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COVID-19 出院后对心理的影响:对意大利已康复患者的随访研究。

Psychological impact of COVID-19 after hospital discharge: A follow-up study on Italian recovered patients.

机构信息

Department of Psychology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.

Department of Psychology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.

出版信息

J Affect Disord. 2022 Nov 15;317:84-90. doi: 10.1016/j.jad.2022.08.086. Epub 2022 Aug 24.

Abstract

BACKGROUND

Since COVID-19 outbreak, clinical experience on its management during the acute phase has rapidly grown, including potential effects on the psychopathological dimension. However, still few data are available regarding the impact on survivors' mental health over the long-term.

METHODS

A sample of 1457 COVID-19 patients underwent a multidisciplinary follow-up protocol, approximately 3 months after hospital discharge, including a psychological evaluation. The primary outcomes were anxiety, depression, resilience, post-traumatic symptoms, and health-related quality of life. Furthermore, we examined the potential role of hospitalization and delay in the follow-up assessment on the increased burden of illness.

RESULTS

Although a general high level of resilience emerged, suggesting most patients relied on their individual and interpersonal resources to face difficulties related to the pandemic, almost one third of the sample reported signs of psychological distress over time, especially post-traumatic symptoms, with anxiety being more represented than depression. Furthermore, hospitalization - regardless of the setting of care - and promptness in follow-up evaluation were found to play a protective role on patients' recovery and mental wellbeing.

LIMITATIONS

Selection bias of patients exclusively admitted to the hospital; absence of a control group; psychological assessment relying on self-reported instruments.

CONCLUSIONS

The current crisis demands resilience and adjustment resources, either in the acute and post-acute phase. Thus, the clinical effort should aim at relieving the traumatic impact of such condition through timely interventions. Further investigation may address potential predictors of developing a traumatic stress response, in order to identify and promptly treat at-risk subpopulations.

摘要

背景

自 COVID-19 爆发以来,人们对其急性期管理的临床经验迅速增加,包括对心理病理维度的潜在影响。然而,关于其对长期幸存者心理健康的影响,仍缺乏相关数据。

方法

我们对 1457 名 COVID-19 患者进行了一项多学科随访方案,大约在出院后 3 个月进行,包括心理评估。主要结局指标是焦虑、抑郁、韧性、创伤后症状和健康相关生活质量。此外,我们还研究了住院和延迟评估对增加疾病负担的潜在作用。

结果

尽管患者普遍表现出较高的韧性,表明大多数患者依靠个人和人际资源来应对与大流行相关的困难,但随着时间的推移,近三分之一的患者出现了心理困扰的迹象,尤其是创伤后症状,焦虑的比例高于抑郁。此外,住院治疗 - 无论护理场所如何 - 以及及时进行随访评估,都对患者的康复和心理健康起到了保护作用。

局限性

仅纳入住院患者存在选择偏倚;缺乏对照组;心理评估依赖于自我报告的工具。

结论

当前的危机需要有韧性和适应资源,无论是在急性期还是在康复期。因此,临床工作的重点应该是通过及时干预来减轻这种情况的创伤影响。进一步的研究可以探讨发生创伤后应激反应的潜在预测因素,以便识别和及时治疗高危亚群。

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