A Longitudinal Investigation of the Effects of the COVID-19 Pandemic on the Mental Health of Individuals with Pre-existing Severe Mental Illnesses

Psychiatry Res. 2020 Dec:294:113493. doi: 10.1016/j.psychres.2020.113493. Epub 2020 Oct 1.


Objective: Individuals with severe mental illnesses (SMI), including schizophrenia spectrum illnesses and affective disorders, may be at increased risk for negative mental health outcomes related to the COVID-19 pandemic. This study compared the severity of pre-pandemic symptoms and affective experiences to current symptoms to evaluate this possibility.

Methods: 148 individuals with SMI (92 with schizophrenia spectrum illnesses and 56 with affective disorders) were recruited from ongoing ecological momentary assessment studies that sampled day-to-day experiences and symptom severity prior to the pandemic. Participants completed a one-time phone survey that queried these same experiences/symptoms between April and June of 2020.

Results: Severity of affective experiences and psychotic symptoms remained stable across time, as did sleep duration. Well-being and the number of substances used increased during the early months of the pandemic. Increases in well-being were associated with being female and spending less time alone pre-pandemic. Patterns of stability/change did not differ according to diagnostic category.

Conclusions: At this relatively early stage, individuals with SMI are not reporting a worsening of symptoms or affective experiences and instead appear to be resilient in the face of the pandemic. Continued assessment is needed to determine whether this resilience will persist as the pandemic progresses.

Keywords: COVID-19; bipolar disorder; mood; pandemic; psychotic symptoms; schizophrenia; well-being.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • COVID-19 / psychology*
  • Ecological Momentary Assessment
  • Female
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Mood Disorders / psychology*
  • Pandemics
  • Psychotic Disorders / psychology*
  • Risk Factors
  • Schizophrenic Psychology*