新冠病毒病康复者自主神经反应性增加及心理健康问题：对医疗服务提供者的启示
Increased Autonomic Reactivity and Mental Health Difficulties in COVID-19 Survivors: Implications for Medical Providers.
作者信息
Dale Lourdes P, Cuffe Steven P, Kolacz Jacek, Leon Kalie G, Bossemeyer Biernacki Nadia, Bhullar Amal, Nix Evan J, Porges Stephen W
机构信息
Department of Psychiatry, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL, United States.
Traumatic Stress Research Consortium (TSRC), Kinsey Institute, Indiana University, Bloomington, IN, United States.
出版信息
Front Psychiatry. 2022 May 25;13:830926. doi: 10.3389/fpsyt.2022.830926. eCollection 2022.
BACKGROUND
Because there is a relationship between mental health (MH) and medical adversity and autonomic dysregulation, we hypothesized that individuals infected with COVID-19 would report greater current autonomic reactivity and more MH difficulties (emotional distress, mindfulness difficulties, and posttraumatic stress). We also hypothesized that individuals diagnosed with COVID-19 who are experiencing difficulties related to their prior adversity and those providing medical care to COVID-19 patients would be more negatively impacted due to their increased stress and infection rates.
METHOD
US participants ( = 1,638; 61% female; Age = 46.80) completed online self-report measures of prior adversity, current autonomic reactivity and current MH difficulties, and COVID-19 diagnosis history. Participants diagnosed with COVID-19 ( = 98) were more likely to be younger and providing medical care to COVID-19 patients.
RESULTS
Individuals diagnosed with COVID-19 reported increased current autonomic reactivity, being more negatively impacted by their prior MH/medical adversities, and currently experiencing more MH difficulties with an increased likelihood of clinically-significant PTSD and depression ( < 0.01 - < 0.001). Current autonomic reactivity mediated 58.9% to 85.2% of the relationship between prior adversity and current MH difficulties; and COVID-19 diagnosis moderated and enhanced the effect of prior adversity on current autonomic reactivity ( < 0.01). Being a medical provider was associated with increased current autonomic reactivity ( < 0.01), while moderating and enhancing the relationship between current autonomic reactivity and emotional distress and posttraumatic stress symptoms ( < 0.05). Combining COVID-19 diagnosis with being a medical provider increased likelihood of clinically-significant PTSD and depression ( < 0.01).
CONCLUSION
Individuals diagnosed with COVID-19, particularly medical providers, have increased current autonomic reactivity that is associated with their prior adversities and current MH difficulties.
背景
由于心理健康（MH）与医疗逆境和自主神经调节异常之间存在关联，我们推测感染新型冠状病毒肺炎（COVID-19）的个体当前的自主神经反应性会更强，且会出现更多的心理健康问题（情绪困扰、正念困难和创伤后应激障碍）。我们还推测，被诊断患有COVID-19且正在经历与既往逆境相关困难的个体以及为COVID-19患者提供医疗护理的个体，因其压力增加和感染率上升，会受到更大的负面影响。
方法
美国参与者（n = 1638；61%为女性；年龄 = 46.80岁）完成了关于既往逆境、当前自主神经反应性和当前心理健康问题以及COVID-19诊断史的在线自我报告测量。被诊断患有COVID-19的参与者（n = 98）更有可能年龄较小且为COVID-19患者提供医疗护理。
结果
被诊断患有COVID-19的个体报告称当前自主神经反应性增强，受既往心理健康/医疗逆境的负面影响更大，且目前正经历更多心理健康问题，临床上显著的创伤后应激障碍和抑郁症的可能性增加（p < 0.01 - p < 0.001）。当前自主神经反应性介导了既往逆境与当前心理健康问题之间58.9%至85.2%的关系；COVID-19诊断调节并增强了既往逆境对当前自主神经反应性的影响（p < 0.01）。作为医疗服务提供者与当前自主神经反应性增加相关（p < 0.01），同时调节并增强了当前自主神经反应性与情绪困扰和创伤后应激症状之间的关系（p < 0.05）。将COVID-19诊断与作为医疗服务提供者相结合，增加了临床上显著的创伤后应激障碍和抑郁症的可能性（p < 0.01）。
结论
被诊断患有COVID-19的个体，尤其是医疗服务提供者，当前的自主神经反应性增强，这与他们既往的逆境和当前的心理健康问题有关。
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