Pre-event psychiatric states predict trajectories of event-related distress in Japan.

Background: Recent time-dependent analyses of stress-related disorders have identified heterogeneity of trajectories and their modifying factors. While psychiatric patients are vulnerable to stress events, it is unclear how psychiatric conditions in the general population modulate subsequent event-related distress trajectories.

Methods: Using a longitudinal online survey from before the COVID-19 pandemic to post-pandemic follow-ups (n = 3815 Japanese adults) and a latent growth mixture model, we identified four trajectories of pandemic-related stress symptoms: resilient, chronic, mild chronic, and early response.

Results: Depression/anxiety was identified as a specific risk factor for the early-response trajectory. In contrast, social withdrawal was identified as a shared protective factor, whereas general psychiatric burden was a common risk factor across trajectories. Further, we estimated latent stress reactivity to examine the predictability of the event-related distress trajectory from pre-pandemic states. The chronic group showed significantly higher latent stress reactivity scores than the mild-chronic and early-response groups, both of which were significantly higher than the resilient group.

Conclusion: Prior psychiatric conditions significantly affect stress symptom trajectories. These results suggest that prior psychiatric conditions may be considered for the prevention and treatment of maladaptive stress responses.