Talk:WikiJournal of Medicine/Working with Bipolar Disorder During the COVID-19 Pandemic: Both Crisis and Opportunity

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WikiJournal of Medicine
Open access • Publication charge free • Public peer review • Wikipedia-integrated

WikiJournal of Medicine is an open-access, free-to-publish, Wikipedia-integrated academic journal for Medical and Biomedical topics. <seo title=" WJM, WikiJMed, Wiki.J.Med., WikiJMed, Wikiversity Journal of Medicine, WikiJournal Medicine, Wikipedia Medicine, Wikipedia medical journal, WikiMed, Wikimedicine, Wikimedical, Medicine, Biomedicine, Free to publish, Open access, Open-access, Non-profit, online journal, Public peer review "/>

<meta name='citation_doi' value='10.15347/WJM/2020.004'>

Article information

Authors: Eric A. Youngstrom[a][i] , Stephen P. Hinshaw[b] , Alberto Stefana[c] , Jun Chen[d] , Kurt Michael[e] , Anna Van Meter[f][ii] , Victoria Maxwell[g], Erin E. Michalak[h] , Emma G. Choplin[i][iii] , Logan T. Smith[j][iv] , Caroline Vincent[k][v] , Avery Loeb[l][vi], Eduard Vieta[m] 

See author information ▼
  1. Department of Psychology and Neuroscience, and Psychiatry, University of North Carolina at Chapel Hill
  2. Department of Psychology, University of California, Berkeley
  3. Department of Clinical and Experimental Sciences, University of Brescia
  4. Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine
  5. Department of Psychology, Appalachian State University
  6. Department of Psychiatry, Northwell Health
  7. Crazy for Life Co.
  8. Department of Psychiatry, University of British Columbia
  9. Helping Give Away Psychological Science
  10. Department of Psychology, Temple University
  11. Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
  12. Chapel Hill High School
  13. Department of Psychiatry and Clinical Psychobiology, University of Barcelona


Overview of Revised Version

We thank the reviewers and editors for their detailed, constructive comments and suggestions. We have revised the application, incorporating all of the feedback as detailed below. In addition, we have updated the citations, replaced pre-prints with published articles, and reviewed the paper and changed verb tenses and adding some detail about the evolution of mental health service provision (elaborating on themes raised by Reviewer 1, as well as research and service trends subsequent to our initial submission. We have documented the permissions for the infographic by Tasha Regan so that it is stable on WikiMedia Commons, and we believe that the other sources are all attributed correctly.

We agree that the paper is substantially improved as a result, and we look forward to next steps in the process. Eyoungstrom (discusscontribs) 15:44, 26 August 2020 (UTC)Reply[reply]

Comment on an image

Comment is in reference to this image

For this file, the authors currently only included the simplified Chinese text (the second word). I would recommend the authors to also include traditional Chinese text into the second word of the image to increase its reach and readability to non-simplified Chinese audiences. OhanaUnitedTalk page 14:56, 20 April 2020 (UTC)Reply[reply]

Thank you! We agree and have uploaded a file with the traditional Chinese text, too. Great suggestion! Eyoungstrom (discusscontribs) 15:54, 21 April 2020 (UTC)Reply[reply]
It is ideal to merge both simplified and traditional Chinese into a single image. OhanaUnitedTalk page 19:26, 26 April 2020 (UTC)Reply[reply]
Hmmm. I don't have the technical skills to do that, and Dr. Chen is back in the hospital service. This may take us a while, but we will endeavor to do it. Eyoungstrom (discusscontribs) 13:58, 2 May 2020 (UTC)Reply[reply]
Follow up question -- if one of the other authors merged the image, how would we indicate attribution uploading it to Wikimedia Commons? Is it still Chen? Only new person (remixing the two from Chen)? Chen and New Person? New Person and Chen? Thanks for any guidance.... Eyoungstrom (discusscontribs) 14:01, 2 May 2020 (UTC)Reply[reply]
We have created a version combining simplified and traditional, as requested, uploaded it to WikiMedia Commons, and replaced the other two images with the single one in the article, as suggested. Eyoungstrom (discusscontribs) 16:18, 27 August 2020 (UTC)Reply[reply]

Editorial suggestions

Comments by Mark D Worthen ,
These editorial comments were submitted on , and refer to this previous version of the article

First of all, I believe this is a good, important article and I appreciate the authors submitting their manuscript to WikiJMed. Here are some suggestions for improving the article, and some questions for other WikiJMed editors regarding policies. Due to time constraints, I will review the article a section at a time. The following suggestions refer to the article's first section, Impact of the Pandemic and Public Health Responses. (Note: I offer these suggestions as a WikiJMed editor, not as a peer reviewer. I am not the action editor for this article.)

  • "These numbers will undoubtedly go up before they recede." - Which numbers? (Since the graph includes more than one metric.)

We have edited to clarify the referent for "these numbers" --

"Both the infection and mortality numbers will undoubtedly continue to go up before the outbreak recedes." Eyoungstrom (discusscontribs) 17:07, 24 August 2020 (UTC)Reply[reply]
  • "... patients with mental health issues ..." - "mental health issues" is vague - "issues" is becoming (or has become) a synonym for "problems", but "problems" is usually better because it is more precise. Alternatives include: "serious mental illness" (particularly since that is the term used in the cited article),[1] "mental health problems", "mental disorders", "mental illness", and "psychiatric disorders".

Thank you, I changed "mental health issues" to "mental health problems" because it is more appropriate to use in this context. Emmagch (discusscontribs)

  • "mental health issues" is hyperlinked mental health problems to the article at - the article is about bipolar disorder specifically, as opposed to an article on mental disorders generally. (Note that I am not referring to the citation—the article by Benjamin Dross in JAMA Psychiatry.) At the same time, it is a very helpful article so I'm not suggesting removing it, but I think a citation at the end of the sentence would make more sense.

Thank you, I agree! I hyperlinked "mental health problems" to because it outlines the impact COVID-19 pandemic puts on people's mental illness including mental health patients. I then added it as a citation as well. Next, I moved the ibpf linked article as a citation at the end of the sentence. Emmagch (discusscontribs)

  • "They require sacrificing daily routines and public/personal social encounters that enhance health and quality of life and provide emotional support." - Clarify: Do daily routines alone enhance health and QoL? Or social encounters alone? Or both? ¶ Reference(s) needed.'

Thank you -- we clarify that both routines and social encounters enhance quality of life. We have added citations to a major review by Grandin, as well as a book by Duhigg. Eyoungstrom (discusscontribs) 16:00, 26 August 2020 (UTC)Reply[reply]

  • "Vulnerable populations are also at an increased risk of getting Coronavirus because of lack of access to physical distancing measures." - "vulnerable populations" should be defined, perhaps in an endnote. ¶ The phrase, "lack of access to physical distancing measures", is vague. Do you mean population density? Or living in crowded living quarters? Or not being able to take time of work or telecommute, thus having to work in close proximity to other people?

We have elaborated to clarify this as follows...

"Vulnerable populations -- such as people with low income, racial and ethnic minorities, and those who struggle with managing their mental health -- are also at an increased risk of contracting coronavirus due to factors such as lack of access to safe transportation (versus having to use subways/busing/metros), the inability to work at home due to unpaid time off, and differences in type of jobs (low-wage essential workers like grocers, sanitation workers, home health aides, delivery drivers, and fast food servers all involve more exposure than desk jobs would).[15][16][17]"

Eyoungstrom (discusscontribs) 16:07, 26 August 2020 (UTC)Reply[reply]

  • Coronavirus - Should be lower case. (Unless there are a good number of reliable sources that do capitalize it.)

Good catch! I corrected this. Emmagch (discusscontribs)

  • Change "getting" to "contracting".[2]

I changed it to "contracting" Emmagch (discusscontribs)


We have deleted the citation, as suggested. Eyoungstrom (discusscontribs) 17:24, 24 August 2020 (UTC)Reply[reply]

  • The sentence that ends with "... and panic-buying" references these two articles, which have not been peer-reviewed (but see Policy questions, below):

Brooks, Samantha K.; Webster, Rebecca K.; Smith, Louise E.; Woodland, Lisa; Wessely, Simon; Greenberg, Neil; Rubin, G. James (2020). "The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence". SSRN Electronic Journal. doi:10.2139/ssrn.3532534. ISSN 1556-5068.[3]

"Forced social isolation and mental health: A study on 1006 Italians under COVID-19 quarantine". doi:10.31234/ Retrieved 2020-04-14.

  - Mark D Worthen PsyD (talk) 14:51, 18 May 2020‎ (UTC)Reply[reply]


As noted, the Brooks et al. has now completed peer review and is published in The Lancet. The other paper appears to still have not completed peer review, so we replaced it with the Clerici et al. 2020, which has completed peer review and also looked at patterns of service utilization in Italy. Eyoungstrom (discusscontribs) 17:27, 24 August 2020 (UTC)Reply[reply]

Policy questions

1. Do we have a policy about articles on sites like SSRN or PsyArXiv that have not been peer-reviewed? (My preference would be to allow such references but with a crystal clear disclaimer, and only if editors review the cited articles and do not find any obvious problems with their reliability and accuracy.)   - Mark D Worthen PsyD (talk) 14:51, 18 May 2020‎ (UTC)Reply[reply]

We've had something similar in the past for this article using the {{*link}} template after a non-peer-reviewed reference. T.Shafee(Evo﹠Evo)talk 06:39, 19 May 2020 (UTC)Reply[reply]
Cool. Thanks! (Btw, that article—Western African Ebola virus epidemic—is superb.)   - Mark D Worthen PsyD (talk) 11:55, 19 May 2020 (UTC)Reply[reply]
Thank you for the guidance! The SSRN citation in question has now been published in the Lancet, and we have updated the citations accordingly. We have also looked for a published version of the Italian data -- it appears to still not be through peer review. We are glad to remove or further clarify the citation as the editorial board sees fit.
Eyoungstrom (discusscontribs) 17:20, 24 August 2020 (UTC)Reply[reply]

2. Do we have a policy about in-text hyperlinks to reputable websites that contain helpful content. (I am in favor of permitting such links as long as editors check the validity of statements made in the article and we include a disclaimer; and if we archive the links.)   - Mark D Worthen PsyD (talk) 14:51, 18 May 2020‎ (UTC)Reply[reply]

I agree that it's reasonable to in-text external links in articles, maybe including the archive link as a ref immediately after? T.Shafee(Evo﹠Evo)talk 06:39, 19 May 2020 (UTC)Reply[reply]
Sounds good to me!   - Mark D Worthen PsyD (talk) 11:55, 19 May 2020 (UTC)Reply[reply]
Thanks for the guidance. If we have not done this correctly, we would be glad for instruction.
Eyoungstrom (discusscontribs) 17:20, 24 August 2020 (UTC)Reply[reply]



  1. Druss, Benjamin G. (3 April 2020). "Addressing the COVID-19 Pandemic in Populations With Serious Mental Illness". JAMA Psychiatry. doi:10.1001/jamapsychiatry.2020.0894
  2. Merriam-Webster, contract, transitive verb ... 1b : to become affected with // contract pneumonia, (accessed 18 May 2020).
  3. "Preprints with The Lancet is part of SSRN´s First Look, a place where journals and other research experts identify content of interest prior to publication. These preprint papers are not peer-reviewed. Authors have either opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet, or submitted directly via SSRN. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. These papers should not be used for clinical decision making or reporting of research to a lay audience without indicating that this is preliminary research that has not been peer-reviewed."

I asked about this template at Help talk:Footnotes#Reflist-talk template.

Peer Review 1

Review by Mary A. Fristad, PhD, ABPP , The Ohio State University
These assessment comments were submitted on , and refer to this previous version of the article

The authors state in the ""Disruption of Services"" section that psychiatric outpatient facilities have suspended all programmed and routine clinical activities. This is not accurate. In many settings, outpatient treatment quickly pivoted to phone only, then video sessions, and many outpatient settings have remained busy, nearly to their usual capacity, during this time. Similarly, many inpatient settings have not directly curtailed admissions; rather, patients were less likely to come to the emergency department seeking admission, thereby driving down inpatient census. The remainder of the article provides a good review of pertinent issues and some opportunities for positive outcomes.


We appreciate the feedback. We have rewritten this section to update the changes in service delivery and policy. The reviewer's description matches how the situation evolved in multiple countries. We also added a second paragraph to better describe subsequent events, citing two peer reviewed studies to support the reviewer's observations.

"There was rapid adjustment, with some clinics pivoting to providing services primarily or only by telephone, and then adding video sessions. Many governments and insurance payers have modified rules to allow more video service provision, including changes to billing codes and regulations. Recommendations for telehealth and about protective measures to allow resumption of in-person services have rapidly followed, balancing issues of safety and prevention of infection with concerns about privacy as well as offering continued service provision. Although the pace of innovation has been rapid, there have been changes in service use patterns, with some hospitals and clinics seeing a big decrease in admissions and appointments.[12] The changes have been larger for elective issues than for emergencies, perhaps in part due to concerns about medical facilities being a place for potential exposure to the virus.[12][18]"

We appreciate the improvements and updates, as well as the general positive evaluation of the paper. Eyoungstrom (discusscontribs) 20:13, 25 August 2020 (UTC)Reply[reply]

Review by Mary A. Fristad, PhD, ABPP , The Ohio State University
These assessment comments were submitted on , and refer to this previous version of the article

The article should include a disclaimer that information is changing rapidly (for example, my comment now needs adjusting as third party payors are starting to put end dates on telehealth reimbursement, etc.)


We agree, and have added several statements to this effect, including in the opening paragraph of the paper, as well as in the middle and conclusion of the specific section about changes in service delivery.

In addition, we have updated the incidence numbers, and also cited the American Psychologist article on the topic of mental health, disparities, and COVID.

Thank you again for the excellent and clinically-informed suggestions! Eyoungstrom (discusscontribs) 13:24, 1 October 2020 (UTC)Reply[reply]

Peer review 2

Review by Seshadri Sekhar Chatterjee, MD , Assistant Professor, Department of Psychiatry, Diamond Harbour Medical College and Hospital, West Bengal, India
These assessment comments were submitted on , and refer to this previous version of the article

The authors have written on a pertinent topic of mental health effect of COVID-19 on bipolar disorder patients in particular. They also discussed and covered a broad areas ranging from treatment to social factors. However, there are some points which should be discussed in more details

1. Sometimes the discussion went quite general and nonspecific beyond the particular topic of Bipolar disorder and COVID. However, given the context of this particular journal (WikiJournal), this is acceptable.


We appreciate the latitude to include some broader points, given the general readership of Wiki Journal of Medicine.
Eyoungstrom (discusscontribs) 17:13, 24 August 2020 (UTC)Reply[reply]

2. It would be better if the drug-interaction part is written in further details. For example- (a) Problem with Liver function with Azithromycin and Ritonavir, (b) Mentioning particular CYP enzyme name which these drugs mainly affects, (c) QT interval prolongation - are among those.

These reference can be of help, if needed-

  • Chatterjee SS, Malathesh BC, Das S, Singh OP. Interactions of recommended COVID-19 drugs with commonly used psychotropics. Asian Journal of Psychiatry. 2020 Aug;52:102173.

Thank you -- we have included this helpful and timely citation.
Eyoungstrom (discusscontribs) 17:13, 24 August 2020 (UTC)Reply[reply]

3. If it can be updated after submission, it is ok but otherwise citation number 32 should be updated.


We have reviewed the citations and updated where possible.
Eyoungstrom (discusscontribs) 17:13, 24 August 2020 (UTC)Reply[reply]

Otherwise the draft is well written and can be accepted after minor revision.


We appreciate the positive feedback as well as the constructive suggestions.
Eyoungstrom (discusscontribs) 17:13, 24 August 2020 (UTC)Reply[reply]

Declaration of conflict of interest

Perhaps I have missed it, but I think the article needs a declaration of conflict of interest somewhere in the case that it is from the same Eric A. Youngstrom on the editorial board, or so I was told should be done on articles from editors. (The preceding unsigned comment was added by Candace Makeda Moore (talkcontribs) )

Thanks! Excellent suggestion, and I just added. Much appreciated! Eyoungstrom (discusscontribs) 00:20, 11 August 2020 (UTC)Reply[reply]

Editorial suggestions

Comments by Thomas Shafee ,
These editorial comments were submitted on , and refer to this previous version of the article

Additionally discussion within the editorial board brought up two final recommendations to consider:

  • It was noted the first image in the 'Increased Strain' section didn't seem to add much scientific value

Thank you for the feedback. We have deleted the image. Eyoungstrom (discusscontribs) 13:31, 1 October 2020 (UTC)Reply[reply]

  • There is no mention of 'flattening the curve' in the article itself and its relevance to the context of the article so may warrant a sentence in the 'Impact of the Pandemic and Public Health Responses' section.

Good point. We now explicitly use the phrase and put it in a larger policy context, as suggested: "Thus, many governments have implemented regional or national stay-at-home orders in an effort to "flatten the curve" of incidence and slow its spread (map of the USA)." Eyoungstrom (discusscontribs) 13:34, 1 October 2020 (UTC)Reply[reply]

Comments by Thomas Shafee ,
These editorial comments were submitted on , and refer to this previous version of the article

A final note: the creator of figure 1 noted that an improved caption might be:

  • "Flattening the curve" of active cases, and "raising the line" of healthcare capacity, attempt to ensure that healthcare can be provided to a population.