,