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大流行相关压力增加创伤性损伤患者患创伤后应激障碍和抑郁症的风险:大流行前与大流行期间创伤病例的比较研究

Pandemic-Related Stress Increases PTSD and Depression Risk in Traumatic Injury Patients: A Comparative Study of Pre- and Peri-Pandemic Trauma Cases.

作者信息

Zapata Juan Pablo, Tomas Carissa W, Timmer-Murillo Sydney, deRoon Cassini Terri A, Larson Christine, Torres Lucas, Brandolino Amber, Geier Timothy, Khan Hason, Schramm Andrew T

机构信息

Department of Medical Social Sciences, Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

出版信息

Stress Health. 2025 Apr;41(2):e3513. doi: 10.1002/smi.3513. Epub 2024 Dec 3.

Abstract

The COVID-19 pandemic significantly impacted the psychological well-being of the general population. However, there are limited studies that examine its mental health effects on patients who have experienced traumatic injuries and tracked their recovery over time. This study aimed to: (1) compare the rates and severity of post-traumatic stress disorder (PTSD) and depression between patients who sustained traumatic injuries before the COVID-19 pandemic (pre-pandemic) and those injured during the pandemic (peri-pandemic); and (2) assess whether the degree of pandemic-related stress (e.g., worry about infection, social isolation, loss of home/job) predicted the severity of PTSD or depression symptoms. Participants (N = 198) were recruited from a Level 1 Trauma Centre in Southeastern Wisconsin following admission for a single-incident traumatic injury. Symptoms of PTSD and depression were assessed during hospitalisation and at three additional points within the subsequent 6 months. Self-report measures were used to evaluate PTSD and depression severity among patients injured before (pre-pandemic; n = 126) and during (peri-pandemic; n = 73) the pandemic. Peri-pandemic participants also completed a modified version of the COVID-19 Family Stress Screener to measure pandemic-related stress. Exploratory factor analysis was conducted to identify the dimensions of pandemic-related stress in our sample. The findings indicated that participants injured during the pandemic exhibited higher symptoms of PTSD and depression compared to those injured before the pandemic. Additionally, greater pandemic-related stress correlated with elevated levels of depression and PTSD at baseline. Our results highlight that the broader context in which patients recover from injuries can intensify the negative mental health consequences of traumatic injury. This underscores the need for enhanced access to psychological services for trauma patients, particularly during major societal stressors like a global pandemic.

摘要

新冠疫情对普通大众的心理健康产生了重大影响。然而,针对其对经历创伤性损伤的患者心理健康影响并长期跟踪其恢复情况的研究却很有限。本研究旨在:(1)比较在新冠疫情之前(疫情前)遭受创伤性损伤的患者与疫情期间(疫情期间)受伤的患者之间创伤后应激障碍(PTSD)和抑郁症的发生率及严重程度;(2)评估与疫情相关的压力程度(如对感染的担忧、社交隔离、失去住所/工作)是否能预测PTSD或抑郁症状的严重程度。研究对象(N = 198)是从威斯康星州东南部的一级创伤中心招募的,这些患者因单次创伤性损伤入院。在住院期间以及随后6个月内的另外三个时间点评估PTSD和抑郁症状。采用自我报告量表评估疫情前(n = 126)和疫情期间(n = 73)受伤患者的PTSD和抑郁严重程度。疫情期间的参与者还完成了一份修改版的新冠疫情家庭压力筛查量表,以测量与疫情相关的压力。进行探索性因素分析以确定我们样本中与疫情相关压力的维度。研究结果表明,与疫情前受伤的患者相比,疫情期间受伤的参与者表现出更高的PTSD和抑郁症状。此外,更大的与疫情相关的压力与基线时更高的抑郁和PTSD水平相关。我们的结果强调,患者从损伤中恢复的更广泛背景可能会加剧创伤性损伤对心理健康的负面影响。这凸显了为创伤患者提供更多心理服务的必要性,尤其是在像全球疫情这样的重大社会压力源期间。

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