Citation

Nam Chan JK, Chang DHH, Fung VSC, Ching Chui EM, Wong CSM, Chu RST, So YK, Chan JMT, Chung AKK, Lee KCK, Cheng CPW, Lo HKY, Law CW, Chan WC, Chang WC. BMC Psychiatry 2024; 24(1): e372.

Copyright

(Copyright © 2024, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12888-024-05815-y

PMID

38760703

Abstract

BACKGROUND: Psychiatric patients are susceptible to adverse mental health outcome during COVID-19 pandemic, but its associated factors are understudied. This observational cross-sectional study aimed to comprehensively examine prevalence and correlates of psychological distress, in terms of depression, anxiety and post-traumatic-stress-disorder (PTSD)-like symptoms, among Chinese adult psychiatric outpatients amidst the peak of fifth COVID-19 wave in Hong-Kong.

METHODS: A total of 415 patients (comprising 246 patients with common-mental-disorders [CMD] and 169 with severe-mental-disorders [SMD]) and 399 demographically-matched controls without mental disorders were assessed with self-rated questionnaires between 28-March and 8-April-2022, encompassing illness profile, mental health symptoms, psychosocial measures (loneliness, resilience, coping styles) and COVID-19 related factors. Univariate and multivariable logistic regression analyses were conducted to determine variables associated with moderate-to-severe depressive, anxiety and PTSD-like symptoms among psychiatric patients.

RESULTS: Our results showed that CMD patients had the greatest psychological distress relative to SMD patients and controls. Approximately 40-55% CMD patients and 25% SMD patients exhibited moderate-to-severe depression, anxiety and PTSD-like symptoms. Multivariable regression analyses revealed that female gender, lower educational attainment, single marital status, being housewife, more severe insomnia, psychotic-like symptoms and cognitive complaints, self-harm behavior, lower resilience, avoidance coping, never contracting COVID-19 infection, greater fear of contagion, and longer exposure to pandemic-related information were independently associated with depression, anxiety and/or PTSD-like symptoms in psychiatric patients.

CONCLUSIONS: Our results affirm increased vulnerability of psychiatric patients toward psychological distress during pandemic. An array of identified correlates facilitates early detection of high-risk psychiatric patients for targeted strategies to minimize pandemic-related negative psychological impact.

Language: en

Keywords

*Anxiety/psychology/epidemiology; *COVID-19/psychology/epidemiology; *Depression/epidemiology/psychology; *Stress Disorders, Post-Traumatic/epidemiology/psychology; Adaptation, Psychological; Adult; Anxiety; COVID-19; Cross-Sectional Studies; Depression; East Asian People; Female; Hong Kong/epidemiology; Humans; Male; Mental disorders; Mental Disorders/epidemiology/psychology; Middle Aged; Post-traumatic stress disorder; Prevalence; Psychiatric patients; Psychological Distress; Resilience, Psychological; SARS-CoV-2