Mental disorders during the pandemic of a new coronavirus infection: causes and predisposing factors

Objective: to study the causes and predictors of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness.
Patients and methods. We examined 100 patients who turned to a psychiatrist due to a deterioration in their mental state during the pandemic, 50 patients were newly diagnosed (Group 1) and 50 with previously diagnosed mental disorders (Group 2). The study was carried out by a clinical method using a specially designed map, followed by statistical processing of the obtained data.
Results and discussion. Mental disorders caused by the COVID-19 pandemic more often occurred at a young age, in patients with higher and secondary specialized education, and in single patients. In the 1st group, as a result of exposure to psychogenic factors (the influence of the media, quarantine, economic changes), anxiety (36.8%) and depressive (21.1%) disorders occurred more often, and after the coronavirus infection, depressive disorders were in the first place (54.2%). The 2nd group mostly included patients with endogenous disorders (bipolar affective disorder – 24%, recurrent depressive disorder – 20%, schizophrenia – 20%), which were exacerbated more often as a result of COVID-19, to a lesser extent – psychogenic (experiences associated with a change in material status and illness of relatives). Obsessive-compulsive disorder, generalized anxiety disorder, somatoform disorders have been associated with epidemic factors.
Conclusion. The results obtained indicate that there are differences between the mental disorders that first appeared during the pandemic and the exacerbations of the condition in mentally ill patients, which relate to the predictors, causes and clinical manifestations of these disorders.

1. Avery J, Leboeuf J, Holding A, et al. Rewriting the script: How COVID-19 affected the relation between intrinsic aspirations and depressive symptoms. Pers Individ Dif. 2023 Jan;200:111869. doi:10.1016/j.paid.2022.111869. Epub 2022 Aug 24.

2. Zhang X, Lewis S, Chen X, et al. Mental health professionals views and the impact of COVID-19 pandemic on implementing digital mental health in China: A nationwide survey study. Internet Interv. 2022 Sep 24;30:100576. doi:10.1016/j.invent.2022.100576

3. Farcas A, Christi P, Fagen J, Iftene F. Possible predictors of Covid-19 vaccine hesitancy in the psychiatric population – A scoping review. Psychiatry Res Commun. 2022 Dec;2(4):100075. doi:10.1016/j.psycom.2022.100075. Epub 2022 Sep 13.

4. Ostroumova TM, Chernousov PA, Kuznetsov IV. Cognitive impairment in COVID-19 survivors. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):126-30. doi:10.14412/2074-2711-2021-1-126-130 (In Russ.).

5. Khasanova DR, Zhitkova YuV, Vaskaeva GR. Post-covid syndrome: a review of pathophysiology, neuropsychiatric manifestations and treatment perspectives. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(3):93-8. doi:10.14412/2074-2711-2021-3-93-98 (In Russ.).

6. Zhao Y, Qu D, Chen S, Chi X. Network analysis of internet addiction and depression among Chinese college students during the COVID-19 pandemic: A longitudinal study. Comput Human Behav. 2023 Jan;138:107424. doi:10.1016/j.chb.2022.107424. Epub 2022 Aug 5.

7. Guo Q, Zheng Y, Shi J, et al. Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: a mixed-method study. Brain Behav Immun. 2020 Aug;88:17-27. doi:10.1016/j.bbi.2020.05.038. Epub 2020 May 19.

8. Lei L, Huang X, Zhang S, et al. Comparison of Prevalence and Associated Factors of Anxiety and Depression Among People Affected by versus People Unaffected by Quarantine During the COVID-19 Epidemic in Southwestern China. Med Sci Monit. 2020 Apr 26;26:e924609. doi:10.12659/MSM.924609

9. Rodriguez-Munoz A, Antino M, Ruiz-Zorrilla P, Sanz-Vergel A. Los Efectos Psicologicos de la Cuarentena por el COVID-19: Un estudio Longitudinal [Proyecto de Investigacion en Ejecucion]. Madrid: Universidad Complutense; 2020.

10. Wang C, Pan R, Wan X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav Immun. 2020;87:40-8. doi:10.1016/j.bbi.2020.04.028

11. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020 Jun;288:112954. doi:10.1016/j.psychres.2020.112954. Epub 2020 Apr 12. Erratum in: Psychiatry Res. 2021 May;299:113803.

12. Brooks SK, Webster RK, Smith LE. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020 Mar 14;395(10227):912-20. doi:10.1016/S0140-6736(20)30460-8. Epub 2020 Feb 26.

13. Reynolds DL, Garay JR, Deamond SL, et al. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008 Jul;136(7):997-1007. doi:10.1017/S0950268807009156. Epub 2007 Jul 30.

14. Merkin AG, Akinfieva SS, MartyushevPoklad AV, et al. Anxiety: phenomenology, epidemiology, and risk factors during the novel coronavirus SARS-CoV-2 (COVID-19) pandemic. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):107-12. doi:10.14412/2074-2711-2021-1-107-112 (In Russ.).

15. Mazza C, Ricci E, Biondi S, et al. A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors. Int J Environ Res Public Health. 2020 May 2;17(9):3165. doi:10.3390/ijerph17093165

16. Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med. 2021 Jan;26(1):13-22. doi:10.1080/13548506.2020.1746817. Epub 2020 Mar 30.

17. Li W, Yang Y, Liu ZH, et al. Progression of Mental Health Services during the COVID-19 Outbreak in China. Int J Biol Sci. 2020 Mar 15;16(10):1732-8. doi:10.7150/ijbs.45120

18. Finatti F, Pigato G, Pavan C, et al. Psychosis in Patients in COVID-19-Related Quarantine: A Case Series. Prim Care Companion CNS Disord. 2020 May 14;22(3):20l02640. doi:10.4088/PCC.20l02640

19. Pandi-Perumal SR, Vaccarino SR, Chattu VK, et al. 'Distant socializing,' not 'social distancing' as a public health strategy for COVID-19. Pathog Glob Health. 2021 Sep;115(6):357-64. doi:10.1080/20477724.2021.1930713. Epub 2021 May 30.

20. Mamun MA, Al-Mamun F, Hosen I, et al. Prevalence and risk factors of sleep problems in Bangladesh during the COVID-19 pandemic: a systematic review and meta-analysis. Sleep Epidemiol. 2022 Dec;2:100045. doi:10.1016/j.sleepe.2022.100045. Epub 2022 Sep 30.

21. Dorozhenok IYu. Somatization disorders of affective and neurotic registers during the COVID-19 pandemic (analysis of clinical cases). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2020;12(6):137-143. doi:10.14412/2074-2711-2020-6-137-143 (In Russ.).

22. Tang W, Hu T, Hu B, et al. Prevalence and correlates of PTSD and depressive symptoms one month after the outbreak of the COVID-19 epidemic in a sample of home-quarantined Chinese university students. J Affect Disord. 2020 Sep 1;274:1-7. doi:10.1016/j.jad.2020.05.009. Epub 2020 May 13.

23. Cosic K, Popovic S, Sarlija M, Kesedzic I. Impact of Human Disasters and COVID-19 Pandemic on Mental Health: Potential of Digital Psychiatry. Psychiatr Danub. 2020 Spring;32(1):25-31. doi:10.24869/psyd.2020.25

24. Asmundson GJG, Paluszek MM, Landry CA, et al. Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping? J Anxiety Disord. 2020 Aug;74:102271. doi:10.1016/j.janxdis.2020.102271. Epub 2020 Jul 7.

25. Hao F, Tan W, Jiang L, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry. Brain Behav Immun. 2020 Jul;87:100-6. doi:10.1016/j.bbi.2020.04.069. Epub 2020 Apr 27.

26. Spada MS, Biffi AM, Belotti L, et al. Psychological impact of COVID-19 after hospital discharge: A follow-up study on Italian recovered patients. J Affect Disord. 2022 Nov 15;317:84-90. doi:10.1016/j.jad.2022.08.086. Epub 2022 Aug 24.

27. Golovacheva VA, Tabeeva GR, Kuznetsov IV. Cognitive impairment in COVID-19: associations, pathogenesis and treatment questions. Nevrologiya, neiropsikhiatriya, psikhosomatika=Neurology, Neuropsychiatry, Psychosomatics. 2021;13(2):123-9. doi:10.14412/2074-2711-2021-2-123-129 (In Russ.).

28. Azoulay E, Resche-Rigon M, Megarbane B, et al. Association of COVID-19 Acute Respiratory Distress Syndrome With Symptoms of Posttraumatic Stress Disorder in Family Members After ICU Discharge. JAMA. 2022 Mar 15;327(11):1042-50. doi:10.1001/jama.2022.2017

29. Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun. 2020 Jul;87:34-9. doi:10.1016/j.bbi.2020.04.027. Epub 2020 Apr 13.

30. Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020 Jul;7(7):611-27. doi:10.1016/S2215-0366(20)30203-0. Epub 2020 May 18.

31. Costa M, Pavlo A, Reis G, et al. COVID-19 Concerns Among Persons With Mental Illness. Psychiatr Serv. 2020 Nov 1;71(11):1188-90. doi:10.1176/appi.ps.202000245. Epub 2020 Sep 3.

32. Ren X, Shen F, Gui Y, et al. The attitudes of psychiatric patients towards COVID-19 vaccination in China: a cross-sectional study. BMC Psychiatry. 2021 Sep 29;21(1):475. doi:10.1186/s12888-021-03484-9

33. Mitchell L, Wilkosz M, Fuehrlein B. COVID-19 Vaccine Administration and Hesitation Among Psychiatric Emergency Services Patients. Community Ment Health J. 2022 Oct;58(7):1381-4. doi:10.1007/s10597-022-00949-3. Epub 2022 Feb 12. Erratum in: Community Ment Health J. 2022 Apr 7.

34. Van Antwerpen N, Turnbull D, Searston RA. The role of anxiety in mediating the relationship between information consumption and COVID-19 protective behaviours. Psychol Health Med. 2022 Oct;27(9):2043-56. doi:10.1080/13548506.2021.2008994. Epub 2021 Nov 22.

35. Yao H, Chen JH, Xu YF. Patients with mental health disorders in the COVID-19 epidemic. Lancet Psychiatry. 2020 Apr;7(4):e21. doi:10.1016/S2215-0366(20)30090-0

36. Jin Y, Sun T, Zheng P, An J. Mass quarantine and mental health during COVID-19: A meta-analysis. J Affect Disord. 2021 Dec 1;295:1335-46. doi:10.1016/j.jad.2021.08.067. Epub 2021 Sep 2.

37. Budimir S, Probst T, Pieh C. Coping strategies and mental health during COVID-19 lockdown. J Ment Health. 2021 Apr;30(2):156-63. doi:10.1080/09638237.2021.1875412. Epub 2021 Jan 27.

38. Hossain MM, Tasnim S, Sultana A, et al. Epidemiology of mental health problems in COVID-19: a review. F1000Res. 2020 Jun 23;9:636. doi:10.12688/f1000research.24457.1