ABSTRACT
Background: Previous studies have shown that epidemic outbreaks have significant effects on mental health and psychological wellbeing, increasing psychiatric morbidity among population [1]. During the initial phase of the COVID-19 outbreak in China, more than half of the general population reported a strong psychological impact and approximately a third moderate to severe anxiety [2]. Furthermore, there is evidence that the psychological effects of infection outbreaks can affect months or years later [3]. A better understanding of the psychological impact of the COVID-19 outbreak is crucial to design coping programs that may mitigate these responses during such outbreaks. Aim: The objective of this study is to determine the early impact of the COVID-19 on mental health among people with history of mental disorders (anxiety, depression and bipolar disorder) and the General Population and people in Spain. Methods: In this study 252 people were included. Sixty three people with a history of bipolar disorder (hBD) were matched by sex and gender with 63 people with a history of anxiety disorders (hAD), 63 people with a history of depression (hDD) and 63 healthy controls (HC). The assessment was made by an online survey during the first days of the national lockdown due to COVID-19 (from 19 March to 26 March 2020) in Spain. Assessment: ad hoc sociodemographic, physical and clinical data questionnaire and the Spanish versions of the Depression, Anxiety and Stress Scale (DASS-21) and the Impact of Event Scale (IES). Results: Mean age was 45 (range 19-69, SD 14.8) years;69.8% were females for the total example and the four groups. Regarding clinical symptoms, 61.9%hBD, 54.0% hAD, 54.0% hDD and 28.6% HC reported depressive symptoms (χ² =15.922, p <0.001);19.0% hBD, 12.7% hAD, 20.6% hDD and 1.6% HC reported anxiety symptoms (χ² =12.104, p = 0.007);38.1%hBD, 34.9% hAD, 41.3% hDD and 19.0% HC reported stress symptoms (χ² =8.286, p = 0.040). Regarding psychological impact, 27.0%hBD, 17.5% hAD, 25.4% hDD and 14.3% HC reported intrusion style (χ² =4.277, p =0.273);38.1% hBD, 47.6% hAD, 57.1% hDD and 30.2% HC reported avoidance style (χ² =10.525, p =0.015). There were differences between groups in the three DASS-21 subscales scores: Depression (F=4.599, p= 0.004), Anxiety (F = 5.443, p <0.001) and Stress (F=3.537, p = 0.015) and in the IES total score (F=6.018, p<0.001) and each IES subscale: Intrusion (F=3.030, p = 0.030) and Avoidance (F=6.041, p <0.001). Conclusions: The emergency confinement by COVID-19 has an impact on mental health, but especially among people with history of mental disorders (anxiety, depression and bipolar disorder). Depressive symptoms were the most frequent symptoms in all groups, followed by stress symptoms. People with history of Bipolar Disorder was the group with the highest percentage of depressive symptoms. The most frequent style was avoidance in all groups. People with history of Bipolar Disorder was the group with the highest percentage of people with an intrusion style. People with history of Depression Disorder was the group with the highest percentage of people with an avoidance style. No conflict of interest