Pre-event psychiatric states predict trajectories of post-traumatic stress symptoms during the COVID-19 pandemic (preprint)

Recent time-dependent analyses of stress-related disorders have identified heterogeneity of trajectories and their modifying factors. While psychiatric patients are vulnerable to stress events, it is unclear how psychiatric conditions in the general population modulate subsequent stress responses. Using our longitudinal online survey from before the COVID-19 pandemic to post-pandemic follow-ups (n = 3815 Japanese adults), here we identified four trajectories of post-traumatic stress symptoms (PTSS) a latent growth mixture model; resilient, chronic, mild chronic, and early response. The depression/anxiety were identified as specific risk factors for the early-response trajectory. In contrast, general psychiatric burden and social withdrawal were identified as common risk/protective factors. Further, we estimated "baseline" PTSS to determine the predictability of the PTSS prognosis from pre-pandemic states. The chronic group showed significantly higher baseline PTSS scores than the mild-chronic and early-response groups, both of which were significantly higher than the resilient group. We concluded that prior psychiatric conditions significantly affect the PTSS trajectory. These results suggest that prior psychiatric conditions may be considered for the prevention and treatment of maladaptive stress responses.

Pre-event psychiatric states predict trajectories of post-traumatic stress symptoms during the COVID-19 pandemic (preprint)

Recent time-dependent analyses of stress-related disorders have identified heterogeneity of trajectories and their modifying factors. While psychiatric patients are vulnerable to stress events, it is unclear how psychiatric conditions in the general population modulate subsequent stress responses. Using our longitudinal online survey from before the COVID-19 pandemic to post-pandemic follow-ups (n = 3815 Japanese adults), here we identified four trajectories of post-traumatic stress symptoms (PTSS) a latent growth mixture model; resilient, chronic, mild chronic, and early response. The depression/anxiety were identified as specific risk factors for the early-response trajectory. In contrast, general psychiatric burden and social withdrawal were identified as common risk/protective factors. Further, we estimated “baseline” PTSS to determine the predictability of the PTSS prognosis from pre-pandemic states. The chronic group showed significantly higher baseline PTSS scores than the mild-chronic and early-response groups, both of which were significantly higher than the resilient group. We concluded that prior psychiatric conditions significantly affect the PTSS trajectory. These results suggest that prior psychiatric conditions may be considered for the prevention and treatment of maladaptive stress responses.

Multiple-time measurements of multidimensional psychiatric states from immediately before the COVID-19 pandemic to one year later: A longitudinal online survey of the Japanese population (preprint)

The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected the mental health of both infected and uninfected people. Although most psychiatric disorders have highly overlapping genetic and pathogenic backgrounds, most studies investigating the impact of the pandemic have examined only single psychiatric disorders. It is necessary to examine longitudinal trajectories of factors that modulate psychiatric states across multiple dimensions. 2274 Japanese citizens participated in online surveys presented in December 2019 (before the pandemic), August 2020, Dec 2020, and April 2021. These surveys included nine questionnaires on psychiatric symptoms, such as depression and anxiety. Multi-dimensional psychiatric time series data were then decomposed into four principal components. We used generalized linear models to identify modulating factors for effects of the pandemic on these components. The four principal components can be interpreted as general psychiatric burden, social withdrawal, alcohol-related problems, and depression/anxiety. Principal components associated with general psychiatric burden and depression/anxiety peaked during the initial phase of the pandemic. They were further exacerbated by the economic burden of the pandemic. In contrast, principal components associated with social withdrawal showed a delayed peak, with human relationships as an important risk modulating factor. In addition, being elderly and female were risk factors shared across all components. Our results show that COVID-19 has imposed a large and varied burden on the Japanese population since the commencement of the pandemic. Although components related to the general psychiatric burden remained elevated, peak intensities differed between components related to depression/anxiety and those related to social anxiety. These results underline the importance of using flexible monitoring and mitigation strategies for mental problems, according to the phase of the pandemic.