Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic

Małgorzata Dragan, Piotr Grajewski, Mark Shevlin, Małgorzata Dragan, Piotr Grajewski, Mark Shevlin

Abstract

Background: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of psychological problems, including stress-related disturbances. However, to date, there is not much research on the prevalence of adjustment disorder during the current pandemic. Objectives: This study aimed to assess the prevalence and severity of symptoms of adjustment disorder compared to posttraumatic symptoms, depression and generalized anxiety in a large sample of adult Poles, in the first phase of the current pandemic. Method: Self-report data from a web-based sample (N = 1,742) was collected between March 25 and April 27, just after the introduction of nationwide quarantine measures in Poland. Results: The current COVID-19 pandemic was a highly stressful event for 75% of participants and the strongest predictor of adjustment disorder. Increased symptoms of adjustment disorder were reported by 49%, and they were associated with female gender and not having a full-time job. However, after exclusion of co-occurring symptomatology, 14% of the sample were finally qualified as meeting diagnostic criteria of adjustment disorder. A substantial proportion of the sample screened also positive for generalized anxiety (44%) and depression (26%); the rate for presumptive PTSD diagnosis was 2.4%. Conclusions: High rates of negative mental health outcomes were found in the Polish population in the first weeks into the COVID-19 pandemic and lockdown measures. They indicate the intense current stress-related symptoms in the early phase of the pandemic and warrant further monitoring on population's mental health.

Keywords: Covid-19 pandemic; adjustment disorder; depression; generalized anxiety; traumatic stress.

Conflict of interest statement

No potential conflict of interest was reported by the authors.

© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

References

    1. Ben-Ezra, M., Mahat-Shamir, M., Lorenz, L., Lavenda, O., & Maercker, A. (2018). Screening of adjustment disorder: Scale based on the ICD-11 and the adjustment disorder new module. Journal of Psychiatric Research, 103, 91–9.
    1. Boyraz, G., & Legros, D. N. (2020). Coronavirus disease (COVID-19) and traumatic stress: Probable risk factors and correlates of posttraumatic stress disorder. Journal of Loss & Trauma, 25(6–7), 503–522.
    1. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 325(10227), 912–920.
    1. Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 287, 112934.
    1. Cloitre, M., Shevlin, M., Brewin, C. R., Bisson, J. I., Roberts, N. P., Maercker, A., … Hyland, P. (2018). The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta Psychiatrica Scandinavica, 138(6), 1–11.
    1. Dong, L., & Bouey, J. (2020). Public mental health crisis during COVID-19 pandemic, China. Emerging Infectious Diseases, 26(7), 1616–1618.
    1. Einsle, F., Köllner, V., Dannemann, S., & Maercker, A. (2010). Development and validation of a self-report for the assessment of adjustment disorders. Psychology, Health & Medicine, 15(5), 584–595.
    1. Holmes, E. A., O’Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., & Bullmore, E. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. The Lancet Psychiatry, 7(6), 547–560.
    1. Hyland, P., Shevlin, M., Elklit, A., Murphy, J., Vallières, F., Garvert, D. W., & Cloitre, M. (2017). An assessment of the construct validity of the ICD-11 proposal for complex posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 9(1), 1–9.
    1. Hyland, P., Shevlin, M., McBride, O., Murphy, J., Karatzias, T., Bentall, R., … Vallières, F. (2020). Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic. Acta Psychiatrica Scandinavica, 3(3), 249–256.
    1. IBM Corp . (Released 2018). IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: Author.
    1. Kazlauskas, E., Zelviene, P., Lorenz, L., Quero, S., & Maercker, A. (2017). A scoping review of ICD-11 adjustment disorder research. European Journal of Psychotraumatology, 8(1–8), 1421819.
    1. Kertz, S., Bigda-Peyton, J., & Bjorgvinsson, T. (2012). Validity of the generalized anxiety disorder-7 scale in an acute psychiatric sample. Clinical Psychology & Psychotherapy, 20, 456–464.
    1. Kiejna, A., Adamowski, T., Piotrowski, P., Moskalewicz, J., Wojtyniak, B., Świątkiewicz, G., … Kessler, R. C. (2015a). Epidemiology of mental disorders and access to mental health care. EZOP – Poland – Research methodology. Psychiatria Polska, 49, 5–13.
    1. Kiejna, A., Piotrowski, P., Adamowski, T., Moskalewicz, J., Wciórka, J., Stokwiszewski, J., … Kessler, R. C. (2015b). The prevalence of common mental disorders in the population of adult Poles by sex and age structure – An EZOP Poland study. Psychiatria Polska, 49, 15–27.
    1. Kokoszka, A., Jastrzębski, A., & Obrębski, M. (2016). Ocena psychometrycznych właściwości polskiej wersji Kwestionariusza Zdrowia Pacjenta-9 dla osób dorosłych [Psychometric properties of the polish version of Patient Health Questionnaire-9]. Psychiatria, 13, 187–193.
    1. Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613.
    1. Lorenz, L., Bachem, R. C., & Maercker, A. (2016). The Adjustment Disorder–New Module 20 as a screening instrument: Cluster analysis and cut-off values. International Journal of Occupational and Environmental Medicine, 7(4), 215–220.
    1. Lotzin, A., Aakvaag, H. F., Acqarini, E., Ajdukovic, D., Ardino, V., Böttche, M., … Schäfer, I. (2020). Stressors, coping and symptoms of adjustment disorder in the course of COVID-19 pandemic – Study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study. European Journal of Psychotraumatology, 11, 178083.
    1. Manea, L., Gilbody, S., & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): A meta-analysis. Canadian Medical Association Journal, 184(3), E191–196.
    1. Manea, L., Gilbody, S., & McMillan, D. (2015). A diagnostic meta-analysis of the Patient Health Questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. General Hospital Psychiatry, 37(1), 67–75.
    1. Mimoun, E., Ben Ari, A., & Margalit, D. (2020). Psychological aspects of employment instability during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S183–S185.
    1. Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The Work and Social Adjustment Scale: A simple measure of impairment in functioning. British Journal of Psychiatry, 180(5), 461–464.
    1. Perkonigg, A., Lorenz, L., & Maercker, A. (2018). Prevalence and correlates of ICD-11 adjustment disorder: Findings from the Zurich Adjustment Disorder Study. International Journal of Clinical and Health Psychology, 18(3), 209–217.
    1. Rodríguez-Rey, R., Garrido-Hernansaiz, H., & Collado, S. (2020). Psychological impact of COVID-19 in Spain: Early data report. Psychological Trauma: Theory, Research, Practice, and Policy, 12(5), 550–552.
    1. Rosenfield, S., & Mouzon, D. (2013). Gender and mental health. In Aneshensel C. S., Phelan J. C., & Bierman A. (Eds.), Handbook of the sociology of mental health. handbooks of sociology and social research (pp. 277–296). Rotterdam: Springer.
    1. Rosenthal, L., Carroll-Scott, A., Earnshaw, V. A., Santilli, A., & Ickovics, J. R. (2012). The importance of full-time work for urban adults’ mental and physical health. Social Science & Medicine, 75, 1692–1696.
    1. Rossi, R., Socci, V., Pacitti, F., Di Lorenzo, G., Di Marco, A., Siracusano, A., & Rossi, A. (2020). Mental health outcomes among front and second line health workers associated with the COVID-19 pandemic in Italy. MedRxiv. doi:10.1101/2020.04.16.20067801
    1. Rutter, L. A., & Brown, T. A. (2016). Psychometric properties of the Generalized Anxiety Disorder Scale-7 (GAD-7) in outpatients with anxiety and mood disorders. Journal of Psychopathology and Behavioral Assessment, 39, 140–146.
    1. Shevlin, M., Hyland, P., Ben‐Ezra, M., Karatzias, T., Cloitre, M., Vallières, F., … Maercker, A. (2019). Measuring ICD-11 Adjustment disorder: The development and initial validation of the International Adjustment Disorder Questionnaire. Acta Psychiatrica Scandinavica, 141(3), 265–274.
    1. Shevlin, M., McBride, O., Murphy, J., Gibson Miller, J., Hartman, T. K., Levita, L., … Bentall, R. P. (2020). Anxiety, depression, traumatic stress, and COVID-19 related anxiety in the UK general population during the COVID-19 pandemic. Preprint. doi:10.31234/
    1. Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166(1092). doi:10.1001/archinte.166.10.1092
    1. Walton, M., Murray, E., & Christian, M. D. (2020). Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. European Heart Journal: Acute Cardiovascular Care, 9, 241–247.
    1. World Health Organization . (2019). International statistical classification of diseases and related health problems (11th ed.).
    1. World Health Organization . (2020a). Survey tool and guidance. Rapid, simple, flexible behavioural insights on COVID-19. Copenhagen: WHO.
    1. World Health Organization . (2020b). WHO COVID-19 preparedness and response progress report. Geneva: WHO.

Source: PubMed

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