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社区精神科患者的 COVID-19 相关心理创伤和心理困扰:受抑郁症和睡眠障碍影响的人群承受着最大的负担。

COVID-19-Related Psychological Trauma and Psychological Distress Among Community-Dwelling Psychiatric Patients: People Struck by Depression and Sleep Disorders Endure the Greatest Burden.

机构信息

Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.

Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt.

出版信息

Front Public Health. 2022 Jan 7;9:799812. doi: 10.3389/fpubh.2021.799812. eCollection 2021.

Abstract

COVID-19 has created a general state of worry and distress, especially among vulnerable groups such as those with psychiatric diagnoses. Worldwide, psychiatric care provision has drastically suffered during the pandemic, with many patients unable to access proper care, which may have implications for increased mental health consequences in patients with psychiatric disorders (e.g., relapse and suicide). This cross-sectional study used structural equation modeling to investigate COVID-19-related trauma and distress among Arab psychiatric population during COVID-19 quarantine. Patients with pre-existing psychiatric disorders ( = 168) completed an online survey that comprised the Depression Anxiety Stress Scale 21 (DASS-21), the Impact of Event Scale-Revised (IES-R), and a questionnaire on COVID-19-related attitudes/perceptions, sources of information, used protective measures, and socio-demographic information. Respondents commonly reported feeling down-hearted/blue, trouble concentrating, along with symptoms of avoidance and rumination related to the pandemic. Patients with depression and sleep disorders expressed higher COVID-19-related trauma than patients with other disorders. Perceived physical health mediated the effect of co-morbid chronic physical disorders on COVID-19 trauma, psychological distress, perceived vulnerability to COVID-19, and perceived likelihood of recovery in case of contracting COVID-19. Perceived physical health and perceived vulnerability to COVID-19 were strong direct predictors of COVID-19-related trauma and psychological distress. Staying at home negatively predicted COVID-19 trauma and exerted an indirect negative effect on psychological distress via COVID-19 trauma. COVID-19 trauma, age, and marital status directly predicted psychological distress, with COVID-19 trauma being the strongest predictor. Educational level, income, having family members working in the medical field, keeping up to date with the news on deaths/infected cases or the development of COVID-19 drugs or vaccines, satisfaction with available information on COVID-19, and using different protective measures were not associated with significant differences in COVID-19 trauma and psychological distress scores. Immuno-psychiatric interventions should be designed to target COVID-19-trauma and distress among younger single patients with perceived poor physical health, especially those diagnosed with depression and sleep disorders.

摘要

COVID-19 引发了普遍的担忧和困扰,尤其是在精神病诊断等弱势群体中。在全球范围内,大流行期间精神保健服务急剧减少,许多患者无法获得适当的护理,这可能对精神病患者的心理健康产生影响(例如,复发和自杀)。这项横断面研究使用结构方程模型调查了 COVID-19 隔离期间阿拉伯精神病患者的 COVID-19 相关创伤和困扰。患有先前存在的精神障碍的患者(n = 168)完成了一项在线调查,其中包括抑郁焦虑应激量表 21 项(DASS-21)、修订后的事件影响量表(IES-R),以及关于 COVID-19 相关态度/看法、信息来源、使用的保护措施和社会人口学信息的问卷。受访者普遍报告感到沮丧/忧郁、难以集中注意力,以及与大流行相关的回避和沉思症状。患有抑郁症和睡眠障碍的患者比其他疾病患者报告的 COVID-19 相关创伤更多。感知到的身体健康状况介导了合并慢性身体疾病对 COVID-19 创伤、心理困扰、对 COVID-19 的脆弱性以及在感染 COVID-19 时康复的可能性的影响。感知到的身体健康状况和对 COVID-19 的脆弱性是 COVID-19 相关创伤和心理困扰的强有力直接预测因素。呆在家里对 COVID-19 创伤有负面影响,并通过 COVID-19 创伤对心理困扰产生间接负面影响。COVID-19 创伤、年龄和婚姻状况直接预测心理困扰,其中 COVID-19 创伤是最强的预测因素。教育水平、收入、有家庭成员在医疗领域工作、及时了解死亡/感染病例或 COVID-19 药物或疫苗的发展情况、对 COVID-19 信息的满意度以及使用不同的保护措施与 COVID-19 创伤和心理困扰评分无显著差异相关。应设计免疫精神病学干预措施,以针对感知身体健康状况不佳、年龄较小的单身患者的 COVID-19 创伤和困扰,特别是那些被诊断为抑郁症和睡眠障碍的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5add/8777039/85db4f420933/fpubh-09-799812-g0001.jpg

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