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Nachrichten, Termine, Experten
Scientists at the University Medical Center Göttingen, Germany, collect long-term data with a newly developed survey method. Results of their study were recently published in „European Archives of Psychiatry and Clinical Neuroscience“
(umg/NUM) Societal, professional and private restrictions as well as the limitation of social contacts during the Corona pandemic can lead to an increase of psychological stress. Previously, it was assumed that people with pre-existing mental disorders would be especially susceptible to negative mental health consequences during the pandemic, finally leading to a worsening of their symptoms (or relapse). Thus, they could be a risk group with special treatment needs, experiencing higher burden from pandemic management measures. Within the sub-project for pandemic management, egePan Unimed, of the Network of University Medicine (NUM), funded by the German Federal Ministry of Education and Research (BMBF), special attention was drawn to these patients.
Claus Wolff-Menzler (MD, MA), Claudia Bartels (PhD) and Michael Belz (PhD) are clinicians and heads of a pandemic related research group at the Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG). Together with a team of researchers and clinicians at their department, they have now been able to show in a long-term study that the course of psychological burden in patients with pre-existing mental disorders follows a characteristic pattern during the pandemic: Patients initially react with a rise of psychosocial burden followed by a steady relief, in parallel to restrictions ("lockdown") and easing of measures. This pattern, compared to studies from the general population, corresponds to a normal stress response with subsequent habituation to pandemic-related stressors. At the same time, however, patients with pre-existing mental disorders experience high stress levels in general.
"Despite these positive results, the long-term course of psychological burden should to be monitored continuously in order to detect clinical worsening at short notice and to proactively counteract such a development by providing appropriate treatment," says Claudia Bartels (PhD), first author of the study and Senior Psychologist at the Department of Psychiatry and Psychotherapy at UMG. This becomes even more important since the research team also found a decrease in resilience among the study participants during the second lockdown. “Such, long-term observation is crucial in order not to miss out time-points at which protective factors may be depleted. In particular, women, patients with multiple mental disor-ders, and patients who initially react strongly to stressful situations show an unfavorable course and are therefore at particular risk for an increased treatment need", says Bartels.
A total of 213 patients between the ages of 18 and 95 covering a broad spectrum of mental disorders were interviewed by telephone during the course of the pan-demic by their treating clinicians at the Department of Psychiatry and Psychothera-py. Using a newly developed survey method, the Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI), patients were asked to estimate their level of psychosocial burden as well as symptom changes, and provided information for individual protective factors.
The results of the study are published in the psychiatric and neurological journal „European Archives of Psychiatry and Clinical Neuroscience“.
Original publication
Bartels C, Hessmann P, Schmidt U, Vogelgsang J, Ruhleder M, Kratzenberg A, Treptow M, Reh-Bergen T, Abdel-Hamid M, Heß L, Meiser M, Signerski-Krieger J, Radenbach K, Trost S, Schott BH, Wiltfang J, Wolff-Menzler C, Belz M (2021): Medium-term and peri-lockdown course of psychosocial burden during the ongoing Covid-19 pandemic: A longitudinal study on patients with pre-existing mental disorders. Eur Arch Psychiatry Clin Neurosci. DOI: 10.1007/s00406-021-01351-y
Background information
People are able to cope with stressful or critical life situations making use of a variety of strategies. This ability may be reduced or even absent in people with mental disorders, making them particularly vulnerable to experiencing stress. This can lead to an exacerbation of symptoms and worse mental health outcomes. Therefore, these patients may belong to a psychiatric risk group with special treatment needs.
The study in detail
The aim of the study was to find out how the ongoing pandemic affects the experience of psychosocial burden in patients with pre-existing mental disorders in order to identify possible treatment needs. The change in psychosocial stress and psychiatric symptoms over time was recorded and risk factors that predict an unfavorable influence on the course of the disease were derived. In order to obtain an overall picture of the health status of the study participants, information was also requested on protective factors (such as sports or family contact), which can help to cope with pandemic-related stressors and positively influence mental health symptoms.
A total of 213 outpatients, aged between 18 and 95 years, covering a broad spectrum of mental disorders and treated at the Department of Psychiatry and Psychotherapy at UMG prior to the first lockdown in spring 2020 participated in the study. Amongst others, patients with depression, anxiety, personality disorders, schizophrenia and autism spectrum disorders were included. Participants underwent a 30-minute telephone interview at the end of the first lockdown in April/May 2020 and were asked to provide an estimate for their experience of psychosocial burden, psychiatric symptoms, and protective factors. 159 of these patients were interviewed again during the second lockdown in November/December 2020. The newly developed Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI), a survey method based on 77 questions, was used. This method allowed both an assessment of current psychological states during both lockdowns and a retrospective assessment for times before the beginning of the pandemic (early 2020) and in the early weeks of the first lockdown (mid-March 2020).
A similar pattern for all psychiatric disorders was observed: psychosocial burden increased in the early phase of the pandemic, but subsequently and steadily decreased across the two lockdowns, finally returning to a pre-pandemic level by the end of 2020. "This characteristic course suggests a normal stress response with subsequent habituation, as can be observed in healthy individuals. Furthermore, most psychiatric symptoms did not show any significant changes in the participants," says Bartels.
The Network of University Medicine (NUM)
Providing optimal care to patients, preventing infections, preserving health care: The Covid-19 pandemic presents challenges that require new strategies for action within a short period of time. The Network of University Medicine (NUM) bundles and strengthens research activities to address the current situation. Funded by the German Federal Ministry of Education and Research and coordinated by Charité – Universitätsmedizin Berlin, the research network involves all German university hospitals and other networks in developing solutions for the best possible patient care during the pandemic. Thirteen comprehensive collaborative projects with leaders at the different sites of university medicine have been designed for this purpose. The program is geared toward rapid, immediate support effects. Emphasis is placed on clinical as well as health care research, the results of which flow directly into health care and crisis management in accordance with the translational approach. The research network and the participating institutions have around 150 million euros at their disposal to implement this task in the first year; from 2021, the network is to be funded with a further 80 million euros per year, or an additional 240 million euros, until 2024. Joint developments in research and patient care, evidence-based approaches and mutual learning are expected to lead to a common approach to pandemic control and pandemic preparedness.
Further information: https://www.netzwerk-universitaetsmedizin.de
Contact
University Medical Center Göttingen
Department of Psychiatry and Psychotherapy
Claus Wolff-Menzler (MD, MA)
Phone: +49 (0) 551-39-33791
Email: claus.wolff-menzler@med.uni-goettingen.de
Claudia Bartels (PhD)
Phone: +49 (0) 551-39-62795
Email: claudia.bartels@med.uni-goettingen.de
Michael Belz (PhD)
Phone: +49 (0) 551-39-65365
Email: michael.belz@med.uni-goettingen.de
University Medical Center Göttingen
Department of Psychiatry and Psychotherapy
Claus Wolff-Menzler (MD, MA)
Phone: +49 (0) 551-39-33791
Email: claus.wolff-menzler@med.uni-goettingen.de
Claudia Bartels (PhD)
Phone: +49 (0) 551-39-62795
Email: claudia.bartels@med.uni-goettingen.de
Michael Belz (PhD)
Phone: +49 (0) 551-39-65365
Email: michael.belz@med.uni-goettingen.de
Original publication
Bartels C, Hessmann P, Schmidt U, Vogelgsang J, Ruhleder M, Kratzenberg A, Treptow M, Reh-Bergen T, Abdel-Hamid M, Heß L, Meiser M, Signerski-Krieger J, Radenbach K, Trost S, Schott BH, Wiltfang J, Wolff-Menzler C, Belz M (2021): Medium-term and peri-lockdown course of psychosocial burden during the ongoing Covid-19 pandemic: A longitudinal study on patients with pre-existing mental disorders. Eur Arch Psychiatry Clin Neurosci. DOI: 10.1007/s00406-021-01351-y
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