Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
Psychoneuroendocrinology. 2020 Dec;122:104869. doi: 10.1016/j.psyneuen.2020.104869. Epub 2020 Sep 14.
The COVID-19 pandemic has given rise to stress worldwide, especially in vulnerable people like those suffering from mental illness. This study aims to investigate the psychological distress perceived by a cohort of patients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD) after a seven-week period of lockdown measures, and to analyze serum 25-hydroxyvitamin D [25(OH)D] levels as a potential predictor of distress severity.
Fifty-nine remitted MDD and fifty-three euthymic BD patients were enrolled. An online dedicated survey was administered to obtain lockdown-related information and to evaluate COVID-19 related distress by using the Kessler 10 Psychological Distress Scale (K10). Patients' medical records were reviewed to collect sociodemographic and clinical data, including serum 25(OH)D levels dosed in the three months preceding the outbreak. A multivariate general linear model was adopted to test the effect of factors of interest on psychological distress.
In our sample (n = 112), 29 subjects (25.9 %) reported no likelihood of psychological distress, whereas 35 (31.2 %) and 48 (42.9 %) displayed mild and moderate-to-severe likelihood of psychological distress, respectively. Low serum 25(OH)D levels (p = 0.005) and MDD diagnosis (p = 0.001) specifically predicted the severity of psychological distress. Living alone during the lockdown, a longer duration of illness, and smoking habits were more frequently detected in subjects with COVID-19 related distress.
Low serum 25(OH)D levels and MDD diagnosis predicted an increased vulnerability to the stressful impact of the COVID-19 outbreak. Our results suggest that vitamin D may represent a biological factor mediating the psychological response to stress in individuals with affective disorders and provide further insight into tailoring intervention strategies.
COVID-19 大流行在全球范围内引发了压力，尤其是在精神疾病患者等弱势群体中。本研究旨在调查一组重性抑郁障碍（MDD）或双相情感障碍（BD）患者在七周的封锁措施后所感受到的心理困扰，并分析血清 25-羟维生素 D [25(OH)D] 水平作为困扰严重程度的潜在预测因子。
纳入 59 例缓解期 MDD 和 53 例稳定期 BD 患者。通过在线专用调查获取与封锁相关的信息，并使用 Kessler 10 项心理困扰量表（K10）评估 COVID-19 相关困扰。回顾患者的病历以收集社会人口统计学和临床数据，包括在疫情爆发前三个月内检测的血清 25(OH)D 水平。采用多元一般线性模型检验感兴趣因素对心理困扰的影响。
在我们的样本中（n=112），29 名受试者（25.9%）报告没有心理困扰的可能性，而 35 名（31.2%）和 48 名（42.9%）分别显示轻度和中重度心理困扰的可能性。低血清 25(OH)D 水平（p=0.005）和 MDD 诊断（p=0.001）特别预测了心理困扰的严重程度。在与 COVID-19 相关的困扰患者中，独居、更长的疾病病程和吸烟习惯更为常见。
低血清 25(OH)D 水平和 MDD 诊断预测了对 COVID-19 爆发的应激影响的易感性增加。我们的结果表明，维生素 D 可能是调节情感障碍个体对压力的心理反应的生物学因素，并为制定干预策略提供了进一步的见解。
