Comparison of Perceived Covid-19 Related Mental Health Stress in SMI and Non-SMI Psychiatric Populations

The purpose of the present study was to investigate differences in perceived COVID-19 associated mental health-related stress in individuals with psychiatric diagnoses at opposite ends of the DSM diagnostic severity spectrum. The opposite poles of the spectrum were represented by Adjustment Disorder (AjD) at one end and disorders categorized as Serious Mental Illness (SMI) at the other. The study hypothesized that persons with SMI disorders are more likely to report their mental health negatively affected by COVID-19 stress compared to individuals with non-SMI disorders. An observational, cross-sectional model was used to collect data from client intake forms completed between April 2020 and December 2020. Participants were 25 male and 23 female U.S. citizens (mean age = 32.9) diagnosed with either SMI or Adjustment Disorder. COVID-related mental health stress was measured by answering 'yes' or 'no' to the following question: "Do you feel that your mental health is being negatively impacted (for the worse) by the life-changes, hardships, and stress being caused by the current coronavirus outbreak?" A Pearson chi-square analysis was used to compare the two groups. Results indicated that individuals diagnosed with SMI disorders were significantly more likely to report their mental health negatively affected by COVID-related stress compared to individuals diagnosed with Adjustment Disorder (SMI 74% vs. AdJ 19%, p<.001). In this study, individuals with a pre-existing SMI disorder are almost four times (Risk Ratio: 3.89) more likely to be adversely affected by perceived stress associated with the COVID-19 pandemic than individuals diagnosed with Adjustment Disorder. No significant differences were found between the two diagnostic groups on sociodemographic characteristics (gender/age/ethnicity). These findings suggest that the mental health of individuals diagnosed with SMI may be considerably more negatively impacted by current COVID-19 related stress and therefore require greater clinical attention compared to those diagnosed with Adjustment Disorder and other non-SMI diagnoses.