The course of psychiatric symptoms in older age bipolar disorder during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic gives us the unique opportunity to study the course of psychiatric symptoms and resilience in older adults with bipolar disorder (OABD) whilst experiencing a collective long lasting stressor. The aim of this study was to investigate the course of depressive, manic and anxiety symptoms in OABD during the first six months of COVID-19 and how loneliness and mastery are associated with this course. Mastery is defined as the control one experiences over one's life and environment. Resilience is defined as adaptation to challenging life conditions encompassing several aspects of personal resources. METHODS: In April 2020 (n = 81), June 2020 (n = 66) and September 2020 (n = 51), participants were included from the Dutch Older Bipolars (DOBi) cohort study. RESULTS: Depressive, manic and anxiety symptoms increased over all timepoints. Participants with a higher sense of mastery experienced a greater increase in depressive and anxiety symptoms. Loneliness did not interact with the course of these symptoms. CONCLUSIONS: OABD were resilient in the first months of COVID-19 outbreak, however depressive, manic and anxiety symptoms increased as the pandemic continued. Treatment strategies in coping with long lasting stressful events should include the focus on sense of mastery.

Psychiatric symptoms during the COVID-19 outbreak in older adults with bipolar disorder.

OBJECTIVES: Older adults with bipolar disorder (OABD) are vulnerable for a COVID-19 infection via multiple pathways. It is essential for OABD to adhere to the COVID-19 measures, with potential consequences for the psychiatric symptoms. This situation offers the unique opportunity to investigate factors of vulnerability and resilience that are associated with psychiatric symptoms in OABD. METHODS: This study included 81 OABD patients aged over 50 years. Factors measured at baseline in patients that participated in 2017/2018 were compared with factors measured during the COVID-19 outbreak. RESULTS: Participants experienced less psychiatric symptoms during COVID-19 than (67.9% euthymic) than at baseline (40.7% euthymic). There was no difference in loneliness between COVID-19 and baseline. Not having children, more feelings of loneliness, lower mastery, passive coping style and neuroticism were associated with more psychiatric symptoms during COVID-19 measures. CONCLUSIONS: Participants experienced less psychiatric symptoms during COVID-19 measures when compared to baseline. Our results indicate promising targets for psychological interventions aimed at curing and preventing recurrence in OABD and improving quality of life in this growing vulnerable group.