Gunathilaka Nayana, Chandradasa Miyuru, Champika Layani, Siriwardana Shirom, Wijesooriya Lakmini
1Department of Parasitology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
2Department of Psychiatry, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama, 11010 Sri Lanka.
Int J Ment Health Syst. 2018 May 2;12:20. doi: 10.1186/s13033-018-0202-6. eCollection 2018.
Although the physical consequences of dengue are well documented, delayed psychological co-morbidities are not well studied to date. Therefore, the objective of the present study was to determine the prevalence of depressive, anxiety and stress symptoms among past dengue patients.
A community-based, case-control study in a multi-ethnic urban setting was conducted in Sri Lanka involving adults who were diagnosed to have dengue fever by a positive dengue IgM antibody response between 6 and 24 months ago. Self-administered Depression, Anxiety and Stress Scale (DASS-21), Centre for Epidemiological Studies Depression Scale (CESD-20) and a structured clinical interview by a psychiatrist were done in the patients and in an age and gender-matched control group.
Fifty-three participants each in the patient (mean age 42.9 years, SD 15.5) and control (mean age 41.6 years, SD 15.3) groups were surveyed. The ages ranged from 18 to 70 years and 64.2% were females. The majority (90.6%; n = 48) of the individuals had been diagnosed with dengue fever followed by dengue haemorrhagic fever (9.4% n = 5). Dengue patients had higher DASS-21 mean depressive scores (means 11.7/9.4, SD 6.4/4.0, t = 2.2, p = .028), anxiety scores (means 10.7/7.2, SD 6.8/1.8, t = 3.6, p = .0005), stress scores (means 12.0/8.8, SD 5.3/3.5, t = 3.6, p = .0004) and CESD-20 scores (means 16.1/11.7, SD 9.4/7.3, t = 2.6, p = .008) than controls. The DSM-5 depressive disorder was clinically detected by the psychiatrist among 15.1 and 7.5% in patient and control groups (OR 2.1; CI .5-7.7; p = .22). Limitations: a limitation is the small sample size.
Patients with past dengue had significantly higher depressive, anxiety and stress symptoms than the control group according to the DASS-21 and CESD-20 tools. To our knowledge, this is the first report on delayed psychological morbidity related to dengue. This may warrant healthcare professionals to incorporate mental counselling for dengue patients.
尽管登革热的身体后果已有充分记录，但延迟出现的心理共病迄今尚未得到充分研究。因此，本研究的目的是确定既往登革热患者中抑郁、焦虑和压力症状的患病率。
在斯里兰卡一个多民族城市环境中开展了一项基于社区的病例对照研究，纳入6至24个月前因登革热IgM抗体反应呈阳性而被诊断为登革热的成年人。对患者及其年龄和性别匹配的对照组进行了自我管理的抑郁、焦虑和压力量表（DASS-21）、流行病学研究中心抑郁量表（CESD-20）调查以及由精神科医生进行的结构化临床访谈。
对患者组（平均年龄42.9岁，标准差15.5）和对照组（平均年龄41.6岁，标准差15.3）各53名参与者进行了调查。年龄范围为18至70岁，64.2%为女性。大多数个体（90.6%；n = 48）被诊断为登革热，其次是登革出血热（9.4%；n = 5）。登革热患者的DASS-21平均抑郁得分（均值11.7/9.4，标准差6.4/4.0，t = 2.2，p = 0.028）、焦虑得分（均值10.7/7.2，标准差6.8/1.8，t = 3.6，p = 0.0005）、压力得分（均值12.0/8.8，标准差5.3/3.5，t = 3.6，p = 0.0004）和CESD-20得分（均值16.1/11.7，标准差9.4/7.3，t = 2.6，p = 0.008）均高于对照组。精神科医生在患者组和对照组中临床检测到的DSM-5抑郁障碍分别为15.1%和7.5%（比值比2.1；可信区间0.5 - 7.7；p = 0.22）。局限性：样本量小是一个局限性。
根据DASS-21和CESD-20工具，既往登革热患者的抑郁、焦虑和压力症状显著高于对照组。据我们所知，这是关于登革热相关延迟心理发病的首份报告。这可能需要医疗保健专业人员为登革热患者提供心理咨询。
