Ferrando Stephen J, Lynch Sean, Ferrando Nicole, Dornbush Rhea, Shahar Sivan, Klepacz Lidia
Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, United States.
Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, United States.
Front Psychiatry. 2023 Jun 2;14:1160852. doi: 10.3389/fpsyt.2023.1160852. eCollection 2023.
Anxiety and post-traumatic stress symptoms have been reported in association with acute and post-acute sequelae of COVID-19 (PASC).
This study aimed to document the cross-sectional prevalence, characteristics and clinical correlates of anxiety and post-traumatic stress in a study of neuropsychiatric sequelae of COVID-19.
75 participants recruited from a post-COVID-19 recovery program and the community were assessed for sociodemographic, medical, psychiatric, and neurocognitive symptoms and performance. The generalized anxiety questionnaire-7 (GAD-7) and post-traumatic stress disorder questionnaire for DSM5 (PCL5) were utilized to measure anxiety and PTSD symptoms. Established cutoff scoring for the GAD-7 and algorithm-based scoring of the PCL5 were utilized to determine clinically significant anxiety symptoms and PTSD, respectively.
The cohort was 71% female, 36% ethnic minority, with the main age of 43.5 years, 80% employment, 40% with the prior psychiatric treatment history and 2/3 seeking post-COVID care for PASC. Clinically significant anxiety symptoms were found in 31% and PTSD was found in 29% of the cohort. Nervousness and excessive worry were the most prominent anxiety symptoms, while changes in mood/cognition and avoidance were most frequent in PTSD. There was a high degree of comorbidity between clinically significant anxiety symptoms, PTSD, depression and fatigue. In logistic regression, acute COVID illness severity, prior psychiatric history, and memory complaints (but not objective neuropsychological performance) predicted clinically significant anxiety symptoms and/or PTSD.
Clinically significant anxiety and PTSD are found in approximately 1 of 3 individuals after COVID-19 infection. They are highly comorbid with each other as well as with depression and fatigue. All patients seeking care for PASC should be screened for these neuropsychiatric complications. Symptoms of worry, nervousness, subjective changes in mood, and cognition as well as behavioral avoidance are particularly important targets of clinical intervention.
焦虑和创伤后应激症状已被报道与新冠病毒病（COVID-19）的急性和急性后遗症（PASC）相关。
本研究旨在记录在一项关于COVID-19神经精神后遗症的研究中焦虑和创伤后应激的横断面患病率、特征及临床相关性。
从一个COVID-19康复项目和社区招募了75名参与者，对其社会人口统计学、医学、精神和神经认知症状及表现进行评估。使用广泛性焦虑问卷-7（GAD-7）和DSM5创伤后应激障碍问卷（PCL5）来测量焦虑和创伤后应激障碍（PTSD）症状。分别采用GAD-7既定的临界评分和基于算法的PCL5评分来确定具有临床意义的焦虑症状和PTSD。
该队列中71%为女性，36%为少数族裔，主要年龄为43.5岁，80%就业，40%有既往精神治疗史，三分之二因PASC寻求COVID-19后护理。队列中31%有具有临床意义的焦虑症状，29%有PTSD。紧张和过度担忧是最突出的焦虑症状，而情绪/认知变化和回避在PTSD中最为常见。具有临床意义的焦虑症状、PTSD、抑郁和疲劳之间存在高度共病。在逻辑回归中，急性COVID疾病严重程度、既往精神病史和记忆主诉（而非客观神经心理学表现）可预测具有临床意义的焦虑症状和/或PTSD。
COVID-19感染后约三分之一的个体存在具有临床意义的焦虑和PTSD。它们彼此之间以及与抑郁和疲劳高度共病。所有因PASC寻求护理的患者都应筛查这些神经精神并发症。担忧、紧张、情绪和认知的主观变化以及行为回避症状是临床干预的特别重要目标。
