Chronic pain and post-traumatic stress in older patients with psychiatric disorders during the Covid- 19 pandemic: co-occurrence and influence of attachment and personality factors (preprint)

ABSTRACT

Objectives The Covid-19 pandemic context may have had numerous effects on the health of older patients with psychiatric disorders (PD), confronting them with a new source of stress and hindering their access to care. The aim of this study was to assess the long-term effects of the pandemic on both chronic pain (CP) and post-traumatic stress (PTS); the comorbidity of the two disorders; and to identify common psychological risk factors. Design: Medical interviews were conducted during and after (12 and 18 months later) the first lockdown. Setting: The STERACOVID longitudinal cohort study, conducted in two French hospitals. Participants: 71 patients aged 65 or over; treated in an outpatient psychiatric service; and free of major neurocognitive disorders. Measurements Validated scales were used to assess CP; PTS; personality traits; attachment style; and coping strategies. χ² and Student's t-tests, analyses of variance and logistic regression were used to compare patients with or without CP and/or PTS, in terms of attachment styles, personality traits and coping strategies. Results CP and PTS were frequent and often co-occurring at T2. Fearful and preoccupied attachment styles and neurotic and extraverted personality traits were associated with the development of these two disorders; while coping strategies were not determinant. Conclusions Our study identified factors associated with a higher risk of developing CP and/or PTS in the pandemic context. Assessment of attachment style and personality traits in clinical routine could help identify patients who are most vulnerable to this type of stress, and prevent the development of disabling chronic conditions.