Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project

Abstract

Background: Physical-distancing strategies during the coronavirus (COVID-19) pandemic may be particularly detrimental to the mental health of individuals with a pre-existing mood disorder. Data on the mental health status of these individuals during the current pandemic is sparse, and their current mental health needs unclear.

Method: We characterised COVID-19 related lifestyle changes, primary concerns and psychological distress in n=1292 respondents self-reporting a mood disorder (either bipolar disorder or depressive disorder) and n=3167 respondents without any reported mental disorder from the COLLATE (COvid-19 and you: mentaL heaLth in AusTralia now survEy) project; an Australian national survey launched on April 1^st 2020.

Results: Psychological distress was heightened in the mood disorder group compared to the group with no mental disorder, with stress and depression further elevated in respondents with bipolar disorder compared to those with depressive disorder; and men with bipolar disorder having even higher levels of depression than women with bipolar disorder. Respondents with bipolar disorder were particularly concerned about financial issues associated with COVID-19 compared to those with depressive disorder and those with no mental disorder. Adverse changes to lifestyle behaviours were more prevalent in respondents with a mood disorder and linked to higher levels of distress.

Limitations: Mood disorder was self-reported and was not clinically verified.

Conclusions: Current psychological distress levels are elevated in individuals with mood disorder and are associated with maladaptive situational and lifestyle changes occurring in response to COVID-19.

Keywords: Alcohol use; Bipolar disorder; Coronavirus; Exercise; Major depressive disorder; sleep.

Fig. 1

Top 10 most frequently endorsed concerns for each group ordered by mean ranking from most concerning (1/left) to least concerning (10/right). Note: Values reflect item ordering in the leftmost column in Table 1; 1=Implications for health and wellbeing of family/loved ones; 2= Loved one dying from COVID-19; 3=Loved one catching COVID-19; 4= Implications for health and wellbeing of society; 5=Australian economy; 6= Catching COVID-19 myself; 7= Implications for health and wellbeing of self; 8=Social isolation and social distancing; 9=Availability of food and medicines; 10=Dying of COVID-19 myself; 11=Access to appropriate medical care; 12=World economy; 13=Personal finances; 14=Risk of unemployment or reduced employment. Blue bars indicate deviation from top 10 most endorsed items by the group with no mental disorder. Error bars represent standard deviation.

Fig. 2

Square root (SQRT) transformed Depression, Anxiety and Stress Scales (DASS) scores by group. Numbers in figures represent Cohen's d effects. Errors bars represent standard error. a) DASS scores for respondents with no mental disorder versus a mood disorder. No group*gender interactions evident. Bars represent estimated marginal means adjusting for age, gender and momentary affect. Blue lines represent main effects of group. b) DASS scores for respondents with depressive disorder versus bipolar disorder. Group*gender interactions were not evident for these variables. Bars represent estimated marginal means adjusting for age, gender and momentary affect. Blue lines represent main effects of group. c) Gender*group interactions for depressive disorder versus bipolar disorder. Bars represent estimated marginal means adjusting for age and momentary affect. Blue lines represent gender differences in the bipolar disorder group (p≤.05 corrected [Tukey]). Cohens d= 0.02 vs. 0.08 for males vs females with depressive disorder and d=0.44 vs 0.36 for males and females with bipolar disorder.

Fig. 3

Square root (SQRT) transformed Depression Anxiety and Stress Scale (DASS) scores as a function of COVID-19 related changes in personal situation, perceptions or behaviours in respondents with no mental disorder versus those with self-reported mood disorder. Note bars represent estimated marginal means. A conservative alpha of p≤.01 was adopted at the first level. Post-hoc results are significant at p≤.05 corrected (Tukey). All comparisons are significant, except those represented by orange (main effect of group) or blue (interaction: mood disorder only) lines. Errors bars represent standard error.