Cerrahpasa Medical Faculty, Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, 81310, Turkey.
Cerrahpasa Medical Faculty, Department of Psychiatry, Division of Geriatric Psychiatry, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Rheumatol Int. 2020 Aug;40(8):1229-1238. doi: 10.1007/s00296-020-04626-0. Epub 2020 Jun 22.
We hypothesized that patients with rheumatic diseases (RD) would have increased psychological distress during the COVID-19 outbreak; therefore, assessed their psychological symptoms and changes in their routine. A web-based questionnaire survey was conducted in a cross-sectional design in three groups of participants: (1.) patients with RD, (2.) hospital workers, and (3.) high-school teachers/academic staff. Psychiatric status was evaluated using Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised scale. Overall response rate was 34.7%. We studied 771 patients with RD, 535 hospital workers, and 917 teachers/academic staff. Most of the patients with RD were unwilling to go to the hospital (86%), while 22% discontinued their medications. Biological DMARDS were the most frequent drugs whose doses were altered. Only 4% were willing to take hydroxychloroquine for protection. Moreover, the frequency of anxiety (20%), depression (43%), and post-traumatic stress (28%) among patients with RD were found to be comparable to that found among the teachers/academic staff (23%, 43% and 29%, respectively), whereas significantly less than that observed among the hospital workers (40%, 62%, and 46%, respectively) (p < 0.001). Female gender, use of social media, having a comorbid disease, or a psychiatric disorder were found to be independently associated with psychiatric symptoms in total study population. The majority of the patients were unwilling to attend outpatient visits and one-fifth skipped or stopped their immunosuppressive agents. Psychiatric symptoms in patient's and teacher's populations were of considerable clinical concern, despite being significantly lower than that observed among the hospital workers.
我们假设患有风湿性疾病（RD）的患者在 COVID-19 爆发期间会有更多的心理困扰；因此，评估了他们的心理症状和日常生活的变化。采用横断面设计，在三组参与者中进行了一项基于网络的问卷调查：（1）RD 患者，（2）医院工作人员，和（3）高中教师/学术人员。使用医院焦虑和抑郁量表和修订后的事件影响量表评估精神状态。总体应答率为 34.7%。我们研究了 771 例 RD 患者、535 名医院工作人员和 917 名教师/学术人员。大多数 RD 患者不愿意去医院（86%），而 22%的患者停止了药物治疗。生物 DMARDs 是最常改变剂量的药物。只有 4%的患者愿意服用羟氯喹进行预防。此外，RD 患者的焦虑（20%）、抑郁（43%）和创伤后应激（28%）的发生率与教师/学术人员（分别为 23%、43%和 29%）相当，而显著低于医院工作人员（分别为 40%、62%和 46%）（p < 0.001）。在总研究人群中，女性、使用社交媒体、患有合并症或精神障碍与精神症状独立相关。大多数患者不愿意去门诊就诊，五分之一的患者跳过或停止使用免疫抑制剂。尽管患者和教师群体的精神症状明显低于医院工作人员，但仍引起了相当大的临床关注。
