# Divergent psychological stress response patterns to the COVID-19 pandemic in psychiatric patients with vs. without PTSD: A real-world exploratory study

## TL;DR

This study found that psychiatric patients with PTSD experienced higher psychological stress during the pandemic compared to those without PTSD.

## Contribution

The study explores pandemic-related stress response patterns in psychiatric patients with PTSD, a previously underconsidered area.

## Key findings

- Psychosocial burden and adjustment disorder symptoms were significantly higher in PTSD patients during the pandemic.
- PTSD patients showed no changes in general psychiatric symptoms during the pandemic.
- PTSD patients may cope less efficiently with pandemic-related stress compared to those without PTSD.

## Abstract

The COVID-19 pandemic has been shown to increase psychological burden and requires efficient coping strategies to maintain mental health. In particular, it remains unclear which pandemic-related stress response pattern occurs in pre-existing posttraumatic stress disorder (PTSD) during the pandemic – at the same time these patients potentially exhibit dysfunctional coping of artificially generated psychosocial stressors. To analyze this so far widely unconsidered pandemic-related stress response in PTSD, this study longitudinally measured psychosocial burden and adjustment disorder (AD) symptom load in 14 patients with a primary or secondary diagnosis of PTSD vs. a cohort of 145 psychiatric patients without PTSD. The previously established Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) was used. Patients were interviewed at the end of the first (April/May 2020) and the second nationwide lockdown in Germany (November/December 2020). In our convenience sample, psychiatric disorders were diagnosed by patients’ treating clinicians prior to study inclusion. Psychosocial burden and AD symptom load were significantly higher in patients with PTSD than in patients without PTSD over the course of the pandemic (both p = .005). Moreover, explorative analysis of Goe-BSI-assessed general psychiatric symptoms did not reveal changes during the pandemic in patients with PTSD. In sum, we provide preliminary evidence that, in relation to psychiatric patients without PTSD, those with PTSD might experience a higher pandemic-related burden and might thus cope less efficiently with this enduring real-world stressor. This study is limited inter alia by the small sample size and by the underrepresentation of some psychiatric diagnoses.