Bulgarian Journal of Psychiatry, 2021; 6(3):29-37


Vessela Stoyanova, Ivayla Kamenova, Rositza Vladimirova

Department of Psychiatry and Medical Psychology, Medical University – Sofia

Abstract. The objective of the study is to evaluate the indirect influence of the COVID-19 pandemic on the manifestation of anxiety and depression, and the burden of perceived stress among out-patients. Methods: The study is pilot, cross-sectional, non-interventional, and includes out-patients with depressive and anxiety disorder and controls, recruited from July 2020 to October 2020. Self-assessment scales are used for the evaluation of anxiety and depression (HADS), perceived stress (PSS-10) and loneliness (UCLA-LS3). The severity of the illness is assessed by the scale for clinical global impression (CGI-S). Results: The study includes 110 individuals, forming the following groups: exacerbated anxiety disorder (n = 23), anxiety disorder in remission (n = 17), exacerbated depressive disorder (n = 18), depressive disorder in remission (n = 24), and healthy controls (n = 28). The patients with exacerbated depression have the highest results on scales HADS-А (= 12.39 ± 4.16); HADS-D (= 10.39 ± 4.07); PSS-10 ( = 24,72 ± 3,68); UCLA-LS3 (= 5.78 ± 1.86), which differs them significantly (р < 0,05) from the control group, from the groups in remission, and from the patients with exacerbated anxiety according to HADS-D (= 6,00 ± 4,54). The perceived stress in the control group, assessed by PSS-10 (= 16,43 ± 4,07), differs significantly only from the group of patients with exacerbated depression (р < 0,05). In terms of this scale, the rest of the groups do not differ significantly from the controls. The loneliness, assessed by UCLA-LS3, is significantly more pronounced (р < 0,05) in the groups of exacerbated anxiety and depression compared with patients in remission and the control group, which do not differ significantly from each other. Conclusions: The exacerbation of anxiety and depressive disorders during the time of COVID-19 pandemic depends on complex factors, but the stability of the remission is an important protective concerning perceived stress and loneliness in these patients. Patients with exacerbated depression demonstrate the highest level of stress.

Key words: anxiety, depression, COVID-19, perceived stress

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