Mental Health Impact of Early Stages of the COVID-19 Pandemic on Individuals with Pre-Existing Mental Disorders: A Systematic Review of Longitudinal Research

Abstract

In view of disease-related threats, containment measures, and disrupted healthcare, individuals with pre-existing mental illness might be vulnerable to adverse effects of the COVID-19 pandemic. Previous reviews indicated increased mental distress, with limited information on peri-pandemic changes. In this systematic review, we aimed to identify longitudinal research investigating pre- to peri-pandemic and/or peri-pandemic changes of mental health in patients, focusing on the early phase and considering specific diagnoses. PsycINFO, Web of Science, the WHO Global literature on coronavirus disease database, and the Cochrane COVID-19 Study Register weresearched through 31 May 2021. Studies were synthesized using vote counting based on effect direction. We included 40 studies mostly from Western, high-income countries. Findings were heterogeneous, with improving and deteriorating mental health observed compared to pre-pandemic data, partly depending on underlying diagnoses. For peri-pandemic changes, evidence was limited, with some suggestion of recovery of mental distress. Study quality was heterogeneous; only few studies investigated potential moderators (e.g., chronicity of mental illness). Mental health effects on people with pre-existing conditions are heterogeneous within and across diagnoses for pre- to peri-pandemic and peri-pandemic comparisons. To improve mental health services amid future global crises, forthcoming research should understand medium- and long-term effects, controlling for containment measures.

Association between the COVID‐19 pandemic and psychiatric symptoms in people with preexisting obsessive‐compulsive, eating, anxiety, and mood disorders: a systematic review and meta‐analysis of before‐after studies

“…The COVID‐19 pandemic may have had little impact on problematic eating symptoms in people with preexisting eating disorders; however, the evidence is very uncertain. Our findings align with a past narrative review 20 of longitudinal studies, but are disparate from Devoe et al . 's systematic review, 60 which concluded that eating disorder symptoms increased during the pandemic.…”

“…Symptom reactivation may explain the high prevalence of anxiety (26%) and depression (19%) reported in people with preexisting psychiatric disorders during the first 5 months of the COVID‐19 pandemic 19 . Third, previous reviews of eating disorder populations have found conflicting results, possibly due to study design differences 12,20 . A narrative synthesis of longitudinal studies found that mental health symptoms probably improved for people with eating disorders, 20 whereas a meta‐analysis that combined study designs showed that 65% of patients with eating disorders reported worse symptoms during the pandemic 12 .…”

“…19 Third, previous reviews of eating disorder populations have found conflicting results, possibly due to study design differences. 12,20 A narrative synthesis of longitudinal studies found that mental health symptoms probably improved for people with eating disorders, 20 whereas a meta-analysis that combined study designs showed that 65% of patients with eating disorders reported worse symptoms during the pandemic. 12 An updated review that quantitatively combines similar high-risk psychiatric populations would lead to an improved understanding of whether psychiatric symptoms changed during the COVID-19 pandemic.…”

Does paraspinal muscle morphometry predict functional status and re-operation after lumbar spinal surgery? A systematic review and meta-analysis

“…When the meta-analysis was inappropriate due to the lack of metrics reported in < 3 studies, a vote-counting model was conducted according to previous studies, with the direction of effect [30][31][32]. The model followed the Cochrane and Synthesis without meta-analysis (SWiM) reporting guidelines [33,34].…”

Measuring Mental Health Crises During the COVID-19 Pandemic—The Importance of Specific and Comprehensive Data Reporting

“…Although the COVID-19 pandemic undeniably impacted mental health worldwide, it is important to critically examine the narrative that the pandemic precipitated a uniformly dramatic increase in mental health crises. The longitudinal data on pandemic-related changes to mental health have been heterogeneous, with various studies 4 demonstrating resilience and even improvements in mental health measures, even among vulnerable groups. This heterogeneity of outcomes, ranging from positive to negative, is often hidden in public and scientific discussions.…”