P.0638 Comparing the psychological impact of COVID-19 pandemic between psychiatric patients and healthy subjects: an observational retrospective study from northern Italy

ABSTRACT

Introduction: From the very beginning, COVID-19 pandemic had a great impact not only on physical, but also on mental health, both in general population and psychiatric patients. Self-isolation, fear of virus exposure and of death, unemployment and poor social network have increased psychological distress and Post-Traumatic Stress Disorder (PTSD) symptoms [1]. Nevertheless, little is known about the difference between subjects affected by mental disorders and healthy individuals in perceiving the pandemic as a traumatic event [2]. Aim: Comparing psychiatric patients and healthy controls (HC) in terms of change over time of post-traumatic symptoms. Methods: Data about demographic and clinical variables were retrospectively collected. Impact of Event Scale Revised (IES-R) scores were registered referring at two time points T1, during the so-called ‘Phase I’ in March-April 2020 (lockdown period) and T2, during the so-called ‘Phase II’ in May-June 2020 (restarting). Descriptive analyses and linear regression models were performed. Summary of results: A total of 166 outpatients were recruited 66 patients (39.8%) were affected by Schizophrenia (SKZ), 29 patients (17.5%) by Bipolar Disorder (BD), 36 patients (21.7%) by Major Depressive Disorder (MDD), 17 patients (10.2%) by Anxiety or Obsessive-Compulsive Disorder (OCD), and 18 (10.8%) by Personality Disorders (PDs). HC sample included 57 individuals from general population. The tests of fixed effects showed that time (F=65.44;p<0.001) and diagnosis (F=2.84;p=0.02) each had a significant effect on the change of IES-R scores. In particular, IES-R scores at T1 were overall higher than T2 scores (p<0.001), except for OCD patients. Moreover, patients presented lower IES-R scores than HC (p=0.02), independently from diagnosis. When HC have been compared with the different diagnostic groups, SKZ patients resulted to have significantly lower IES-R scores than HC (p=0.004). Differently, only PD patients showed higher IES-R scores than HC, but the result did not reach the statistical significance (p=0.44). Conclusions: In general, both patients and HC presented a significant decrease of IES-R scores between T1 and T2, when the pandemic showed a decline and preventive restrictions have been removed;only OCD patients have shown a different trend, which can be explained by a global worsening of obsession and compulsion, associated with the urge of control against risks of contamination [3]. Comparing patients and HC, higher scores on IES-R scale have been observed in HC this trend is particularly meaningful in SKZ subgroup, and it may be explained considering the limited awareness about the risk of infection, associated with less fear or striking emotion related to pandemic [4]. PD patients, in contrast, were found to be more affected by social restrictions than HC, probably because of a greater vulnerability to PTSD symptomatology and poorer coping skills [5], pointing out the need to implement telematic interventions, such as psychotherapy and group therapy. This is, to our knowledge, one of the few studies evaluating and comparing the psychological distress perceived by psychiatric patients (including all major diagnoses) and HC during the first wave of COVID-19 pandemic. Conflict of interest Disclosure statement The study has been registered on ClinicalTrials.gov with the following ID number NCT04694482