Fuchs-Leitner Isabella, Yazdi Kurosch, Gerstgrasser Nikolas W, Tholen Matthias G, Graffius Sophie-Therés, Schorb Alexander, Rosenleitner Jan
Medical Faculty, Johannes Kepler University Linz, Linz, Austria.
Department of Psychiatry - Specialization Addiction Medicine, Kepler University Hospital GmbH, Linz, Austria.
Front Psychiatry. 2021 Sep 30;12:729460. doi: 10.3389/fpsyt.2021.729460. eCollection 2021.
The impact of the COVID-19 pandemic on the mental health of patients suffering from addictive disorders is of major concern. This study aimed to explore the presence and potential increase in post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety since the beginning of the pandemic for patients in opioid substitution therapy (OST). This cross-sectional survey study evaluated a clinical sample of patients in OST ( = 123). Symptoms of post-traumatic stress disorder (PTSD) due to the COVID-19 pandemic were assessed by an adapted version of the impact of event scale (IES-R), resulting in two subgroups of low and high risk for PTSD. The depression, anxiety, and stress scale (DASS-21) was applied to collect data on the respective symptoms, and changes since the onset of the pandemic were reported on separate scales. Sociodemographic and COVID-19 related factors, as well as data on craving, consumption patterns, concomitant use, and the drug market were further assessed. A binary logistic regression analysis confirmed the impact of self-perceived higher burden by psychological and economic factors on the elevated risk for PTSD due to the pandemic. The high-risk PTSD group also showed higher levels of depression, anxiety and stress, as well as a more pronounced deterioration in these symptoms since the pandemic. While reported levels of craving did not differ between the two groups, the high-risk PTSD group indicated a significantly higher increase in craving since the crisis, when compared to the low-risk group. Our findings demonstrate elevated levels of clinical symptoms among patients in OST, with more than a quarter of patients found at risk for PTSD due to the COVID-19 pandemic. Furthermore, about 30-50% of our patients reported concerning levels of depression, anxiety, or stress. Special attention should be drawn to these findings, and potential deterioration of the situation should be addressed by health care facilities. Particularly, psychological, and financial burden due to the crisis were identified as factors increasing the risk for PTSD. These factors can easily be evaluated during routine anamneses, and might be a valuable source of information, when special attention is needed.
新冠疫情对成瘾性疾病患者心理健康的影响备受关注。本研究旨在探讨自疫情开始以来,接受阿片类药物替代疗法(OST)的患者创伤后应激障碍(PTSD)症状、抑郁和焦虑症状的存在情况及潜在增加情况。这项横断面调查研究评估了123例接受OST治疗的临床样本患者。采用事件影响量表修订版(IES-R)评估因新冠疫情导致的创伤后应激障碍(PTSD)症状,从而将患者分为PTSD低风险和高风险两个亚组。应用抑郁、焦虑和压力量表(DASS-21)收集相关症状的数据,并通过单独量表报告自疫情开始以来的变化情况。进一步评估了社会人口学因素、与新冠疫情相关的因素,以及关于渴求、消费模式、合并使用情况和毒品市场的数据。二元逻辑回归分析证实,心理和经济因素导致的自我感知负担加重对因疫情导致的PTSD风险升高有影响。高风险PTSD组还表现出更高水平的抑郁、焦虑和压力,且自疫情以来这些症状的恶化更为明显。虽然两组报告的渴求水平没有差异,但与低风险组相比,高风险PTSD组自危机以来渴求显著增加。我们的研究结果表明,接受OST治疗的患者临床症状水平升高,超过四分之一的患者因新冠疫情有患PTSD的风险。此外,约30%-50%的患者报告有令人担忧的抑郁、焦虑或压力水平。应特别关注这些研究结果,医疗机构应应对可能出现的情况恶化。特别是,危机导致的心理和经济负担被确定为增加PTSD风险的因素。这些因素在常规问诊中很容易评估,在需要特别关注时可能是有价值的信息来源。