Dissociative symptoms during the SARS-CoV-2 pandemic situation in mental health patients

Abstract:

Background: Dissociative symptoms arise in reaction to significant stress and are common in post-traumatic stress disorder (PTSD).

Methods: We longitudinally investigated the course of dissociative symptoms in psychiatric patients over the first year of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic situation (04/2020–05/2021). The group was separated into patients with relevant symptoms of PTSD at study start (Group 1: PTSDG) and those without (Group 2: noPTSDG), and we also employed a control group (Group 3: CG). Dissociative symptoms were tracked using the “Fragebogen zu Dissoziativen Symptomen” (FDS), an adapted and extended German version of the “Dissociative Experience Scale” (DES). Datasets of 93 participants were analyzed over up to three time periods. In addition, the regional incidence of positive SARS-CoV-2 tests (7di) and the intensity of non-pharmacological interventions (NPI) were included in multilevel linear models.

Results: Patients reported stronger dissociative symptoms in the PTSDG than in the noPTSDG, while the CG showed the lowest symptom intensity. Importantly, regarding the course of symptoms over time, while public counts of positive SARS-CoV-2 tests had no influence, dissociative symptom severity was significantly impacted by the intensity of non-pharmacological interventions, particularly in the PTSDG and regarding depersonalization and derealization.

Conclusion: Patients with relevant symptoms of PTSD at study start suffered from intense dissociative symptoms over the first year of the SARS-CoV-2 pandemic situation, driven by non-pharmacological interventions. In a milder way, other psychiatric patients were also affected. The results underline the responsivity of these patient groups regarding social and political stress.