TY - JOUR
T1 - Can we predict a “tsunami”? Symptomatic and syndromal density, mood instability and treatment intensity in people with bipolar disorders under a strict and long lockdown
AU - Strejilevich, Sergio
AU - Samamé, Cecilia
AU - Marengo, Eliana
AU - Godoy, Antonella
AU - Smith, José
AU - Camino, Sebastián
AU - Oppel, Melany
AU - Sobrero, Martina
AU - López Escalona, Lautaro
N1 - Publisher Copyright:
© 2024 Elsevier B.V.
PY - 2024/4/15
Y1 - 2024/4/15
N2 - Background: Converging evidence supports the involvement of circadian rhythm disturbances in the course and morbidity of bipolar disorders (BD). During 2020, lockdown measures were introduced worldwide to contain the health crisis caused by the COVID-19 pandemic. As a result, chronobiological rhythms were critically disrupted and illness outcomes were expected to worsen. The current study aimed to explore changes in morbidity among BD patients living under lockdown. Methods: Ninety BD outpatients under naturalistic treatment conditions were followed from March to September 2020 using a mood chart technique. Different treatment and illness variables, including mood instability, were assessed and compared with the outcomes obtained during the same 28-week period in 2019. Results: For most clinical variables, no significant differences were observed between time periods. A slight decrease was found in symptom intensity (from 15.19 ± 20.62 to 10.34 ± 15.79, FDR-adjusted p = 0.04) and in the number of depressive episodes (from 0.39 ± 0.74 to 0.22 ± 0.63, FDR-adjusted p = 0.03), whereas the intensity of pharmacological treatment remained unchanged. Previous illness course predicted mood outcomes during the confinement. Limitations: Follow-up periods were relatively short. Further, actigraphy or other methods capable of ensuring significant changes in physical activity were not used. Conclusions: In line with other studies, our findings show no worsening in the clinical morbidity of BD patients during lockdown. This conspicuous contrast between our initial predictions and the observed findings highlights the fact that we are still far from being able to provide accurate predictive models for BD.
AB - Background: Converging evidence supports the involvement of circadian rhythm disturbances in the course and morbidity of bipolar disorders (BD). During 2020, lockdown measures were introduced worldwide to contain the health crisis caused by the COVID-19 pandemic. As a result, chronobiological rhythms were critically disrupted and illness outcomes were expected to worsen. The current study aimed to explore changes in morbidity among BD patients living under lockdown. Methods: Ninety BD outpatients under naturalistic treatment conditions were followed from March to September 2020 using a mood chart technique. Different treatment and illness variables, including mood instability, were assessed and compared with the outcomes obtained during the same 28-week period in 2019. Results: For most clinical variables, no significant differences were observed between time periods. A slight decrease was found in symptom intensity (from 15.19 ± 20.62 to 10.34 ± 15.79, FDR-adjusted p = 0.04) and in the number of depressive episodes (from 0.39 ± 0.74 to 0.22 ± 0.63, FDR-adjusted p = 0.03), whereas the intensity of pharmacological treatment remained unchanged. Previous illness course predicted mood outcomes during the confinement. Limitations: Follow-up periods were relatively short. Further, actigraphy or other methods capable of ensuring significant changes in physical activity were not used. Conclusions: In line with other studies, our findings show no worsening in the clinical morbidity of BD patients during lockdown. This conspicuous contrast between our initial predictions and the observed findings highlights the fact that we are still far from being able to provide accurate predictive models for BD.
KW - Bipolar disorder
KW - COVID-19
KW - Lockdown
KW - Longitudinal
KW - Mood
KW - Mood instability
UR - http://www.scopus.com/inward/record.url?scp=85184761537&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2024.02.007
DO - 10.1016/j.jad.2024.02.007
M3 - Artículo
AN - SCOPUS:85184761537
SN - 0165-0327
VL - 351
SP - 827
EP - 832
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -