Effects of COVID-19-related stress and fear on depression in schizophrenia patients and the general population

Abstract

This study compared the coronavirus disease 2019 (COVID-19)-related stress, fear of infection, loneliness, and depression between patients with schizophrenia and the general population. A face-to-face survey was administered to 1340 patients with a schizophrenia spectrum disorder and online survey of the general population (n = 2000) was conducted. The information gathered included the level of COVID-19-related stress, fear of infection, the Patient Health Questionnaire-9 score, and the three-item UCLA Loneliness Scale score. Structural equation modeling revealed a significant effect of fear of COVID-19 infection on depression among the general population and on loneliness among patients with schizophrenia. Loneliness experienced during COVID-19 exacerbated depression in both groups. In the COVID-19-related stress–loneliness–depression pathway, the partial mediating effect of loneliness was significant in both groups. Conversely, in the COVID-19-related fear–loneliness–depression pathway, the full mediating effect of loneliness was only significant in patients with schizophrenia. In conclusion, the loneliness associated with COVID-19-related stress and fear of infection was an important factor influencing depression, and the impact was greater in patients with schizophrenia compared with the general population. Thus, different mental health intervention plans are needed for patients with schizophrenia during the COVID-19 pandemic. During the long-lasting COVID-19 pandemic, social support and provision of mental health services to prevent loneliness and consequent depression are required in patients with schizophrenia.

Predictors of COVID-19 Stress and COVID-19 Vaccination Acceptance among Adolescents in Ghana

“…To the best of the researchers' knowledge, this is the first study to examine COVID-19-related variables that influence COVID-19 stress among adolescents. A study among healthy adults and people with schizophrenia revealed a significant positive association between fear of COVID-19 and COVID-19 stress [35]. A closely related study that examined predictive factors of post-traumatic stress disorder (PTSD) revealed that stigma was not able to predict PTSD, which is contrary to this study's finding [70].…”

“…Further studies are needed to examine the factors that mediate the association between other COVID-19-related variables and COVID-19 vaccine acceptance. These findings are not entirely new as some studies have also examined and established similar relationships between some COVID-19-related variables [32][33][34][35]44].…”

“…Furthermore, adolescents' perceived stress from COVID-19 was associated with mental health problems (e.g., depression and sleep disorders) and other COVID-19-related variables such as fear of COVID-19 [30][31][32]. Other studies have also examined the relationships between some COVID-19-related variables [33][34][35]. Therefore, it can be deduced that COVID-19-related variables such as fear of COVID-19, believing COVID-19 information, and COVID-19 stress may be related to each other.…”

COVID-19 related risk factors and their association with non-syndromic orofacial clefts in five Arab countries: a case-control study

“…It also persisted after accounting for COVID-19 infection. Our study, thus, adds to the growing literature documenting the impact of COVID-19 related stresses and fear on health [ 25 , 41 , 42 ]. Previous research showed an association between COVID-related stresses and stress-related oral conditions such as plaque accumulation and gingival inflammation [ 43 ] and oral ulcers [ 44 ].…”

Experiences of the COVID-19 pandemic amongst individuals with severe mental health conditions and caregivers in South Africa: a qualitative study

“…Social isolation and changes to people's 'social ecosystem', structure and routine have been documented across the globe since the onset of the COVID-19 pandemic, including in HIC [39,47]. Isolation and loneliness may increase symptom severity for people with mental health conditions [48][49][50][51]. Although most service users in this study felt their degree of social isolation was already high and largely unchanged by the pandemic, which has likewise been reported in some HIC settings [39], opportunities for social interaction and relationships (including via casual social contacts in neighbourhoods) became further restricted.…”