Department of Nosocomial Infection Management, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430012, Hubei province, China.
Transl Psychiatry. 2021 Jul 5;11(1):374. doi: 10.1038/s41398-021-01503-7.
Suffering from COVID-19 and witnessing the suffering and deaths of patients with COVID-19 may place frontline healthcare workers (HCWs) at particularly high risk for posttraumatic stress disorder (PTSD); however, few data are available on the clinical characteristics of PTSD among frontline HCWs who survived COVID-19 ("surviving HCWs" hereafter). The present study examined the prevalence, correlates, and clinical symptoms of possible PTSD in surviving HCWs 6 months after the COVID-19 outbreak in China. A total of 291 surviving HCWs and 42 age- and gender-matched COVID-19-free frontline HCWs (control group) were recruited and administered the Chinese Essen Trauma Inventory, which was used to assess the presence of possible PTSD according to DSM-IV-TR criteria. Survivors' clinical data and characteristics of exposure to COVID-19 were collected via self-report questionnaires. Surviving HCWs had significantly higher rates of possible PTSD than controls (19.9% vs. 4.8%, P = 0.017). Correlates of PTSD in survivors were ICU admission (OR = 8.73, P = 0.003), >10 respiratory symptoms during the most symptomatic period of COVID-19 (OR = 3.08, P = 0.006), the residual symptom of dizziness (OR = 2.43, P = 0.013), the residual symptom of difficult breathing (OR = 2.23, P = 0.027), life in danger due to COVID-19 (OR = 16.59, P = 0.006), and exposure to other traumatic events (OR = 2.94, P = 0.035). Less commonly seen PTSD symptoms in survivors were having nightmares about the event (34.5%), suddenly feeling like they were living through the event suddenly (25.9%), being unable to remember an important part of the event (32.8%), and overalertness (31.0%). Nearly one-fifth of the surviving HCWs had possible PTSD 6 months after the COVID-19 outbreak. Mental health services for this vulnerable population should include periodic screening for PTSD, expanded social support, and, when necessary, psychotherapy and psychopharmacological treatment.
患有 COVID-19 并目睹 COVID-19 患者的痛苦和死亡可能使一线医护人员（HCWs）面临创伤后应激障碍（PTSD）的极高风险；然而，关于在 COVID-19 中幸存的一线 HCWs 中 PTSD 的临床特征（以下简称“幸存 HCWs”）的数据很少。本研究调查了中国 COVID-19 爆发后 6 个月幸存 HCWs 中 PTSD 的患病率、相关性和临床症状。共招募了 291 名幸存 HCWs 和 42 名年龄和性别匹配的无 COVID-19 一线 HCWs（对照组），并进行了中国 Essen 创伤量表，根据 DSM-IV-TR 标准评估可能的 PTSD 的存在。幸存者的临床数据和接触 COVID-19 的特征通过自我报告问卷收集。幸存 HCWs 的 PTSD 发生率明显高于对照组（19.9%比 4.8%，P=0.017）。幸存者 PTSD 的相关因素是 ICU 入院（OR=8.73，P=0.003）、COVID-19 症状最严重期间出现超过 10 种呼吸道症状（OR=3.08，P=0.006）、头晕残留症状（OR=2.43，P=0.013）、呼吸困难残留症状（OR=2.23，P=0.027）、因 COVID-19 而生命危险（OR=16.59，P=0.006）和接触其他创伤性事件（OR=2.94，P=0.035）。幸存者中不太常见的 PTSD 症状包括做有关事件的噩梦（34.5%）、突然感觉自己突然经历了事件（25.9%）、无法记住事件的重要部分（32.8%）和过度警觉（31.0%）。COVID-19 爆发后近五分之一的幸存 HCWs 可能患有 PTSD。应向这一弱势群体提供心理健康服务，包括定期筛查 PTSD、扩大社会支持以及在必要时进行心理治疗和精神药理学治疗。
