Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun 1;9(1):16.
doi: 10.1186/s40345-021-00222-8.

Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation

Nina Dalkner  1 , Jolana Wagner-Skacel  2 , Michaela Ratzenhofer  1 , Frederike Fellendorf  1 , Melanie Lenger  1 , Alexander Maget  1 , Adelina Tmava-Berisha  1 , René Pilz  1 , Robert Queissner  1 , Carlo Hamm  1 , Susanne Bengesser  1 , Martina Platzer  1 , Armin Birner  1 , Eva Reininghaus  1
Affiliations

Psychological symptoms during and after Austrian first lockdown in individuals with bipolar disorder? A follow-up control-group investigation

Nina Dalkner et al. Int J Bipolar Disord. .

Abstract

Background: The coronavirus disease (COVID-19) pandemic, a global health crisis, has resulted in widespread socioeconomic restrictions including lockdown, social distancing, and self-isolation. To date, little is known about the psychological impact of the COVID-19 pandemic and lockdown on patients with bipolar disorder as a particularly vulnerable group.

Methods: An online survey was conducted in Austria at two points of measurement (T1 April 2020 during the first lockdown vs. T2 May 2020 at post-lockdown). The sample comprises 20 patients with bipolar disorder (mean age = 49.4 ± 15.6 years) and 20 healthy controls (mean age = 32.7 ± 9.6 years). A 2 × 2 factorial design to compare two time points (T1 vs. T2) and two groups (patients vs. healthy controls) was used. Main outcome measures included the Brief Symptom Inventory-18 (BSI-18) and a (non-validated and non-standardized) assessment to determine COVID-19 fears and emotional distress due to social distancing. Multiple linear regression analyses were used to assess the longitudinal association of COVID-19 fears/emotional distress due to social distancing during lockdown (T1) and psychological symptoms after lockdown (T2).

Results: At T1, results demonstrated higher scores in BSI-18 subscales depression, anxiety and global severity index as well as emotional distress due to social distancing in bipolar patients compared to controls. There was a significant time x group interaction in the BSI-18 subscale somatization showing a decreasing trend in patients with BD compared to controls. No time effects in BSI-18 subscales or COVID-19 fears/emotional distress due to social distancing were observed. Regression analyses showed that COVID-19 fears during lockdown predicted somatization, only in patients.

Conclusions: There was a connection between the lockdown measures and somatization symptoms observed in patients. When the first steps of easing the social restrictions in May 2020 took place, somatization decreased only in the bipolar compared to the control group. Higher COVID-19 fears during lockdown predicted later symptoms at post-lockdown. Long-term impacts of the COVID-19 pandemic need further investigations to improve current therapeutic approaches and prevent fears and distress during lockdown in individuals with bipolar disorder in times of crisis.

Keywords: Anxiety; Bipolar disorder; COVID-19; Depression; Global symptom load; Lockdown; Somatization.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig.1
Fig.1
Overview of the COVID-19 protective measures in Austria in April 2020 (T1) and May 2020 (T2)
Fig. 2
Fig. 2
Median change from T1 to T2 in BSI-18 global severity index(GSI) BD bipolar disorder, GSI global severity index
Fig. 3
Fig. 3
Main result of the two-tailed repeated measure ANCOVAs for BSI-18 somatization and BSI-18 global severity index (GSI)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Altman EG, Hedeker D, Peterson JL, Davis JM. The Altman self-rating mania scale. Biol Psychiat. 1997;42(10):948–55. doi: 10.1016/s0006-3223(96)00548-3. - DOI - PubMed
    1. Barzilay R, Moore TM, Greenberg DM, DiDomenico GE, Brown LA, White LK, Gur RE. Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers. Transl Psychiatry. 2020;10(1):1–8. doi: 10.1038/s41398-020-00982-4. - DOI - PMC - PubMed
    1. Bender RE, Alloy LB. Life stress and kindling in bipolar disorder: review of the evidence and integration with emerging biopsychosocial theories. Clin Psychol Rev. 2011;31(3):383–98. doi: 10.1016/j.cpr.2011.01.004. - DOI - PMC - PubMed
    1. Bengesser S, Reininghaus E. Polygenic risk scores and bipolar disorder. J Psychiatry Brain Sci. 2018;3(6):1–11.
    1. Brietzke E, Mansur RB, Soczynska J, Powell AM, McIntyre RS. A theoretical framework informing research about the role of stress in the pathophysiology of bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2012;39(1):1–8. doi: 10.1016/j.pnpbp.2012.05.004. - DOI - PubMed

LinkOut - more resources