Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Dec 19, 2021; 11(12): 1387-1406
Published online Dec 19, 2021. doi: 10.5498/wjp.v11.i12.1387
Psychological impact of the COVID-19 pandemic on individuals with serious mental disorders: A systematic review of the literature
Eva Fleischmann, Nina Dalkner, Frederike T Fellendorf, Eva Z Reininghaus
Eva Fleischmann, Nina Dalkner, Frederike T Fellendorf, Eva Z Reininghaus, Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz 8036, Austria
Author contributions: Fleischmann E and Dalkner N contributed equally; Fleischmann E collected the data and wrote the first draft of the paper; Dalkner N supervised the study procedure, edited the paper and gave important intellectual input; Fellendorf F and Reininghaus EZ edited the paper and gave important intellectual input.
Conflict-of-interest statement: The authors do not have any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nina Dalkner, MSc, PhD, Senior Scientist, Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Auenbruggerplatz 31, Graz 8036, Austria. nina.dalkner@medunigraz.at
Received: February 25, 2021
Peer-review started: February 25, 2021
First decision: May 13, 2021
Revised: May 27, 2021
Accepted: November 12, 2021
Article in press: November 12, 2021
Published online: December 19, 2021
Processing time: 292 Days and 13.6 Hours
Abstract
BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic is having a great impact on individuals from all over the world, particularly on individuals with mental disorders. Several studies found more pronounced psychiatric symptoms, notably symptoms of depression and anxiety.

AIM

To assess the situation of patients with serious mental illness (SMI: Affective disorders and schizophrenia) regarding their mental health outcome during the pandemic.

METHODS

A systematic search using the databases PubMed and MEDLINE was conducted, employing the key words “COVID-19”, “SARS-CoV-2”, “psychiatric/mental disorder/illness”, “affective/mood disorder”, “bipolar disorder”, “(major) depression”, “schizoaffective disorder”, and “schizophrenia”. Studies that had been published up until January 9, 2021 were included. Information of studies in languages other than English and German was mostly taken from their English abstracts.

RESULTS

The literature search concluded in the finding of 36 studies containing relevant clinical data. A general impairment of the mental health of individuals with SMI could be detected, particularly in individuals with affective disorders, as compared to those with schizophrenia. Compared to healthy controls, symptoms of anxiety, depression, and stress were more pronounced in individuals with SMI. Relevant factors found that impacted their mental health were age, resilience, and socioeconomic environment, especially the shortage of mental health services, lack of social support, and inadequate information about COVID-19.

CONCLUSION

In light of these results, mental health services should be reinforced, notably the use of telemental health services. Furthermore, supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is important. When researching the impact of the COVID-19 pandemic on individuals with SMI, standardization as well as follow-up studies are needed to enable better comparability and understanding.

Keywords: COVID-19 pandemic, Serious mental illness, Affective disorders, Bipolar disorder, Major depressive disorder, Schizophrenia

Core Tip: A greater deterioration was found in individuals with affective disorders, compared to individuals with schizophrenia. Factors influencing the impact on mental health were age, resilience, and socioeconomic circumstances. Consequently, the strengthening of mental health services, including the use of telemental health services with a focus on strengthening resilience, is necessary. Additionally, psychiatric patients should be supplied with appropriate information about the pandemic. In research, follow-up studies and standardization are required.