The treatment of COVID-19 and severe mental illness together: comparing clinical features of patients with bipolar disorder and major depressive disorder

Abstract

Objective: COVID-19 can be codiagnosed in people who need to be treated in psychiatry services with symptoms such as acute mood or psychotic episodes, aggression, and suicidal thoughts. The aim of the study was to compare the clinical features of patients with COVID-19 and major depressive disorder (MDD) or bipolar disorder (BD). Materials and Methods:Of 84 patients, 60 were diagnosed with BD, and 24 were diagnosed with MDD. Patients, who were treated in a psychiatry service for COVID-19, were included in the study. The two groups were compared in terms of sociodemographic data, medications, psychiatric symptoms, comorbid diseases, progression (CALL) scores, laboratory markers of inflammation, and procoagulation.Results: There was no significant difference between the BD and MDD groups in terms of age and gender. While self-harm/suicidal ideation was found significantly more frequently in MDD patients compared to the BD group (p=0.024), agitation/aggression and treatment refusal rates were significantly higher in the BD group (p= 0.001, p= 0.002). Lactate dehydrogenase and ferritin levels were significantly higher in the BD group (p= 0.016, p= 0.032). Finally, there was no significant difference between the two groups in terms of CALL scores (p=0.678). Conclusion:Cases diagnosed with BD may need hospitalization for manic symptoms such as agitation/aggression/rejection of treatment during the pandemic period. BD may pose a susceptibility to inflammation associated with COVID-19 or given the underlying inflammation associated with illness. The treatment and primary prevention of these patients for COVID-19 may be of particular importance.