Differential psychological response to the COVID-19 pandemic in psychiatric inpatients compared to a non-clinical population from Germany

Abstract

The COVID-19 pandemic is an inherently stressful situation, which may lead to adverse psychosocial outcomes in various populations. Yet, individuals may not be affected equally by stressors posed by the pandemic and those with pre-existing mental disorders could be particularly vulnerable. To test this hypothesis, we assessed the psychological response to the pandemic in a case–control design. We used an age-, sex- and employment status-matched case–control sample (n = 216) of psychiatric inpatients, recruited from the LMU Psychiatry Biobank Munich study and non-clinical individuals from the general population. Participants completed validated self-report measures on stress, anxiety, depression, paranoia, rumination, loneliness, well-being, resilience, and a newly developed index of stressors associated with the COVID-19 pandemic. Multiple linear regression analyses were conducted to assess the effects of group, COVID-19-specific stressors, and their interaction on the different psychosocial outcomes. While psychiatric inpatients reported larger mental health difficulties overall, the impact of COVID-19-specific stressors was lower in patients and not associated with worse psychological functioning compared to non-clinical individuals. In contrast, depressive symptoms, rumination, loneliness, and well-being were more strongly associated with COVID-19-specific stressors in non-clinical individuals and similar to the severity of inpatients for those who experienced the greatest COVID-19-specific stressor impact Contrary to expectations, the psychological response to the pandemic may not be worse in psychiatric inpatients compared to non-clinical individuals. Yet, individuals from the general population, who were hit hardest by the pandemic, should be monitored and may be in need of mental health prevention and treatment efforts.

Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis

“…International research has shown that these stressors might lead to reduced levels of well‐being within the population (e.g., South Korea: Kim et al., 2021 ; New Zealand: Sibley et al., 2020 ). German studies (Jung et al., 2020 ; Rek et al., 2021 ) found an average of 20% lower well‐being scores compared to a pre‐COVID‐19 norming sample (Brähler et al., 2007 ).…”

“…Given the multiple stressors during the current pandemic and first evidence indicating a general reduction of well‐being (Jung et al., 2020 ; Rek et al., 2021 ), the present study aimed to (1) identify latent coping profiles in the German general population during the first year of the COVID‐19 pandemic and to (2) investigate differences between these profiles in well‐being.…”

Development and validation of 21-item outcome inventory (OI-21)

“…During this COVID-19 pandemic, research demonstrated an increased level of mental health problems, e.g., anxiety, depression and somatization of people across population subgroups, especially in nonclinical population ( Dragioti et al., 2021 ; Hu et al., 2022 ; Zhang et al., 2022 ). The level of some symptoms, depression and loneliness due to COVID, were raised in nonclinical populations to the extent that nondifferences between clinical and nonclinical subjects were observed ( Rek et al., 2022 ). The role of self-report questionnaires, including OI-21, should be suitable for identifying and monitoring such mental health problems.…”

Exploring Hikikomori-like idiom of distress a year into the SARS-CoV-2 pandemic in Oman: Factorial validity of the 25-item Hikikomori Questionnaire, prevalence and associated factors

“…This culture-reactive hypothesis is aligned with the diathesis-stress model of psychopathology, which asserts that a person’s genetic or biological predisposition influences the probability of developing distress when a particular stressor is present [ 21 ]. The diathesis-stress model also appears to be supported by the recent tribulations of the SARS-COV-2 pandemic [ 22 ]. With the emergence of the pandemic, when lockdowns and social isolation were promoted to curb infection spread, there has been heightened reporting of the proliferation of loneliness and the development of something akin to HLID [ 23 – 25 ].…”