School of Medicine, Department of Psychiatry, Baskent University, Ankara, Turkey.
School of Medicine, Department of Infectious Disease, Ankara University, Ankara, Turkey.
Psych J. 2022 Aug;11(4):550-559. doi: 10.1002/pchj.557. Epub 2022 May 20.
It is known that there is an increase in the frequency of psychiatric disturbances in the acute and post-illness phase of coronavirus disease (COVID-19). Comorbid psychiatric symptoms complicate the management of patients and negatively affect the prognosis, but there is no clear evidence of their progress. We aimed to determine psychiatric comorbidity in inpatients and outpatients with COVID-19 and recognize the factors that predict psychiatric comorbidity. For this purpose, we evaluated patients on the first admission and after 4 weeks. We investigated psychiatric symptoms in outpatients (n = 106) and inpatients (n = 128) diagnosed with COVID-19. In the first 7 days after diagnosis (first phase), sociodemographic and clinic data were collected, a symptom checklist was constructed, and the Hospital Anxiety and Depression Scale (HADS) and the Severity of Acute Stress Symptoms Scale (SASSS) were applied. After 30-35 days following the diagnosis, the SASSS and the HADS were repeated. In the first phase, the frequency of depression and anxiety were 55% and 20% in inpatients, and 39% and 18% in outpatients, respectively. In the second phase, depression scores are significantly decreased in both groups whereas anxiety scores were decreased only in inpatients. The frequencies of patients reporting sleep and attention problems, irritability, and suicide ideas decreased after 1 month. Patients with loss of smell and taste exhibit higher anxiety and depression scores in both stages. Our results revealed that the rate of psychiatric symptoms in COVID-19 patients improves within 1 month. Inpatients have a more significant decrease in both depression and anxiety frequency than do outpatients. The main factor affecting anxiety and depression was the treatment modality. Considering that all patients who were hospitalized were discharged at the end of the first month, this difference may be due to the elimination of the stress caused by hospitalization.
已知在冠状病毒病（COVID-19）的急性期和疾病后阶段，精神障碍的频率增加。合并的精神科症状使患者的管理复杂化，并对预后产生负面影响，但尚无其进展的明确证据。我们旨在确定 COVID-19 住院患者和门诊患者的合并精神科症状，并识别预测合并精神科症状的因素。为此，我们在首次入院时和 4 周后对患者进行了评估。我们评估了 106 例门诊和 128 例住院诊断为 COVID-19 的患者的精神科症状。在诊断后 7 天内（第一阶段），收集社会人口统计学和临床数据，构建症状检查表，并应用医院焦虑和抑郁量表（HADS）和急性应激症状严重程度量表（SASSS）。在诊断后 30-35 天，重复使用 SASSS 和 HADS。在第一阶段，住院患者的抑郁和焦虑发生率分别为 55%和 20%，门诊患者的抑郁和焦虑发生率分别为 39%和 18%。在第二阶段，两组患者的抑郁评分均明显降低，而焦虑评分仅在住院患者中降低。在 1 个月后，报告睡眠和注意力问题、易怒和自杀想法的患者频率降低。在两个阶段，有嗅觉和味觉丧失的患者焦虑和抑郁评分均较高。我们的研究结果表明，COVID-19 患者的精神症状在 1 个月内得到改善。与门诊患者相比，住院患者的抑郁和焦虑发生率下降更为明显。影响焦虑和抑郁的主要因素是治疗方式。考虑到所有住院患者在第一个月结束时都出院了，这种差异可能是由于住院引起的压力消除了。
