Objective: This study examines the challenges faced by patients with schizophrenia (SCZ) and bipolar disorder (BD) during the coronavirus disease 2019 (COVID-19) pandemic, including healthcare accessibility, treatment adherence, social support, illness course, vegetative symptoms, concerns about COVID-19, protective healthcare behavior, sources of COVID-19-related information, and attitudes toward telepsychiatry.
Methods: A dual-interview method was employed with 200 patients: 100 interviews were conducted by telephone and 100 face-to-face in the outpatient clinic (50 SCZ and 50 BD patients in each group), enabling a comparative analysis of interview modalities.
Results: Among the patients, 22% experienced difficulties reaching their doctors or hospitals, 6.5% were unable to access medications, and 7.5% reported insufficient social support. Avoidance of hospital visits due to COVID-19 concerns was higher in the telephone group than in the outpatient group (61% vs. 31%, p=0.001). Exacerbations occurred in 27% of participants, and treatment nonadherence was observed in 25.5%. Nonadherence, insufficient social support, insomnia, and appetite and weight loss were significantly associated with exacerbations. Nonadherence was highest among patients receiving sodium valproate (40%), whereas clozapine (17.1%) and lithium (20%) were associated with better adherence. Adoption of COVID-19 protective behaviors ranged from 83% to 95%, while only 23% used online resources, with slightly higher use among outpatients. Most patients (92.5%) were unaware of telepsychiatry; however, after receiving an explanation, willingness to use it was higher in the telephone group, except among patients with SCZ or delusional symptoms.
Conclusion: This study highlights the need for tailored healthcare strategies for individuals with chronic mental illnesses. Lack of familiarity with telepsychiatry may contribute to disruptions in the continuity of psychiatric care during crises, underscoring the importance of integrating telehealth services and improving access pathways.