Symptom severity and well-being of patients with mental illness during the COVID-19 pandemic: a two-wave survey

Abstract

Purpose of the article

To examine changes in symptom severity and well-being during the coronavirus disease 2019 (COVID-19) pandemic among individuals with pre-existing mental illness.

Materials and methods

In February 2021, we conducted a follow-up questionnaire-based survey among adults with mental illness, who responded to a similar survey on mental health in June 2020. The participants completed the 18-item Brief Symptom Inventory (BSI-18), the five-item World Health Organization Well-Being Index (WHO-5), and 14 questions evaluating worsening or improvement in mental health using the pre-pandemic period as reference. The survey data were merged with sociodemographic and clinical data from the medical records of all invitees to the first survey, enabling analysis of attrition and weighting of the results.

Results

A total of 613 of 992 (62%) invitees participated in the follow-up wave of the survey. The weighted mean WHO-5 and BSI-18 scores were 38 and 27, respectively, and did not differ statistically significantly from the first wave. Multivariate logistic regression showed that having a vocational education (skilled worker/craftsman) was positively associated with reporting deterioration in psychological well-being (OR: 2.95, 95%CI: 1.14–7.81), while being unemployed was negatively associated with reporting deterioration in psychological well-being (OR: 0.20, 95%CI: 0.07–0.56) from the first to the second survey wave. The most common reason for self-reported deterioration in mental health was loneliness (70%).

Conclusions

Approximately one year into the COVID-19 pandemic, the level of symptoms remained high, whereas the level of psychological well-being remained low among patients with mental illness.

Keywords:

• COVID-19
• mental health
• quality of life
• mental disorders
• longitudinal studies

Disclosure statement

SDØ received the 2020 Lundbeck Foundation Young Investigator Prize. Furthermore, SDØ owns units of mutual funds with stock tickers DKIGI and WEKAFKI, as well as units of exchange-traded funds with stock tickers TRET, QDVE, QDVH, EUNL, SADM and BATE.

Additional information

Funding

The study is funded by a grant from the Novo Nordisk Foundation [grant number: NNF20SA0062874]. Østergaard reports further funding from the Lundbeck Foundation [grant numbers: R358-2020-2341 and R344-2020-1073], the Danish Cancer Society [grant number: R283-A16461], the Central Denmark Region Fund for Strengthening of Health Science [grant number: 1-36-72-4-20], the Danish Agency for Digitisation Investment Fund for New Technologies [grant number 2020-6720], and Independent Research Fund Denmark [grant number: 7016-00048B].

Notes on contributors

Pernille Kølbæk

Pernille Kølbæk, MD (2017), PhD (2020), is currently a Postdoctoral Researcher at Aarhus University Hospital – Psychiatry, Denmark.

Yael Gil

Yael Gil, Medical student, Aarhus University, Denmark.

Frida Cecilie Lassen Schmidt

Frida Cecilie Lassen Schmidt, Medical student, Aarhus University, Denmark.

Maria Speed

Maria Speed, Cand.Scient, PhD (2018) is currently a Statistician at Aarhus University Hospital – Psychiatry, Denmark.

Søren Dinesen Østergaard

Søren Dinesen Østergaard, MD (2009), PhD (2014), is currently a Professor of Psychiatry at Aarhus University Hospital – Psychiatry, Denmark