Holistic approach in the assessment of the relapse of depressive and anxiety disorders during COVID-19

General Medicine,2023, 25(1), 16-24.

V. Stoyanova, I. Kamenova, R. Vladimirova

Psychiatric Clinic, UMHAT „Alexandrovska“ ‒ Sofia

Abstract. The aim of the current study was to assess the influence of the first wave of COVID-19 (March‒ June 2020) on individuals with depression and anxiety, evaluating the impact of different groups of factors in a complex (holistic) manner. Materials and methods: The study is cross-sectional, including outpatients with depressive and anxiety disorders in remission (n = 60), outpatients in relapse (n = 65), a group of healthy controls (n = 30), and a control group with relatives of the patients with depression and anxiety (n= 30) for the period July‒October 2020. Socio-demographic factors, the presence of somatic comorbidity and risk factors related to it, and the need for medical care during the first COVID wave were analyzed. Results: Patients with deteriorated anxiety disorders have a significantly lower educational status (p < 0.001) in comparison to the other groups. Individuals with deteriorated major depressive disorder and controls-relatives have significantly more somatic comorbidity compared to healthy controls (p < 0.05). Individuals with anxiety disorders do not differ from healthy controls on this measure. Visits to medical specialists in those with worsening depression increased during the analyzed period but were comparable to the control groups. In persons with anxiety – worsened or in remission, there is a significant increase in this indicator compared to healthy controls (p < 0.05). Conclusions: In the conditions of the first COVID- wave, individuals with worsened depression, as well as relatives of anxious and depressed patients have significantly more somatic problems compared to healthy controls. However, individuals with anxiety but not depression seek significantly more healthcare consultations, despite the isolation. The holistic approach implies a complex assessment of somatic and mental comorbidity and the need for additional knowledge and resources in the service of persons with anxiety and depression, although there is relatively easy access to consultation care in our country.

Key words: depression, anxiety, COVID-19, outpatient service

Address for correspondence: Assoc. Prof. Vesela Stoyanova, MD, е-mail: vestoyan@yahoo.com