Nahidi Mahsa, Mokhber Naghmeh, Sinichi Farideh, Hatefipour Zahra, Zohorian Sadr Parvin, Emadzadeh Maryam, Rezaei Ardani Amir
Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Psychiatry, Western University, London, Ontario, Canada.
Iran J Psychiatry. 2022 Jul;17(3):276-283. doi: 10.18502/ijps.v17i3.9727.
The immediate impacts of coronavirus disease 2019 (COVID-19) on mental health of affected patients and psychiatric morbidities of these patients has been neglected by researchers. We assessed mental health outcomes and sleep status among inpatients and outpatients with COVID-19 who were initially referred to our COVID-19 clinic in Mashhad, Iran during April-October 2020. In this ethically approved cross-sectional study, 130 patients with confirmed COVID-19 who were referred to outpatient clinics and wards of a referral hospital in Mashhad, Iran were surveyed during April-October 2020. Demographic data were collected after obtaining informed written consent. Validated Persian versions of insomnia severity index (ISI), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder (GAD-7) and revised impact of event scale (IES-R) were used as main outcome measures (i.e. status of anxiety, depression, insomnia, and event-related distress). Analysis was performed with SPSS using binary logistic regression. P-values < 0.05 were considered significant. Overall, 65 inpatients and 65 outpatients were surveyed. The two groups did not significantly defer in terms of insomnia and depression severity, but the outpatients showed higher levels of anxiety (52.3% vs. 24.6%, P = 0.005) and distress compared to inpatients (80.0% vs. 64.6%, P < 0.001). Male sex (OR = 0.017, 95%CI = 0.000-0.708, P = 0.032) exhibited independent and inverse association with depression in COVID-19 patients. Being married (OR = 0.102, 95% CI = 0.018-0.567, P = 0.009) was independently and inversely associated with anxiety. Insomnia was independently associated with event-related distress (OR = 7.286, 95%CI = 2.017-26.321, P = 0.002). Only depression was independently associated with insomnia (OR = 49.655, 95%CI = 2.870-859.127, P = 0.007). We found symptoms of psychological distress and anxiety to be more prevalent among outpatients with COVD-19 than inpatients. Insomnia can be a potential risk factor for adverse mental health outcomes in these patients.
2019冠状病毒病（COVID-19）对受影响患者心理健康及这些患者精神疾病的直接影响一直被研究人员忽视。我们评估了2020年4月至10月期间最初被转诊至伊朗马什哈德我们的COVID-19诊所的COVID-19住院患者和门诊患者的心理健康结局及睡眠状况。 在这项经伦理批准的横断面研究中，2020年4月至10月期间对130例确诊为COVID-19且被转诊至伊朗马什哈德一家转诊医院门诊和病房的患者进行了调查。在获得知情书面同意后收集人口统计学数据。采用经过验证的波斯语版失眠严重程度指数（ISI）、9项患者健康问卷（PHQ-9）、7项广泛性焦虑障碍（GAD-7）和修订的事件影响量表（IES-R）作为主要结局指标（即焦虑、抑郁、失眠和事件相关痛苦的状况）。使用SPSS进行二元逻辑回归分析。P值<0.05被认为具有统计学意义。 总体而言，共调查了65例住院患者和65例门诊患者。两组在失眠和抑郁严重程度方面无显著差异，但门诊患者的焦虑水平（52.3%对24.6%，P = 0.005）和痛苦程度高于住院患者（80.0%对64.6%，P < 0.001）。男性（OR = 0.017，95%CI = 0.000 - 0.708，P = 0.032）与COVID-19患者的抑郁呈独立负相关。已婚（OR = 0.102，95%CI = 0.018 - 0.567，P = 0.009）与焦虑呈独立负相关。失眠与事件相关痛苦独立相关（OR = 7.286，95%CI = 2.017 - 26.321，P = 0.002）。只有抑郁与失眠独立相关（OR = 49.655，95%CI = 2.870 - 859.127，P = 0.007）。 我们发现，COVID-19门诊患者的心理痛苦和焦虑症状比住院患者更普遍。失眠可能是这些患者不良心理健康结局的潜在危险因素。
