Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2024; 12(11): 1929-1935
Published online Apr 16, 2024. doi: 10.12998/wjcc.v12.i11.1929
COVID-19 pandemic amplified mortality rates among adolescents with bipolar disorder through family-related factors
Zhuo-Fan Ye, Yi-Han Hong, Jian-Lin Yang, Meng-Qing Tan, Ju-Min Xie, Zu-Cai Xu
Zhuo-Fan Ye, Department of Neurology, The Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Yi-Han Hong, Jian-Lin Yang, Ju-Min Xie, Hubei Key Laboratory of Renal Disease Occurrence and Intervention, Medical School, Hubei Polytechnic University, Huangshi 435003, Hubei Province, China
Meng-Qing Tan, Psychological Children's Ward, Mental Health Center of Huangshi, Huangshi 435111, Hubei Province, China
Zu-Cai Xu, The Collaborative Innovation Center of Tissue Damage Repair and Regeneration Medicine, Zunyi Medical University, Zunyi 563000, Guizhou Province, China
Co-corresponding authors: Ju-Min Xie and Zu-Cai Xu.
Author contributions: Ye ZF, Xie JM, and Xu ZC conceived the study; Xie JM and Xu ZC supervised the study; Tan MQ and Ye ZF provided the data source; Ye ZF, Hong YH, and Yang JL analyzed the data, performed the statistical analysis and drew the figure; Ye ZF and Xie JM wrote the manuscript; Xie JM revised the manuscript. All authors read and agreed to publish the paper.
Supported by Local Special Projects in Major Health of Hubei Provincial Science and Technology Department, No. 2022BCE054; and Key Scientific Research Projects of Hubei Polytechnic University, No. 23xjz08A.
Institutional review board statement: This study was approved by the Bioethical Safety Committee of Hubei Polytechnic University (with the license number: BSCHBPU-2023002). It was in conformity with the Helsinki declaration (recognized in 1964 by the 18th World Medical Association General Assembly in Helsinki, Finland) and all its subsequent updates.
Informed consent statement: All patients in this study had been informed, and they consented to sharing the data. All participants in this study provided written informed consent or parental consent if under the age of 18.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The processed data was available in the paper, and raw data is freely serviced from first and corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ju-Min Xie, PhD, Associate Professor, Hubei Key Laboratory of Renal Disease Occurrence and Intervention, Medical School, Hubei Polytechnic University, No. 16 Guilin North Road, Huangshi 435003, Hubei Province, China. xiejumin@hbpu.edu.cn
Received: December 11, 2023
Peer-review started: December 11, 2023
First decision: January 25, 2024
Revised: January 31, 2024
Accepted: March 20, 2024
Article in press: March 20, 2024
Published online: April 16, 2024
Processing time: 122 Days and 4.8 Hours
Abstract
BACKGROUND

Recently, a growing number of adolescents have been afflicted with mental disorders, with annual morbidity rates on the rise. This trend has been exacerbated by the global coronavirus disease 2019 (COVID-19) pandemic, leading to a surge in suicide and self-harm rates among this demographic.

AIM

To investigate the impact of the COVID-19 pandemic on adolescent bipolar disorder (BD), along with the underlying factors contributing to heightened rates of suicide and self-harm among adolescents.

METHODS

A comprehensive statistical analysis was conducted utilizing clinical interviews and self-reports obtained from patients or their guardians. Diagnostic criteria for BDs were based on the Diagnostic and statistical manual of mental disorders, international classification of diseases-11, and the National institute of mental health research domain criteria. Statistical analyses were performed using SPSS 26.0 software, with significance set at P < 0.05.

RESULTS

A cohort of 171 adolescents diagnosed with BD between January 1, 2018, and December 31, 2022, was included in the analysis. The gender distribution was 2.8:1 (female to male), with ages ranging from 11 to 18 years old. Major factors contributing to adolescent BDs included familial influences, academic stress, genetic predisposition and exposure to school-related violence. Notably, a significant increase in suicide attempts and self-harm incidents was observed among adolescents with BD during the COVID-19 pandemic. Statistical analysis indicated that the pandemic exacerbated familial discord and heightened academic stress, thereby amplifying the prevalence of suicidal behavior and self-harm among adolescents.

CONCLUSION

The COVID-19 pandemic has exacerbated familial tensions and intensified the incidence of suicide and self-harm among adolescents diagnosed with BD. This study underscores the urgent need for societal, familial and educational support systems to prioritize the well-being of adolescents and offers valuable insights and guidelines for the prevention, diagnosis and treatment of adolescent BDs.

Keywords: Adolescents; Bipolar disorder; COVID-19; Suicide; Self-harm

Core Tip: More adolescents have suffered from bipolar disorder (BD) since the coronavirus disease 2019 (COVID-19) pandemic outbreak. A total of 171 adolescents with BD were recruited and analyzed from January 1, 2018 to December 31, 2022. Family-related factors and academic stress played significant roles in emergence and exacerbation of adolescent BDs. The COVID-19 pandemic exacerbated family relationships and greatly increased the occurrence of suicide and self-harm among adolescents with BD. This study aimed to focus the attention of society, families and schools to increase care about adolescents and also provide guidance and references for the prevention, diagnosis and treatment of adolescent BDs.