Prevalence and predictors of post-traumatic stress disorder in patients with cured coronavirus disease 2019 (COVID-19) one month post-discharge

Yumeng Ju; Jin Liu; Roger M K Ng; Bangshan Liu; Mi Wang; Wentao Chen; Mei Huang; Aiping Yang; Kongliang Shu; Yun Zhou; Li Zhang; Mei Liao; Jiyang Liu; Yan Zhang

doi:10.1080/20008198.2021.1915576

Prevalence and predictors of post-traumatic stress disorder in patients with cured coronavirus disease 2019 (COVID-19) one month post-discharge

Eur J Psychotraumatol. 2021 Jun 17;12(1):1915576. doi: 10.1080/20008198.2021.1915576. eCollection 2021.

Authors

Yumeng Ju^{1

2}, Jin Liu^{1

2}, Roger M K Ng³, Bangshan Liu^{1

2}, Mi Wang^{1

2}, Wentao Chen^{1

2}, Mei Huang^{1

2}, Aiping Yang⁴, Kongliang Shu⁵, Yun Zhou⁶, Li Zhang^{1

2}, Mei Liao^{1

2}, Jiyang Liu⁷, Yan Zhang^{1

2}

Affiliations

¹ Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P.R. China.
² China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Mental Health Institute of Central South University, Changsha, Hunan, P.R. China.
³ Department of Psychiatry, Kowloon Hospital, Hong Kong SAR, P.R. China.
⁴ Department of Obstetrics & Gynecology, The First Hospital of Changsha, Changsha, Hunan, P.R. China.
⁵ Department of Neurology, The First Hospital of Changsha, Changsha, Hunan, P.R. China.
⁶ Department of Orthopedics, The First Hospital of Changsha, Changsha, Hunan, P.R. China.
⁷ Administrative Office, The First Hospital of Changsha, Changsha, Hunan, P.R. China.

Abstract
in English, Spanish, Chinese

Background: Coronavirus disease 2019 (COVID-19) can place an immense psychological strain on the infected patient. The psychological distress can linger after the initial recovery from the infection. Objective: This study aimed to evaluate the prevalence and predictors of provisional post-traumatic stress disorder (PTSD) in patients with cured COVID-2019. Methods: The baseline survey was conducted from 10 to 25 February 2020 in patients with COVID-19 in a designated hospital. Demographic and clinical characteristics were acquired, and depression and anxiety levels were assessed, using the 9-item Patient Health Questionnaire and 7-item Generalized Anxiety Disorder scale, respectively. A follow-up survey was conducted 1 month post-discharge. PTSD symptoms were measured by the Impact of Event Scale-6 (IES-6) and patients' perception of supportive care during hospitalization was investigated using a self-developed questionnaire. Results: In total, 114 patients completed both the baseline and follow-up surveys. Of these, 41 (36.0%) met the cut-off score for provisional PTSD diagnosis according to the IES-6. Female gender [odds ratio (OR) = 4.69, 95% confidence interval (CI) 1.54-14.37], educational level of high school or below (OR = 15.49, 95% CI 1.13-212.71), higher anxiety levels (OR = 1.34, 95% CI 1.12-1.61) and lower perceptions of emotional support during hospitalization (OR = 0.41, 95% CI 0.17-0.96) predicted a higher risk for provisional PTSD. Conclusions: PTSD is commonly seen in patients with COVID-19 1 month post-discharge. Female patients, and patients with lower educational levels, higher anxiety levels and lower perceptions of emotional support during hospitalization may be more likely to develop PTSD in the near future. Enhancing emotional support during hospitalization could help to prevent PTSD in patients with COVID-19.

Antecedentes: El COVID-19 ha supuesto una inmensa carga psicológica para el paciente infectado. El malestar psicológico puede persistir aún después de la recuperación inicial de la infección.Objetivos: Este estudio tuvo como objetivo evaluar la prevalencia y los factores predictores del trastorno de estrés postraumático (TEPT) provisional en pacientes recuperados de COVID-2019.Métodos: El cuestionario inicial se realizó en pacientes con el COVID-19 desde el 10 de febrero del 2020 hasta el 25 de febrero del 2020 en un hospital designado. Se consideraron las variables demográficas y clínicas, además, se evaluaron los niveles de depresión y ansiedad mediante el cuestionario de salud del paciente de 9 elementos y el cuestionario del trastorno de ansiedad generalizada de 7 elementos, respectivamente. Un cuestionario de seguimiento fue realizado un mes después del alta. Los síntomas de TEPT fueron medidos por el Cuestionario de Eventos de Impacto 6 (IES-6 por sus siglas en ingles) y el nivel de percepción de los pacientes sobre el cuidado de soporte durante la hospitalización fue investigado utilizando un cuestionario auto-administrado.Resultados: Ciento catorce pacientes completaron tanto el cuestionario inicial como el de seguimiento. Cuarenta y un (36.0%) pacientes cumplieron con el punto de corte para el diagnóstico provisional de TEPT según el IES-6. El sexo femenino (OR = 4.69, 95% CI: 1.54-14.37), un nivel de educación secundaria o inferior (OR = 15.49, 95% CI: 1.13-212.71), niveles elevados de ansiedad (OR = 1.34, 95% CI: 1.12-1.61) y una menor percepción de soporte emocional durante la hospitalización (OR = 0.41, 95% CI: 0.17-0.96) fueron factores predictores de riesgo elevado para el desarrollo provisional de TEPT.Conclusiones: El TEPT es observado con frecuencia en pacientes con COVID-19 un mes después del alta. Las pacientes de sexo femenino, los pacientes con un nivel de educación bajo, los pacientes con un nivel elevado de ansiedad y una menor percepción de apoyo emocional durante la hospitalización podrían tener mayor probabilidad de desarrollar TEPT en el futuro cercano. El reforzamiento del apoyo emocional durante la hospitalización podría ayudar a prevenir el TEPT en pacientes con COVID-19.

背景: COVID-19对受感染的患者造成了极大的心理压力, 最初的感染恢复后, 这种心理困扰可能会持续。目的: 本研究旨在评估COVID-2019出院患者中创伤后应激障碍 (PTSD) 的患病率及其预测因素。方法: 于2020年2月10日至2020年2月25日在定点医院对 COVID-19 患者进行基线调查, 包括人口学和临床特征, 同时采用9项患者健康问卷和广泛性焦虑障碍量表评估患者住院期间的抑郁焦虑程度。出院一个月后进行随访调查, 采用6项事件影响量表评估创伤后应激障碍症状, 并采用自编问卷调查患者在住院期间对医务人员支持性护理的认知。结果: 114例患者完成了基线调查和随访调查。41例患者 (36.0%) 达到 PTSD 诊断的临界值。女性 (OR = 4.69, 95% CI: 1.54-14.37), 高中及以下文化程度(OR = 15.49, 95% CI: 1.13-212.71), 住院期间较高的焦虑水平 (OR = 1.34, 95% CI: 1.12-1.61) 和住院期间较低的情感支持认知 (OR = 0.41, 95% CI: 0.17-0.96) 预示着PTSD的高风险。结论: COVID-19患者出院后患创伤后应激障碍比例较高。女性, 文化程度较低, 住院期间的较高焦虑状态以及感受到较低情感支持的患者, 更有可能在近期内发展为PTSD。在住院期间加强情感支持可能有助于预防 COVID-19 患者发生 PTSD。.

Keywords: Coronavirus disease 2019 (COVID-19); patients; post-traumatic stress disorder (PTSD); predictors; supportive care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19 / epidemiology
COVID-19 / psychology*
China / epidemiology
Female
Humans
Length of Stay
Longitudinal Studies
Male
Middle Aged
Pandemics
Prevalence
Risk Factors
SARS-CoV-2
Stress Disorders, Post-Traumatic / epidemiology*
Surveys and Questionnaires
Survivors / psychology*

Grants and funding

This work was supported by the project of Hunan Provincial Department of Science and Technology [grant number 2020SK3014], the Defense Innovative Special Region Program [grant number 17-163-12-ZT-001-041-01], the project of Changsha Department of Science and Technology [grant number kq2001005], the National Natural Science Foundation of China [grant number 81671353], and the National Key Research and Development Program of China [grant number 2019YFA0706200]. Yumeng Ju’s work is supported by the Central South Postdoctoral Programme. The authors gratefully acknowledge the financial support from the above affiliations. The sponsors had no role in this review.

Abstract in English, Spanish, Chinese

Publication types

MeSH terms

Grants and funding

Abstract
in English, Spanish, Chinese