Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, China.
BMJ Open. 2022 Mar 30;12(3):e049749. doi: 10.1136/bmjopen-2021-049749.
The COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing devastating implications for the mental health. This study aimed to shed light on the mental health status of patients with rheumatic disease (RD) during the massive outbreak of COVID-19 in China, especially the prevalence and severity of post-traumatic stress disorder (PTSD) compared with healthy individuals.
A total of 486 patients with RD and 486 age-matched and sex-matched healthy individuals were recruited into the study. For each participant, we collected demographic and clinical characteristics data. The PTSD Checklist for DSM-5 (PCL-5) and four items from the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the prevalence and severity of PTSD and sleep quality, respectively.
Compared with healthy control subjects (n=486), patients with RD (n=486) had a higher prevalence of PTSD (12.1% vs 4.1%; p<0.001). Higher total scores on the PCL-5 and on all four items from the PSQI (p≤0.001) were also observed. Female, old age, poor sleep quality, long duration of RD, poor subjective evaluation of the disease and pessimistic subjective perception of the epidemic were identified as risk factors of PTSD in patients with RD during the COVID-19 epidemic.
During the COVID-19 outbreak, patients with RD presented a higher prevalence and severity of PTSD and showed more sleep disturbances. Our findings confirm the importance of psychological assessment and mental healthcare out of regular clinical care for patients with RD during the pandemic.
COVID-19 大流行不仅是一个创伤性事件，而且是一个随着时间的推移不断展开的集体应激源，对心理健康造成了毁灭性的影响。本研究旨在探讨 COVID-19 在中国大规模爆发期间，风湿性疾病（RD）患者的心理健康状况，特别是与健康个体相比，创伤后应激障碍（PTSD）的患病率和严重程度。
共纳入 486 例 RD 患者和 486 例年龄和性别匹配的健康个体。对于每个参与者，我们收集了人口统计学和临床特征数据。使用 PTSD 检查表 DSM-5（PCL-5）和匹兹堡睡眠质量指数（PSQI）的四个项目，分别调查 PTSD 和睡眠质量的患病率和严重程度。
与健康对照组（n=486）相比，RD 患者（n=486）的 PTSD 患病率更高（12.1%比 4.1%；p<0.001）。PCL-5 的总分和 PSQI 的四个项目的总分也更高（p≤0.001）。女性、年龄较大、睡眠质量差、RD 病程较长、对疾病的主观评价较差和对疫情的悲观主观认知被确定为 RD 患者在 COVID-19 流行期间发生 PTSD 的危险因素。
在 COVID-19 疫情期间，RD 患者 PTSD 的患病率和严重程度更高，睡眠障碍更多。我们的研究结果证实，在大流行期间，除了常规临床护理之外，对 RD 患者进行心理评估和心理健康护理非常重要。
