Ielmini Marta, Casarin Jvan, Callegari Camilla, Bellini Alessandro, Favata Manuela Giada, Giudici Anna, Ghezzi Fabio, Cromi Antonella, Caselli Ivano
Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese, Italy.
Obstetrics and Gynecology Department, University of Insubria, 21100 Varese, Italy.
J Clin Med. 2024 May 27;13(11):3148. doi: 10.3390/jcm13113148.
The severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic led to several needed containment measures that conditioned the onset of depressive, anxiety, and post-traumatic stress symptoms in the population. These symptoms, especially if not diagnosed and treated, can also occur in patients undergoing medical care or surgery, with a high impact on people's lives and causing low adherence to treatment. The study evaluates whether the spread of the coronavirus disease 2019 (COVID-19) worsened the onset of post-surgical distress and symptoms of anxiety and depression in a population undergoing hysterectomy for benign disease during the pandemic era, comparing it with a population with the same characteristics but recruited before COVID-19. The sample was evaluated before surgery (T1), post-operatively (T2), and 3 months after surgery (T3) through a sociodemographic questionnaire and through the HADS (Hospital Anxiety and Depression Scale) to evaluate anxious-depressive symptoms and the PCL-5 (Post-traumatic Stress Disorder Checklist for DSM-5) to assess the onset of post-surgical distress. Patients treated after the COVID-19 pandemic showed a higher depressive symptoms rate compared with those treated before (-value = 0.02); conversely, pre-COVID-19 patients were more prone to develop post-traumatic stress disorder (PTSD) (-value = 0.04). A significant association between the occurrence of PTSD and anxiety-depressive symptoms registered at T2 (-value = 0.007) and T3 (-value < 0.0001) emerged. In the end, the COVID-19 pandemic has exerted a detrimental influence on the mental well-being of the patients under investigation, with a notable exacerbation of their mood disturbances. The findings advocate for the implementation of psychometric and psychodiagnostic assessments to promptly detect high-risk scenarios that could lead to PTSD, compromising treatment compliance and exacerbating the overall outcome, resulting in substantial direct and indirect burdens.
严重急性呼吸综合征冠状病毒（SARS-CoV-2）大流行导致了多项必要的防控措施，这些措施使人群中出现了抑郁、焦虑和创伤后应激症状。这些症状，尤其是如果未被诊断和治疗，也可能出现在接受医疗护理或手术的患者中，对人们的生活产生重大影响，并导致治疗依从性降低。该研究评估了2019冠状病毒病（COVID-19）的传播是否使大流行时代因良性疾病接受子宫切除术的人群术后痛苦以及焦虑和抑郁症状的发作情况恶化，并将其与具有相同特征但在COVID-19之前招募的人群进行比较。通过社会人口统计学问卷以及医院焦虑抑郁量表（HADS）评估焦虑抑郁症状，通过创伤后应激障碍检查表（PCL-5）评估术后痛苦的发作情况，在手术前（T1）、术后（T2）和术后3个月（T3）对样本进行评估。与COVID-19大流行之前接受治疗的患者相比，在COVID-19大流行之后接受治疗的患者抑郁症状发生率更高（P值=0.02）；相反，COVID-19之前的患者更容易患上创伤后应激障碍（PTSD）（P值=0.04）。在T2（P值=0.007）和T3（P值<0.0001）时，PTSD的发生与焦虑抑郁症状之间出现了显著关联。最后，COVID-19大流行对所调查患者的心理健康产生了不利影响，其情绪障碍明显加剧。研究结果主张实施心理测量和心理诊断评估，以及时发现可能导致PTSD的高风险情况，这些情况会影响治疗依从性并使总体结果恶化，从而导致巨大的直接和间接负担。
