Dynamic patterns of depressive symptoms and sleep during the first month of strict lockdown in two women with major depressive disorder

This article aimed to document the day-to-day patterns of depressive symptoms and sleep parameters, and to explore the dynamic network structure of depressive symptoms during the first COVID strict lockdown. Two participants with major depressive disorder were included in a 30-days observational ecological momentary assessment study just before the lockdown in Montreal, Canada. In both cases, the self-reported depressive symptoms and core affects fluctuated during the lockdown. However, all depressive symptoms were not systematically exacerbated. Among them, significant linear and non-linear temporal patterns have been identified. For case 1, the lockdown period did not worsen the sleep quality and sleep parameters. The psychomotor retardation, fatigue, appetite loss and level of arousal played a prominent role in the idiographic dynamic symptom networks. These case studies allow a granular understanding of the lockdown effects on depressive symptoms and affective experiences dynamics, and highlight the need for person-centered mental health care to help people with major depressive disorder.