Psychological distress and suicidality in psychiatric patients during the COVID-19 pandemic in Norway: A repeated cross-sectional study

Background: Psychiatric patients are vulnerable to disruptions caused by the Corona Virus Disease 2019 (COVID-19) pandemic. This study aimed to investigate the effects of the pandemic on mental health symptoms and suicidality among these patients during lockdowns.Methods: This repeated cross-sectional study utilized data from "Psychological distress and Coping in Patients in Community Mental Health Centers during COVID-19 pandemic (PsyCo-COVID-19) " study, conducted in two phases between June-July 2020 and March-April 2021. It included 261 participants from six Community Mental Health Centers (CMHCs) who completed a digital questionnaire, including Norwegian version of Mini Interna-tional Neuropsychiatric Interview Plus (M.I.N.I. Plus), Hopkins Symptoms Checklist (HSCL-25), Post-traumatic Stress Disorder Checklist (PCL-5).Results: A higher percentage of patients reported PTSD during the second phase of lockdown (47.4%) compared to the first phase of lockdown (33.7%). A third of participants (33.7%) reported high levels of suicidality. Moderate to severe effects of pandemic on mental health were associated with a significantly higher risk of suicide (AOR = 3.12; 95% CI: 1.50, 6.48; p = 0.0001), while having children (AOR = 0.35; 95% CI: 0.16, 0.76; p = 0.008) and being employed (AOR = 0.44; 95% CI: 0.23, 0.84; p = 0.013) were protective factors. Non-Norwegian background was associated with a higher risk of suicide (AOR = 2.59; 95% CI: 1.08, 6.19; p = 0.032).Conclusion: High prevalence of suicidality was found among patients in CMHCs in Norway, with a significant association with self-reported worsening of mental health. PTSD and suicidality increased significantly during the second phase of lockdown, emphasizing the lasting impact of the pandemic on mental health. Targeted in-terventions and support services are needed for psychiatric patients during times of increased stress and un-certainty. Healthcare providers should be aware of the increased risk of suicide and provide appropriate support and interventions to prevent adverse outcomes.