Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
Front Public Health. 2023 Jul 28;11:1223429. doi: 10.3389/fpubh.2023.1223429. eCollection 2023.
COVID-19 survivors suffer from persistent mental distress and impaired quality of life (QOL) after recovery from the infection. However, the symptom-symptom interaction between these psychological variables remained unexplored. The present study aimed to determine the symptom network of mental distress (depression, anxiety, sleep disturbance, fatigue, and post-traumatic stress disorder) and their association with QOL among 535 COVID-19 survivors 1 year after hospital discharge.
9-item Patient Health Questionnaire, 7-item Generalized Anxiety Disorder Scale, Chalder fatigue scale, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and 36-Item Short-Form Health Survey were applied to measure depression, anxiety, fatigue, PTSD, sleep disturbances, and QOL, respectively. Two networks were estimated using Gaussian graphical model. Network 1 consisted of mental symptoms to determine the central and bridge symptoms. Network 2 additionally included QOL to determine which mental symptoms were mostly related to QOL.
60% of the COVID-19 survivors experienced mental distress 1 year after hospital discharge. Uncontrollable and excessive worry, psychomotor symptoms, intrusion, and daytime dysfunction were the most central symptoms. Daytime dysfunction and fatigue (especially mental fatigue and loss of energy) served as the bridge symptoms across the mental distress network and exhibited the most substantial association with QOL.
Our study demonstrated several key symptoms that played a vital role in mental distress and QOL among COVID-19 survivors. Prompt screening and targeted interventions for these symptoms might hold great promise in preventing mental distress and improving QOL in COVID-19 survivors.
COVID-19 幸存者在从感染中康复后，会持续遭受精神困扰和生活质量受损。然而，这些心理变量之间的症状-症状相互作用仍未得到探索。本研究旨在确定 535 名 COVID-19 幸存者出院 1 年后精神困扰（抑郁、焦虑、睡眠障碍、疲劳和创伤后应激障碍）的症状网络及其与生活质量的关系。
使用 9 项患者健康问卷、7 项广泛性焦虑症量表、Chalder 疲劳量表、修订后的事件影响量表、匹兹堡睡眠质量指数和 36 项简短健康调查问卷分别测量抑郁、焦虑、疲劳、创伤后应激障碍、睡眠障碍和生活质量。使用高斯图形模型估计了两个网络。网络 1 由精神症状组成，用于确定核心和桥梁症状。网络 2 还包括生活质量，以确定哪些精神症状与生活质量最相关。
60%的 COVID-19 幸存者在出院 1 年后出现精神困扰。无法控制和过度担忧、精神运动症状、闯入和日间功能障碍是最核心的症状。日间功能障碍和疲劳（特别是精神疲劳和精力丧失）是精神困扰网络中的桥梁症状，与生活质量的关联最为密切。
我们的研究表明，COVID-19 幸存者的一些关键症状在精神困扰和生活质量中起着至关重要的作用。对这些症状进行及时筛查和针对性干预，可能有望预防 COVID-19 幸存者的精神困扰并改善其生活质量。
