A four-year longitudinal evaluation of the impact of the COVID-19 pandemic on patients with a range of mental health disorders.

Objectives: To examine if the COVID-19 pandemic had a differential impact longitudinally over four years on psychological and functional impact in individuals with a pre-existing anxiety, bipolar or emotionally unstable personality Disorder (EUPD).

Methods: Semi-structured interviews were conducted with 52 patients attending the Galway-Roscommon Mental Health Services with an International Classification of Diseases (ICD)-10 diagnosis of an anxiety disorder (n = 21), bipolar disorder (n = 18), or EUPD (n = 13) at four time points over a four-year period. Patients' impression of the impact of the COVID-19 pandemic was assessed in relation to anxiety and mood symptoms, social and occupational functioning and quality of life utilising psychometric instruments and Likert scale data, with qualitative data assessing participants' subjective experiences.

Results: Individuals with EUPD exhibited higher anxiety (BAI) symptoms compared to individuals with bipolar disorders and anxiety disorders (F = 9.63, p = 0.001), with a more deleterious impact on social functioning and quality of life also noted at all time points. Themes attained from qualitative data included isolation resulting from COVID-19 mandated restrictions (N = 22), and these same restrictions allowing greater appreciation of family (n = 19) and hobbies/nature (n = 13).

Conclusions: Individuals with EUPD reported increased symptomatology and reduced functioning and quality of life as a consequence of the COVID-19 pandemic over a four-year period compared to individuals with either an anxiety or bipolar disorder. This could be related to the differing interaction of the COVID-19 pandemic's restrictions on the symptoms and support requirements of this cohort.