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
ARTICLE HIGHLIGHTS
Research background

Recently, there has been an alarming escalation in mental health disorders among adolescents, with annual incidence rates steadily increasing. The onset of the coronavirus disease 2019 (COVID-19) pandemic has particularly seen a surge in cases of bipolar disorder (BD) among this demographic.

Research motivation

This study aimed to examine trends in BD prevalence among adolescents before and during the COVID-19 pandemic. It investigates the escalation in abnormal mental health behaviors and identifies potential risk factors, such as family factors and academic pressures.

Research objectives

The primary goal of this research is to assess the impact of the COVID-19 pandemic on the incidence of BD in adolescents. It also seeks to understand the factors contributing to the increased rates of suicide and self-harm within this group.

Research methods

For this study, data collection was conducted through clinical observations. The diagnosis of BD was based on the criteria given in the Diagnostic and statistical manual of mental disorders, international classification of diseases-11 and the National Institute of Mental Health’s Research Domain Criteria.

Research results

The study revealed that family-related factors and academic stress are pivotal in the onset and intensification of BDs in adolescents. The COVID-19 pandemic has further strained familial relationships and led to a significant increase in suicide and self-harm incidents among adolescents diagnosed with BD.

Research conclusions

The study suggests that the rise in suicide and self-harm rates among adolescents with BD may be more closely linked to family-related factors than to the COVID-19 pandemic itself. However, the pandemic has potentially aggravated the family-related factors through enforced social isolation and other restrictive measures.

Research perspectives

The study highlights that social isolation, a preventative measure during a pandemic, is closely associated with challenging household dynamics. Understanding the interplay between family factors and a pandemic is crucial for developing strategies to prevent adverse behaviors in adolescents with BD. Future research, including prospective randomized trials, is required to further elucidate this relationship.