Implications of the COVID-19 pandemic for people with bipolar disorders: A scoping review

Michele Fornaro; Michele De Prisco; Martina Billeci; Eleonora Ermini; Allan H Young; Beny Lafer; Jair C Soares; Eduard Vieta; Joao Quevedo; Andrea de Bartolomeis; Kang Sim; Lakshmi N Yatham; Michael Bauer; Dan J Stein; Marco Solmi; Michael Berk; Andre F Carvalho

doi:10.1016/j.jad.2021.08.091

Implications of the COVID-19 pandemic for people with bipolar disorders: A scoping review

J Affect Disord. 2021 Dec 1:295:740-751. doi: 10.1016/j.jad.2021.08.091. Epub 2021 Sep 4.

Authors

Michele Fornaro¹, Michele De Prisco¹, Martina Billeci¹, Eleonora Ermini¹, Allan H Young², Beny Lafer³, Jair C Soares⁴, Eduard Vieta⁵, Joao Quevedo⁶, Andrea de Bartolomeis⁷, Kang Sim⁸, Lakshmi N Yatham⁹, Michael Bauer¹⁰, Dan J Stein¹¹, Marco Solmi¹², Michael Berk¹³, Andre F Carvalho¹⁴

Affiliations

¹ Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy.
² Department of Psychological Medicine, Psychology and Neuroscience, Institute of Psychiatry, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent BR3 3BX, UK.
³ Bipolar Research Program, Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
⁴ Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA.
⁵ Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia 08036, Spain.
⁶ Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Department of Psychiatry and Behavioral Sciences, Translational Psychiatry Program, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Center of Excellence On Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Neuroscience Graduate Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
⁷ Section on Psychiatry, Department of Neuroscience, Reproductive Science and Odontostomatology Federico II University of Naples, Naples, Italy; Laboratory of Molecular and Translational Psychiatry and Unit of Treatment-Resistant Psychosis, University of Naples Federico II, Italy; Staff of Unesco Chair for Health Education and Sustainable Development, Naples, Italy.
⁸ Institute of Mental Health Singapore, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁹ Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
¹⁰ Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Medical Faculty, Technische Universität Dresden, Dresden, Germany.
¹¹ Department of Psychiatry and Neuroscience Institute, SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.
¹² Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.
¹³ IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia; Department of Psychiatry, Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Australia; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
¹⁴ IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia. Electronic address: andrefc7@hotmail.com.

Abstract

Introduction: The COVID-19 (coronavirus disease 2019)-related pandemic represents a global source of societal and health burden. Yet, the impact of the pandemic on people with severe mental illness, including bipolar disorder (BD), remains unclear, warranting scoping review on the matter.

Methods: The MEDLINE and EMBASE databases were systematically searched from inception up to April 24, 2021, adopting broad inclusion criteria to assess a variety of clinical and public health themes related to people with a primary diagnosis of BD during the COVID-19 pandemics. The present work complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) registered in the Open Science Framework (OSF) repository (https://osf.io/7evpx/).

Results: Fourteen papers informed the present scoping review. Four major themes were identified: (i) impact of COVID-19-related stressors on BD; (ii) impact of COVID-19 on mental health service utilization among people with BD; (iii) impact of BD on the risk of acquiring SARS-CoV-2 infection; (iv) engagement in preventative behaviors among people with BD. Additional themes warranting further research were nonetheless detected.

Limitations: Further original studies are needed.

Conclusion: The present study confirmed the high-vulnerability hypothesis concerning people with BD versus the general population, reinforcing the need for further research related to the COVID-19 pandemic. Additional information is warranted to compare the impact of the pandemic period among BD people against pre-pandemic records, the general population, and other severe mental illnesses, namely people with schizophrenia or major depressive disorder, to inform the public health and the delivery of patient-tailored interventions.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Bipolar Disorder* / epidemiology
COVID-19*
Depressive Disorder, Major*
Humans
Pandemics
SARS-CoV-2