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创伤后应激障碍症状的患病率及危险因素:一项为期3个月的随访研究。

Prevalence and risk factors of PTSD symptoms: a 3-month follow-up study.

作者信息

Shang Zhilei, Pan Xiao, Cheng Suhui, Yang Yuchen, Yan Wenjie, Sun LiangLiang, Huang Hai, Bai Yonghai, Xie Weifen, Xu Shu

机构信息

Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, China.

The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, China.

出版信息

Ther Adv Psychopharmacol. 2024 Nov 15;14:20451253241298816. doi: 10.1177/20451253241298816. eCollection 2024.

Abstract

BACKGROUND

During the peak of the epidemic, hospitalized patients frequently encountered significant health risks and potentially life-threatening circumstances, including uncertainty regarding treatment and the potential for complications.

OBJECTIVE

The present study aimed to explore the prevalence of post-traumatic stress disorder (PTSD) symptoms among hospitalized patients 3 months after discharge during the first peak of the epidemic, and the association of PTSD with disease-related characteristics.

DESIGN

A single-center and full-sample follow-up study was conducted on COVID-19 patients from the Optical Valley Branch of Maternal and Child Hospital of Hubei Province, Wuhan, China. Data were collected during their hospitalization and 3 months after discharge.

METHODS

PTSD symptoms were evaluated by primary care post-traumatic stress disorder (PC-PTSD), a total score of 3 or above was considered as clinically significant PTSD symptoms. Demographic and disease-related characteristics were collected to identify related associations with PTSD symptoms.

RESULTS

A total of 903 patients completed the follow-up survey, yielding a response rate of 63.5%. A total of 212 (23.5%) of the patients were positive in PC-PTSD screening. Univariate regression analysis identified several factors correlated with PTSD symptoms, including female gender, younger age, a lower body mass index (BMI), preexisting sleep problems, bereavement due to COVID-19, a severe clinical diagnosis, the presence of three or more clinical symptoms at disease onset, and residual respiratory symptoms after discharge. Notably, in the multivariate regression analysis, experiencing three or more clinical symptoms at onset emerged as a robust predictor of PTSD symptoms (OR = 2.09, 95% CI: 1.48-2.95). An intriguing finding was that patients who underwent radiological assessment post-discharge reported a higher incidence of PTSD symptoms, whereas those who underwent re-testing for IgG or IgM antibodies exhibited a lower prevalence of PTSD symptoms.

CONCLUSION

Three months post-recovery, PTSD symptoms prevalence among COVID-19 patients was 23.5%. Those with three or more clinical symptoms at onset or residual respiratory symptoms post-discharge showed higher risk. These findings highlighted the long-term effect of COVID-19 on mental health, urging enhanced attention and interventions for survivors.

摘要

背景

在疫情高峰期,住院患者经常面临重大健康风险和潜在的危及生命的情况,包括治疗的不确定性和并发症的可能性。

目的

本研究旨在探讨疫情首个高峰期出院3个月后住院患者创伤后应激障碍(PTSD)症状的患病率,以及PTSD与疾病相关特征的关联。

设计

对中国武汉湖北省妇幼保健院光谷院区的新冠肺炎患者进行了一项单中心全样本随访研究。在患者住院期间和出院后3个月收集数据。

方法

采用初级保健创伤后应激障碍(PC-PTSD)评估PTSD症状,总分3分及以上被视为具有临床意义的PTSD症状。收集人口统计学和疾病相关特征,以确定与PTSD症状的相关关联。

结果

共有903例患者完成随访调查,应答率为63.5%。共有212例(23.5%)患者PC-PTSD筛查呈阳性。单因素回归分析确定了几个与PTSD症状相关的因素,包括女性、年龄较小、体重指数(BMI)较低、既往有睡眠问题、因新冠肺炎失去亲人、临床诊断严重、发病时出现三种或更多临床症状以及出院后残留呼吸道症状。值得注意的是,在多因素回归分析中,发病时出现三种或更多临床症状是PTSD症状的有力预测因素(OR = 2.09,95%CI:1.48 - 2.95)。一个有趣的发现是,出院后接受放射学评估的患者PTSD症状发生率较高。而接受IgG或IgM抗体复测的患者PTSD症状患病率较低。

结论

康复后3个月,新冠肺炎患者PTSD症状患病率为23.5%。发病时出现三种或更多临床症状或出院后残留呼吸道症状的患者风险较高。这些发现凸显了新冠肺炎对心理健康的长期影响,敦促加强对康复者的关注和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca47/11569496/04af3e026e69/10.1177_20451253241298816-fig1.jpg

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