Table 2.
Description of included studies.
| Study | Country | Pandemic | Type of study | Participants | Age |
Measure/Evaluation of mental health symptoms |
Summary of findings | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Psychiatric Patients | Control Group | Measuring Scales | Psychiatric Patients |
Controls |
||||||||
| Mean | SD | Mean | SD | |||||||||
| Hao et al., (2020)∗ | China | Covid-19 | Case-control study OP | 76 people with mental illness and 109 healthy controls | 32.8 (11.8) | 33.1 (11.2) | IES –R (PTSD) | 17.7 | 14.2 | 11.3 | 10.1 | Psychiatry patients were at higher risk of displaying higher levels of symptoms of PTSD, depression, anxiety, stress and insomnia as compared to healthy controls. |
| DASS-21 (Anxiety) | 6.6 | 90 | 1.5 | 2.7 | ||||||||
| DASS-21 (Depression) | 8.3 | 10.3 | 2.2 | 3.5 | ||||||||
| DASS-21 (Stress) | 8.0 | 9.8 | 2.7 | 4.2 | ||||||||
| ISI(Insomnia) | 10.1 | 7.16 | 4.63 | 4.04 | ||||||||
| Maguire et al., (2019)∗ | Australia | Influenza | Case control study purposive sample, cases IP and OP, controls OP | 71 people with schizophrenia and 238 controls without mental illness | 36.1 (9.7) | 36.6 (14.0) | K10: Anxiety | 8.66 | 3.25 | 7.06 | 2.84 | Patients with schizophrenia had higher levels of anxiety and psychological distress than the general population. |
| K10: Depression | 12.68 | 4.74 | 11.54 | 4.78 | ||||||||
| Iancu et al., (2005)∗ | Israel | SARS | Case control study of inpatients with schizophrenia | 30 patients with a diagnosis of Schizophrenia and 30 healthy controls who were HCWs | 36.5 (12.0) | 33.2 (7.0) | MSAS | 16.6 | 4.9 | 13.5 | 3.5 | The patient group had higher MSAS and psychotic interpretation scores than controls. Psychological reactions (anxiety, depression, fright or despair) to SARS were similar in both groups, but patients with schizophrenia felt they were more protected from SARS than the control sample. |
| Psychotic interpretation score | 12.16 | 4.0 | 8.66 | 1.7 | ||||||||
| Anxiety about SARS | 1.8 | 1.17 | 1.56 | 0.68 | ||||||||
| Depression about SARS | 1.23 | 0.81 | 1.10 | 0.4 | ||||||||
| Frightened due to SARS | 1.53 | 0.94 | 1.56 | 0.73 | ||||||||
| Liu et al., (2020) | China | Covid-19 | Retrospective case-control, Case note based study (Inpatient wards) | 21 patients with schizophrenia suspected of having Covid-19 compared with 30 patients with schizophrenia not suspected of covid-19 | 43.1 (2.6) | 45 (9.2) | Suspected sample | Clean sample | No difference in psychotic symptoms, but suspected group (in isolation ward) was more depressed, anxious, stressed and had more sleep problems. | |||
| PANSS psychotic symptoms | 67.1 (19.5) | 61.5 (14.9) | ||||||||||
| PSS stress | 26.5 (6) | 11.6 (4) | ||||||||||
| HAMD depression | 14.1 (8.1) | 0.4 (0.8) | ||||||||||
| HAMA anxiety | 13.9 (9.3) | 2.2 (2.1) | ||||||||||
| PSQI sleep | 8 (3.8) | 4.7 (3.6) | ||||||||||
| Ozdin and Ozdin (2020)∗ | Turkey | Covid-19 | Internet based Cross-sectional study (Community) | 343 participants | 37.16 (10.39) | 37.16 (10.39) | Subjects with previous psychiatric illness (n = 75) | Subjects without previous psychiatric illness (n = 268) | People with previous psychiatric illness were among the groups most affected by Covid-19 pandemic. Cross sectional study, generalisability unclear, self-selected sample, but power calculation done. |
|||
| HADS (Anxiety) | 7.8 | 4.7 | 6.7 | 4.1 | ||||||||
| HADS (Depression) | 8.3 | 4.8 | 6.5 | 4.1 | ||||||||
| HAI | 18.3 | 7.2 | 14.8 | 6.9 | ||||||||
| Phillipou et al., (2020)∗ | Australia | Covid-19 | Internet based study cross sectional. Self-selected sample, self-reported diagnosis |
5496 respondents of which 108 self-reported an Eating Disorder | 30.47 | 40.62 | Eating disorder patients | General population | In the eating disorders group, increased restricting, binge eating, purging and exercise behaviours were found. | |||
| DASS-21 (Anxiety) | 12.2 | 9.3 | 7.2 | 7.3 | ||||||||
| DASS-21 (Depression) | 18.7 | 11.7 | 11.1 | 9.1 | ||||||||
| DASS-21 (Stress) | 21.0 | 10.7 | 14.5 | 8.8 | ||||||||
| Gonzalez-Sanguino et al., (2020)∗ | Spain | Covid-19 | Cross sectional-online (Community) | 213 patients with mental illness, control group were 2937 people without any illness. Author provided mean scores | 37.92 | 37.92 | PCL-C-2 (PTSD) | 2.08 | 2.34 | 1.34 | 1.76 | Presence of mental health problems were associated with higher levels of anxiety, depression and PTSD. |
| GAD-2 (Anxiety) | 2.74 | 1.93 | 1.68 | 1.54 | ||||||||
| PHQ-2 (Depression) | 2.66 | 1.79 | 1.5 | 1.42 | ||||||||
| Goodman-Casanova et al., (2020) | Spain | Covid-19 | Cross-sectional telephone survey- nested in a Clinical trial TV Assist Dem (Community) | 93 patients (out of 100 who were approached) with a diagnosis of mild cognitive impairment or dementia. Consecutive sample |
73.34 (6.07) | Proportions – n(%) | Those who lived alone were at higher risk of psychological distress and sleep problems. | |||||
| Well | 57 (61%) | |||||||||||
| Calm | 8 (9%) | |||||||||||
| Sad | 27 (29%) | |||||||||||
| Worried | 20 (22%) | |||||||||||
| Afraid | 10 (11%) | |||||||||||
| Anxious | 22 (24%) | |||||||||||
| Bored | 13 (14%) | |||||||||||
| Lara et al., (2020) | Spain | Covid-19 | Follow-up study (Pre and post Covid-19 lockdown study) | 40 subjects (out of 42) seen within the last month with a diagnosis of MCI (20) or mild AD (20) | Mean age of whole sample 77.4 (5.25) | NPI | Pre covid-19 score 333.75 (22.28) |
Post confinement score 39.05 (27.96) |
Worsening of neuro-psychiatric symptoms in patients with AD and MCI during 5 weeks of lockdown, with agitation, apathy and aberrant motor activity being the most affected symptoms. | |||
| Berthelot et al., (2020) | Canada | Covid-19 | Cross sectional study of 2 cohorts of pregnant women (1 pre covid-19 pandemic sample and 1 sample during covid-19 pandemic) | 1258 Pregnant women recruited during the Covid-19 pandemic compared with 496 pregnant women recruited prior to the pandemic. | 29.35 (4.04) (mean age of Covid-19 sample) | K-10 | Scores in sample with pre-existing/lifetime psychiatric disorders not reported by authors | Pregnant women from the COVID-19 pandemic cohort reported more prenatal psychiatric distress than pregnant women from the pre-COVID-19 cohort, even when controlling for the effect of age, gestational age, education, household income and lifetime psychiatric diagnoses. | ||||
| PANAS | ||||||||||||
| PCL-5 (PTSD) | ||||||||||||
| DES-II (Dissociative experiences) | ||||||||||||
| Zhou et al., (2020) | China | Covid-19 | Online Cross-sectional Questionnaire Survey (Community) | 2065 (out of 3441 out-patients who attended the Psychiatry, Neurology and Sleep medicine depts during the study period). Of these, 1434 had pre-existing psychiatric disorders. Sampling not specified |
GAD (anxiety) | Data not reported separately for patients with pre-existing psychiatric disorders | 20.9% of patients with psychiatric disorders reported deterioration of their mental health. | |||||
| PHQ (depression) | ||||||||||||
| ISI (sleep) | ||||||||||||
| Fernandez-Aranda et al., (2020) | Spain | Covid-19 | Cross sectional Telephone Survey (Community) | 32 patients with Eating disorders (sampling method not specified) | 29.5 | ED symptoms | Increased in 12 (38%) | Eating disorder patients on survey reported increase in ED symptoms including grazing behaviours and emotional eating alongside over half reporting additional anxiety. | ||||
| Anxiety | Increased in 18 (56.2%) | |||||||||||
| Van Der Heide and Coutinho, (2006) | Netherlands | Influenza pandemic | Ecological time trend study | Non-significant increased number of compulsory psychiatric admissions during the peak of the 1918 Influenza pandemic in Amsterdam. Pandemic did not have a significant effect on provision of psychiatric care. | ||||||||
| Pang and Tam, (2004) | Hong Kong | SARS | Service evaluation of Psychiatric unit | There was reduction in number of patients admitted into psychiatric unit and in average length of hospitalization. Drop in outpatient attendance while people delayed entering treatment. In community services, number of home visits dropped by 50%. |
||||||||
| Clerici et al., (2020) | Italy | Covid-19 | Ecological time trend study | Reduction in the total number of psychiatry admissions. This was explained by voluntary admissions, while there was not a noticeable reduction for involuntary admissions. | ||||||||
Keywords: SD – Standard deviation,IES-R– Impact of Event Scale – Revised; DASS 21 – The Depression, Anxiety and Stress Scale - 21 Items; ISI –Insomnia Severity Index; K10 –Kessler Psychological Distress Scale; MSAS – Modified Spielberg Anxiety Scale; PANSS –The Positive and Negative Syndrome Scale; PSS –Perceived Stress Scale; HAMD –Hamilton Depression Rating Scale; HAMA –Hamilton Anxiety Rating Scale; PSQI – Pittsburgh Sleep Quality Index; HADS –Hospital Anxiety and Depression Scale; HAI – Health Anxiety Inventory; PCL-C-2 – PTSD Checklist Calculator 2; GAD – Generalized Anxiety Disorder;PHQ-2 –Patient Health Questionnaire (PHQ-2);MCI – Mild Cognitive Impairment; AD – Alzheimer’s Dementia; QOL– Quality of Life; NPI– Neuropsychiatric Inventory;PANAS - Positive and negative affect schedule;PCL-5 – PTSD Checklist for DSM-5; DES-II – Dissociative Experiences Scale – II; ED – Eating disorder. ∗ indicates studies included in meta-analysis with details of scales combined.