Anxiety, Depression and Cognitive Emotion Regulation Strategies in Psychiatric Patients during the COVID-19 Pandemic

Woraphat  Ratta-apha; Nichkamol  Kittipavara; Varaporn  Sripirom; Chia-Chun  Hung; Tony Szu-Hsien  Lee; Pornjira  Pariwatcharakul; Kamonporn  Wannarit; Panate  Pukrittayakamee; Netnapa  Promsuwong; Jingswat  Sirikunchoat; Sirirat  Kooptiwoot

doi:10.33192/Smj.2022.100

Authors

Woraphat Ratta-apha Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Nichkamol Kittipavara Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University
Varaporn Sripirom Psychiatric Outpatient Department Unit, Siriraj Hospital, Bangkok
Chia-Chun Hung Center for Addiction Prevention and Policy Research, National Taiwan Normal University, Taipei, / Continuing Education Master's Program of Addiction Prevention and Treatment, National Taiwan Normal University, Taipei
Tony Szu-Hsien Lee Center for Addiction Prevention and Policy Research, National Taiwan Normal University, Taipei / Continuing Education Master's Program of Addiction Prevention and Treatment, National Taiwan Normal University, Taipei / Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei
Pornjira Pariwatcharakul Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University
Kamonporn Wannarit Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Panate Pukrittayakamee Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University
Netnapa Promsuwong Psychiatric Outpatient Department Unit, Siriraj Hospital, Bangkok
Jingswat Sirikunchoat Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Sirirat Kooptiwoot Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/Smj.2022.100

Keywords:

COVID-19, coronavirus, cognitive emotional regulation, anxiety, depression

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic likely impacted emotional regulation and mood states. The present study aimed to investigate the perceived risk, stigma, and emotional regulation strategies of psychiatric patients, as well as the association between these characteristics, cognitive emotion regulation strategies (emotional suppression and cognitive reappraisal), and anxiety and depressive symptoms during the COVID-19 pandemic.

Materials and Methods: The present cross-sectional study of 282 patients with anxiety and mood disorders was conducted during the COVID-19 pandemic in 2020. Participants completed questionnaires that investigated anxiety (hospital anxiety and depression scale [HADS]), depression (patient health questionnaire [PHQ-9]), and cognitive emotion regulation strategies (emotion regulation questionnaire [ERQ]). Descriptive statistics were used to assess the data. The t-test, chi-square test, and Mann-Whitney U test were used to compare the differences between the two groups, with cut-off scores of 11 in the HADS and nine in the PHQ-9.

Results: Most participants were female (78.4%), and the median age was 31 years. A total of 23.8% of participants reported having anxiety symptoms, and 24.8% and 54.3% of participants reported having depression on the HADS-D and PHQ-9, respectively. HADS-A, HADS-D, and PHQ-9 were found to be significantly associated with emotional regulation style (P=0.002, P=0.005, P=0.006) but not with perceived risk and stigma. Patients with anxiety or depression tended to use expressive suppression more often than cognitive reappraisal.

Conclusion: This study found that mood states were associated with cognitive emotional regulation strategies during the COVID-19 pandemic. Patients with anxiety or depression tended to use expressive suppression more often than cognitive reappraisal.

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