Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Affect Disord. 2025 Jan 1;368:390-397. doi: 10.1016/j.jad.2024.09.091. Epub 2024 Sep 16.
Posttraumatic stress disorder (PTSD) has become a main psychological consequence of COVID-19. This study assessed the association between social support, psychological resilience, and probable COVID-19-related PTSD.
The PTSD Checklist for DSM-5, Medical Outcomes Study Social Support Survey, and Connor-Davidson Resilience Scale (CD-RISC) were used to assess for PTSD symptoms, social support, and resilience among COVID-19 patients treated at a large medical system in New York City between July 2020 and July 2023. Logistic regression evaluated the association between social support and resilience with PTSD. We further investigated whether associations differed across age, gender, site of acute care, vaccination status, and pre-existing mental disorders.
Among the 1484 participants, 16.6 % had probable COVID-19-related PTSD. Higher scores on measures of resilience (OR: 0.68, 95 % CI: 0.61-0.75) and social support (OR: 0.96, 95 % CI: 0.93-0.99) were associated with lower odds of probable COVID-19-related PTSD. The association between resilience and PTSD was moderated by sex (p for interaction = 0.001), with resilience showing a stronger negative association with PTSD among men relative to women. Associations between resilience, social support, and COVID-19-related PTSD did not differ by age, sites of acute care, vaccination status, and pre-existing mental disorders.
Cross-sectional design precludes establishing causal relationships; assessment timing was not considered; the short CD-RISC may limit measurement precision; single-center study may not be fully generalizable.
These findings suggest that individuals with low social support and resilience may be at higher risk of PTSD and should be screened and be the target of preventive interventions.
创伤后应激障碍（PTSD）已成为 COVID-19 的主要心理后果。本研究评估了社会支持、心理弹性与可能与 COVID-19 相关的 PTSD 之间的关系。
使用 PTSD 检查表 DSM-5、医疗结局研究社会支持调查和 Connor-Davidson 弹性量表（CD-RISC）评估 2020 年 7 月至 2023 年 7 月期间在纽约市一家大型医疗系统接受治疗的 COVID-19 患者的 PTSD 症状、社会支持和弹性。Logistic 回归评估了社会支持和弹性与 PTSD 之间的关联。我们进一步调查了这些关联是否因年龄、性别、急性护理地点、疫苗接种状况和先前存在的精神障碍而有所不同。
在 1484 名参与者中，有 16.6%患有可能与 COVID-19 相关的 PTSD。在弹性和社会支持方面得分较高（比值比：0.68，95%置信区间：0.61-0.75）与较低的可能与 COVID-19 相关的 PTSD 几率相关。弹性与 PTSD 之间的关联受到性别调节（交互作用的 p 值=0.001），与女性相比，男性的弹性与 PTSD 之间存在更强的负相关。弹性、社会支持和 COVID-19 相关 PTSD 之间的关联不受年龄、急性护理地点、疫苗接种状况和先前存在的精神障碍的影响。
横断面设计排除了因果关系的确立；未考虑评估时间；CD-RISC 较短可能限制测量精度；单中心研究可能无法完全推广。
这些发现表明，社会支持和弹性低的个体可能面临更高的 PTSD 风险，应进行筛查并成为预防干预的目标。
