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新冠病毒感染对退伍军人长期抑郁症状的影响。

Impact of SARS-CoV-2 Infection on Long-Term Depression Symptoms among Veterans.

机构信息

Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System (HCS), Portland, OR, USA.

Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.

出版信息

J Gen Intern Med. 2024 Jun;39(8):1310-1316. doi: 10.1007/s11606-024-08630-z. Epub 2024 Apr 16.

Abstract

BACKGROUND

Prior research demonstrates that SARS-COV-2 infection can be associated with a broad range of mental health outcomes including depression symptoms. Veterans, in particular, may be at elevated risk of increased depression following SARS-COV-2 infection given their high rates of pre-existing mental and physical health comorbidities. However, few studies have tried to isolate SARS-COV-2 infection associations with long term, patient-reported depression symptoms from other factors (e.g., physical health comorbidities, pandemic-related stress).

OBJECTIVE

To evaluate the association between SARS-COV-2 infection and subsequent depression symptoms among United States Military Veterans.

DESIGN

Survey-based non-randomized cohort study with matched comparators.

PARTICIPANTS

A matched-dyadic sample from a larger, stratified random sample of participants with and without known to SARS-COV-2 infection were invited to participate in a survey evaluating mental health and wellness 18-months after their index infection date. Sampled participants were stratified by infection severity of the participant infected with SARS-COV-2 (hospitalized or not) and by month of index date. A total of 186 participants in each group agreed to participate in the survey and had sufficient data for inclusion in analyses. Those in the uninfected group who were later infected were excluded from analyses.

MAIN MEASURES

Participants were administered the Patient Health Questionnaire-9 as part of a phone interview survey. Demographics, physical and mental health comorbidities were extracted from VHA administrative data.

KEY RESULTS

Veterans infected with SARS-COV-2 had significantly higher depression symptoms scores compared with those uninfected. In particular, psychological symptoms (e.g., low mood, suicidal ideation) scores were elevated relative to the comparator group (M = 3.16, 95%CI: 2.5, 3.8; M = 1.96, 95%CI: 1.4, 2.5). Findings were similar regardless of history of depression.

CONCLUSION

SARS-COV-2 infection was associated with more depression symptoms among Veterans at 18-months post-infection. Routine evaluation of depression symptoms over time following SARS-COV-2 infection is important to facilitate adequate assessment and treatment.

摘要

背景

先前的研究表明,SARS-CoV-2 感染可能与广泛的心理健康结果相关,包括抑郁症状。退伍军人由于先前存在的精神和身体健康合并症的比例较高,因此在感染 SARS-CoV-2 后可能面临更高的抑郁风险。然而,很少有研究试图将 SARS-CoV-2 感染与其他因素(例如身体健康合并症、大流行相关压力)相关的长期、患者报告的抑郁症状区分开来。

目的

评估 SARS-CoV-2 感染与美国退伍军人随后出现抑郁症状之间的关联。

设计

基于调查的非随机队列研究,具有匹配的对照。

参与者

邀请来自 SARS-CoV-2 感染已知参与者的更大分层随机样本的匹配对偶样本,以及没有 SARS-CoV-2 感染的参与者,在感染后 18 个月对其心理健康和健康状况进行评估。感染 SARS-CoV-2 的参与者的抽样按感染参与者的严重程度(住院或不住院)和指数日期的月份进行分层。每组共有 186 名参与者同意参与调查,并且有足够的数据纳入分析。在未感染组中,后来感染的参与者被排除在分析之外。

主要措施

参与者接受了患者健康问卷-9 的调查,作为电话访谈调查的一部分。从 VHA 行政数据中提取了人口统计学、身体和心理健康合并症的数据。

主要结果

感染 SARS-CoV-2 的退伍军人的抑郁症状评分明显高于未感染者。特别是,心理症状(例如情绪低落、自杀意念)评分高于对照组(M=3.16,95%CI:2.5,3.8;M=1.96,95%CI:1.4,2.5)。无论是否有抑郁病史,结果都相似。

结论

在感染后 18 个月,SARS-CoV-2 感染与退伍军人的更多抑郁症状相关。感染 SARS-CoV-2 后,随着时间的推移,对抑郁症状进行常规评估非常重要,以促进充分的评估和治疗。

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