COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients

İlhan Ahmet Çetiner; Hülya Ertekin

Research Article

Ötimik bipolar bozukluk hastalarında COVID-19 ile ilişkili anksiyete, korku ve biyopsikososyal risk faktörlerinin işlevselliğe etkisi

Year 2025, Volume: 10 Issue: 2, 44 - 52

Abstract

Giriş: Bu çalışmanın amacı, COVID-19 korkusu, kaygısı ve biyopsikososyal risk faktörlerinin ötimik bipolar hastaların işlevselliği üzerindeki etkisini, pandemi sırasında sağlıklı bir kontrol grubuyla karşılaştırarak değerlendirmektir.
Yöntem: Kasım 2021 ile Ağustos 2022 arasında yürütülen bu vaka-kontrol çalışmasına 80 ötimik BD hastası ve 80 sağlıklı kontrol katıldı. Katılımcılar Hamilton Depresyon Derecelendirme Ölçeği (HAM-D), Young Mani Derecelendirme Ölçeği (YMRS), Kısa İşlevsellik Değerlendirme Ölçeği (FAST), COVID-19 Pandemisine Yönelik Algılar ve Tutumlar Anketi (PACPQ), Koronavirüs Kaygı Ölçeği-Kısa Form (CAS) ve Koronavirüs Korku Ölçeği (CFS) kullanılarak değerlendirildi.
Bulgular: BD tanısı konulan bireylerin %71,3’ünde (n=57) BD-Tip 1, %28,8’inde (n=23) BD-Tip 2 saptandı. BD hastalarında sağlıklı kontrollerle karşılaştırıldığında genel uyku, iştah ve alkol tüketiminde istatistiksel olarak anlamlı artış, pandemi döneminde sosyal ve fiziksel aktivitelere harcanan sürede ise istatistiksel olarak anlamlı azalma görüldü. FAST, PACPQ, CAS Hastalık Algısı, Nedenleri ve Kaçınma Davranışları alt ölçek puanları BD hastalarında belirgin olarak daha yüksekti (p<0,05). Regresyon analizi, pandemi sırasındaki toplam BD atak sayısının ve eğitim yıllarının ortalama FAST toplam puanını açıklamada önemli faktörler olduğunu gösterdi (OR, sırasıyla 0,224, -0,226; p < 0,05)
Sonuç: COVID-19 pandemisi sırasında ötimik bipolar hastalarda kaçınma davranışları ve yaşam tarzı değişiklikleri arttı. Fonksiyonel bozulmanın atak sayısı ve eğitim düzeyi ile öngörüldüğü tespit edildi.

Keywords

Bipolar Bozukluk, Ötimik Durum, COVID-19, Anksiyete, Vaka-Kontrol Çalışmaları, Sosyal İzolasyon

Ethical Statement

Approval of this study was obtained from the Ministry of Health by our application to the Scientific Research Platform of the Ministry of Health of Turkey on 08.11.2021. The approval of the ethics committee for our study was obtained from the Ethics Committee for Non-Interventional Clinical Research of Çanakkale Onsekiz Mart University Faculty of Medicine on 24.11.2021 - 2021-09.

References

1. Khatun A, Tamilanban T, Chitra V. Psychiatric Manifestations of COVID-19: A Literature Review. CNS Neurol Disord Drug Targets 2023;22(6):892-905. https://doi.org/10.2174/1871527321666220701152821
2. Torales J, O'Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry 2020;66(4):317-320. https://doi.org/10.1177/0020764020915212
3. Kahl KG, Correll CU. Management of Patients With Severe Mental Illness During the Coronavirus Disease 2019 Pandemic. JAMA Psychiatry. 2020;77(9):977-978. https://doi.org/10.1001/jamapsychiatry.2020.1701
4. Karantonis JA, Rossell SL, Berk M, Van Rheenen TE. The mental health and lifestyle impacts of COVID-19 on bipolar disorder. J Affect Disord 2021;282:442-447. https://doi.org/10.1016/j.jad.2020.12.186
5. Ceban F, Nogo D, Carvalho IP, et al. Association Between Mood Disorders and Risk of COVID-19 Infection, Hospitalization, and Death: A Systematic Review and Meta-analysis. JAMA Psychiatry 2021;78(10):1079-1091. https://doi.org/10.1001/jamapsychiatry.2021.1818
6. Varsak N, Topaloğlu M, Özdemir E. First Manic Attack During COVID-19 Treatment: A Case Report. Clin Psychopharmacol Neurosci 2021;19(4):786-788. https://doi.org/10.9758/cpn.2021.19.4.786
7. Zarate CA, Tohen M, Land M, Cavanagh S. Functional impairment and cognition in bipolar disorder. Psychiatr Q 2000;71(4):309-329. https://doi.org/10.1023/A:1004632206684
8. Rosa AR, Reinares M, Franco C, Comes M, Torrent C, Sánchez-Moreno J, et al. Clinical predictors of functional outcome of bipolar patients in remission. Bipolar Disord 2009;11(4):401-409. https://doi.org/10.1111/j.1399-5618.2009.00698.x
9. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23(1):56-62. https://doi.org/10.1136/jnnp.23.1.56
10. Karadag F, Oral ET, Yalcın F, Eren E. Young Mania Rating Scale reliability and validity in Turkey. Turk Psycho J 2002;13(2):107-114.
11. Artan T, Meydan S, Irmak HS. Turkish Version of the Fear of COVID-19 Scale: Validity and Reliability Study. Arch Health Sci Res 2021; 8: 117-123 https://doi.org/10.5152/ArcHealthSciRes.2021.20113
12. Biçer İ, Çakmak C, Demir H, Kurt ME.. Coronavirus Anxiety Scale Short Form: Turkish Validity and Reliability Study Anatolian Clin J Med Sci 2020; 25: 216-225 https://doi.org/10.21673/anadoluklin.731092
13. Artan T, Karman M, Atak I, Cebeci F. Evaluation of the Perception and Attitudes Evaluation Scale towards the Covid-19. Turk J Soc Work.2020;4:101-107.
14. Rosa AR, Sánchez-Moreno J, Martínez-Aran A, Salamero M, Torrent C, Reinares M, et al. Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemiol Ment Health 2007;3:5. https://doi.org/10.1186/1745-0179-3-5
15. Schmidt RA, Genois R, Jin J, Vigo D, Rehm J, Rush B. The early impact of COVID-19 on the incidence, prevalence, and severity of alcohol use and other drugs: A systematic review. Drug Alcohol Depend 2021;228:109065. https://doi.org/10.1016/j.drugalcdep.2021.109065
16. Murthy P, Narasimha VL. Effects of the COVID-19 pandemic and lockdown on alcohol use disorders and complications. Curr Opin Psychiatry 2021;34(4):376-85. https://doi.org/10.1097/YCO.0000000000000720
17. Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients 2020;12(6):1583. https://doi.org/10.1159/000512852
18. Di Renzo L, Gualtieri P, Cinelli G, Bigioni G, Soldati L, Attinà A, et al. Psychological Aspects and Eating Habits during COVID-19 Home Confinement: Results of EHLC-COVID-19 Italian Online Survey. Nutrients 2020;12(7):2152. https://doi.org/10.3390/nu12072152
19. Van Rheenen TE, Meyer D, Neill E, Phillipou A, Tan EJ, Toh WL, vd. Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project. J Affective Dis 2020;275:69-77. https://doi.org/10.1016/j.jad.2020.06.037
20. Aydınoğlu Ü, Yazla E. The effect of COVID-19 pandemic on the sleep quality of patients who have the diagnosis of Bipolar Disorder (tur). Turk J Clin Psy 2021;24(1):33-40. https://doi.org/10.5505/kpd.2020.26576
21. Li G, Tang D, Song B, Qunshan S, Xu C, Geng H, et al. Impact of the COVID-19 Pandemic on Partner Relationships and Sexual and Reproductive Health: Cross-Sectional, Online Survey Study. J Med Internet Res 2020;22(8):e20961. https://doi.org/10.2196/20961
22. Yuksel B, Ozgor F. Effect of the COVID-19 pandemic on female sexual behavior. Int J Gynaecol Obstet. 2020;150(1):98-102. https://doi.org/10.1002/ijgo.13193
23. Fornaro M, De Prisco M, Billeci M, Ermini E, Young AH, Lafer B, et al. Implications of the COVID-19 pandemic for people with bipolar disorders: A scoping review. J Affect Disord. 2021;295:740-751. https://doi.org/10.1016/j.jad.2021.08.091
24. Çökmüş FP, Aşçibaşi K, Dikici DS, Çöldür EÖ, Avci E, Aydemir Ö. Seasonality in Bipolar Disorder: Impact on Mood Symptoms, Psychosocial Functioning, Neurocognition, and Biological Rhythm. Noro Psikiyatr Ars. 2020;58(1):41-47. https://doi.org/10.29399/npa.25056
25. Léda-Rêgo G, Bezerra-Filho S, Miranda-Scippa Â. Functioning in euthymic patients with bipolar disorder: A systematic review and meta-analysis using the Functioning Assessment Short Test. Bipolar Disord. 2020;22(6):569-581. https://doi.org/10.1111/bdi.12904
26. Kaçan H, Öztürk A, Değer VB. Do the Anxiety of Individuals Affect their Perceptions and Attitudes towards the Covid-19 Outbreak? Curr Approaches Psychiatry 2021; 13(Suppl 1):405-420 https://doi.org/10.18863/pgy.1009613
27. Jiménez E, Arias B, Castellví P, et al. Impulsivity and functional impairment in bipolar disorder. J Affect Disord 2012;136(3):491-497. https://doi.org/10.1016/j.jad.2011.10.044
28. Samalin L, Boyer L, Murru A, Pacchiarotti I, Reinares M, Bonnin CM, et al. Residual depressive symptoms, sleep disturbance and perceived cognitive impairment as determinants of functioning in patients with bipolar disorder. J Affect Disord 2017;210:280-286. https://doi.org/10.1016/j.jad.2016.12.054
29. Marangoni C, Hernandez M, Faedda GL. The role of environmental exposures as risk factors for bipolar disorder: A systematic review of longitudinal studies. J Affect Disord 2016;193:165-174. https://doi.org/10.1016/j.jad.2015.12.041

COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients

Year 2025, Volume: 10 Issue: 2, 44 - 52

İlhan Ahmet Çetiner , Hülya Ertekin

Abstract

Introduction: This study aimed to assess the influence of COVID-19 fear, anxiety and biopsychosocial risk factors on the functionality of euthymic bipolar patients by comparing with those of a healthy control group in pandemic.
Methods: Eighty euthymic BD patients and eighty healthy controls took part in this case-control study conducted between November 2021 and August 2022. Participants were assessed using the Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Functioning Assessment Short Test (FAST), Perceptions and Attitudes towards COVID-19 Pandemic Questionnaire (PACPQ), Coronavirus Anxiety Scale-Short Form (CAS), and Coronavirus Fear Scale (CFS).
Results: Among individuals diagnosed with BD, 71.3% (n = 57) had BD-Type 1, while 28.8% (n = 23) had BD-Type 2. In comparison to healthy controls, BD patients exhibited a statistically significant increase in overall sleep, appetite, and alcohol consumption and demonstrated a statistically significant decrease in time spent on social and physical activities during the pandemic period FAST, PACPQ, CAS, Perception of Disease, Reasons, and Behaviors of Avoidance subscale scores were notably higher in BD patients (p < 0.05). Regression analysis indicated that the total number of BD episodes during the pandemic and the years of education were significant factors in explaining the average FAST total score (OR, respectively 0.224, -0.226; p < 0.05)
Conclusions: During the COVID-19 pandemic, euthymic bipolar patients showed increased avoidance behaviors and lifestyle changes. Functional impairment was predicted by the number of episodes and education level.

Keywords

Bipolar Disorder, Euthymic State, COVID-19, Anxiety, Case–Control Studies, Social Isolation

Ethical Statement

Approval of this study was obtained from the Ministry of Health by our application to the Scientific Research Platform of the Ministry of Health of Türkiye on 08.11.2021. The approval of the ethics committee for our study was obtained from the Ethics Committee for Non-Interventional Clinical Research of Çanakkale Onsekiz Mart University Faculty of Medicine on 24.11.2021 - 2021-09.

References

1. Khatun A, Tamilanban T, Chitra V. Psychiatric Manifestations of COVID-19: A Literature Review. CNS Neurol Disord Drug Targets 2023;22(6):892-905. https://doi.org/10.2174/1871527321666220701152821
2. Torales J, O'Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry 2020;66(4):317-320. https://doi.org/10.1177/0020764020915212
3. Kahl KG, Correll CU. Management of Patients With Severe Mental Illness During the Coronavirus Disease 2019 Pandemic. JAMA Psychiatry. 2020;77(9):977-978. https://doi.org/10.1001/jamapsychiatry.2020.1701
4. Karantonis JA, Rossell SL, Berk M, Van Rheenen TE. The mental health and lifestyle impacts of COVID-19 on bipolar disorder. J Affect Disord 2021;282:442-447. https://doi.org/10.1016/j.jad.2020.12.186
5. Ceban F, Nogo D, Carvalho IP, et al. Association Between Mood Disorders and Risk of COVID-19 Infection, Hospitalization, and Death: A Systematic Review and Meta-analysis. JAMA Psychiatry 2021;78(10):1079-1091. https://doi.org/10.1001/jamapsychiatry.2021.1818
6. Varsak N, Topaloğlu M, Özdemir E. First Manic Attack During COVID-19 Treatment: A Case Report. Clin Psychopharmacol Neurosci 2021;19(4):786-788. https://doi.org/10.9758/cpn.2021.19.4.786
7. Zarate CA, Tohen M, Land M, Cavanagh S. Functional impairment and cognition in bipolar disorder. Psychiatr Q 2000;71(4):309-329. https://doi.org/10.1023/A:1004632206684
8. Rosa AR, Reinares M, Franco C, Comes M, Torrent C, Sánchez-Moreno J, et al. Clinical predictors of functional outcome of bipolar patients in remission. Bipolar Disord 2009;11(4):401-409. https://doi.org/10.1111/j.1399-5618.2009.00698.x
9. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23(1):56-62. https://doi.org/10.1136/jnnp.23.1.56
10. Karadag F, Oral ET, Yalcın F, Eren E. Young Mania Rating Scale reliability and validity in Turkey. Turk Psycho J 2002;13(2):107-114.
11. Artan T, Meydan S, Irmak HS. Turkish Version of the Fear of COVID-19 Scale: Validity and Reliability Study. Arch Health Sci Res 2021; 8: 117-123 https://doi.org/10.5152/ArcHealthSciRes.2021.20113
12. Biçer İ, Çakmak C, Demir H, Kurt ME.. Coronavirus Anxiety Scale Short Form: Turkish Validity and Reliability Study Anatolian Clin J Med Sci 2020; 25: 216-225 https://doi.org/10.21673/anadoluklin.731092
13. Artan T, Karman M, Atak I, Cebeci F. Evaluation of the Perception and Attitudes Evaluation Scale towards the Covid-19. Turk J Soc Work.2020;4:101-107.
14. Rosa AR, Sánchez-Moreno J, Martínez-Aran A, Salamero M, Torrent C, Reinares M, et al. Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder. Clin Pract Epidemiol Ment Health 2007;3:5. https://doi.org/10.1186/1745-0179-3-5
15. Schmidt RA, Genois R, Jin J, Vigo D, Rehm J, Rush B. The early impact of COVID-19 on the incidence, prevalence, and severity of alcohol use and other drugs: A systematic review. Drug Alcohol Depend 2021;228:109065. https://doi.org/10.1016/j.drugalcdep.2021.109065
16. Murthy P, Narasimha VL. Effects of the COVID-19 pandemic and lockdown on alcohol use disorders and complications. Curr Opin Psychiatry 2021;34(4):376-85. https://doi.org/10.1097/YCO.0000000000000720
17. Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients 2020;12(6):1583. https://doi.org/10.1159/000512852
18. Di Renzo L, Gualtieri P, Cinelli G, Bigioni G, Soldati L, Attinà A, et al. Psychological Aspects and Eating Habits during COVID-19 Home Confinement: Results of EHLC-COVID-19 Italian Online Survey. Nutrients 2020;12(7):2152. https://doi.org/10.3390/nu12072152
19. Van Rheenen TE, Meyer D, Neill E, Phillipou A, Tan EJ, Toh WL, vd. Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project. J Affective Dis 2020;275:69-77. https://doi.org/10.1016/j.jad.2020.06.037
20. Aydınoğlu Ü, Yazla E. The effect of COVID-19 pandemic on the sleep quality of patients who have the diagnosis of Bipolar Disorder (tur). Turk J Clin Psy 2021;24(1):33-40. https://doi.org/10.5505/kpd.2020.26576
21. Li G, Tang D, Song B, Qunshan S, Xu C, Geng H, et al. Impact of the COVID-19 Pandemic on Partner Relationships and Sexual and Reproductive Health: Cross-Sectional, Online Survey Study. J Med Internet Res 2020;22(8):e20961. https://doi.org/10.2196/20961
22. Yuksel B, Ozgor F. Effect of the COVID-19 pandemic on female sexual behavior. Int J Gynaecol Obstet. 2020;150(1):98-102. https://doi.org/10.1002/ijgo.13193
23. Fornaro M, De Prisco M, Billeci M, Ermini E, Young AH, Lafer B, et al. Implications of the COVID-19 pandemic for people with bipolar disorders: A scoping review. J Affect Disord. 2021;295:740-751. https://doi.org/10.1016/j.jad.2021.08.091
24. Çökmüş FP, Aşçibaşi K, Dikici DS, Çöldür EÖ, Avci E, Aydemir Ö. Seasonality in Bipolar Disorder: Impact on Mood Symptoms, Psychosocial Functioning, Neurocognition, and Biological Rhythm. Noro Psikiyatr Ars. 2020;58(1):41-47. https://doi.org/10.29399/npa.25056
25. Léda-Rêgo G, Bezerra-Filho S, Miranda-Scippa Â. Functioning in euthymic patients with bipolar disorder: A systematic review and meta-analysis using the Functioning Assessment Short Test. Bipolar Disord. 2020;22(6):569-581. https://doi.org/10.1111/bdi.12904
26. Kaçan H, Öztürk A, Değer VB. Do the Anxiety of Individuals Affect their Perceptions and Attitudes towards the Covid-19 Outbreak? Curr Approaches Psychiatry 2021; 13(Suppl 1):405-420 https://doi.org/10.18863/pgy.1009613
27. Jiménez E, Arias B, Castellví P, et al. Impulsivity and functional impairment in bipolar disorder. J Affect Disord 2012;136(3):491-497. https://doi.org/10.1016/j.jad.2011.10.044
28. Samalin L, Boyer L, Murru A, Pacchiarotti I, Reinares M, Bonnin CM, et al. Residual depressive symptoms, sleep disturbance and perceived cognitive impairment as determinants of functioning in patients with bipolar disorder. J Affect Disord 2017;210:280-286. https://doi.org/10.1016/j.jad.2016.12.054
29. Marangoni C, Hernandez M, Faedda GL. The role of environmental exposures as risk factors for bipolar disorder: A systematic review of longitudinal studies. J Affect Disord 2016;193:165-174. https://doi.org/10.1016/j.jad.2015.12.041

There are 29 citations in total.

Details

Primary Language	English
Subjects	Psychiatry
Journal Section	Original Research
Authors	İlhan Ahmet Çetiner 0009-0003-2287-8906 Hülya Ertekin 0000-0003-4787-5333
Publication Date
Submission Date	March 27, 2025
Acceptance Date	May 21, 2025
Published in Issue	Year 2025Volume: 10 Issue: 2

Cite

APA	Çetiner, İ. A., & Ertekin, H. (n.d.). COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients. Family Practice and Palliative Care, 10(2), 44-52.
AMA	Çetiner İA, Ertekin H. COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients. Fam Pract Palliat Care. 10(2):44-52.
Chicago	Çetiner, İlhan Ahmet, and Hülya Ertekin. “COVID-19-Related Anxiety, Fear and Biopsychosocial Risk Factors on Functionality in Euthymic Bipolar Disorder Patients”. Family Practice and Palliative Care 10, no. 2 n.d.: 44-52.
EndNote	Çetiner İA, Ertekin H COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients. Family Practice and Palliative Care 10 2 44–52.
IEEE	İ. A. Çetiner and H. Ertekin, “COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients”, Fam Pract Palliat Care, vol. 10, no. 2, pp. 44–52.
ISNAD	Çetiner, İlhan Ahmet - Ertekin, Hülya. “COVID-19-Related Anxiety, Fear and Biopsychosocial Risk Factors on Functionality in Euthymic Bipolar Disorder Patients”. Family Practice and Palliative Care 10/2 (n.d.), 44-52.
JAMA	Çetiner İA, Ertekin H. COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients. Fam Pract Palliat Care.;10:44–52.
MLA	Çetiner, İlhan Ahmet and Hülya Ertekin. “COVID-19-Related Anxiety, Fear and Biopsychosocial Risk Factors on Functionality in Euthymic Bipolar Disorder Patients”. Family Practice and Palliative Care, vol. 10, no. 2, pp. 44-52.
Vancouver	Çetiner İA, Ertekin H. COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients. Fam Pract Palliat Care. 10(2):44-52.

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Ötimik bipolar bozukluk hastalarında COVID-19 ile ilişkili anksiyete, korku ve biyopsikososyal risk faktörlerinin işlevselliğe etkisi

Abstract

Keywords

Ethical Statement

References

COVID-19-related anxiety, fear and biopsychosocial risk factors on functionality in euthymic bipolar disorder patients

Abstract

Keywords

Ethical Statement

References

Details

Cite

Family Practice and Palliative Care ISSN 2458-8865 E-ISSN 2459-1505