Background: Psychological consequences after a COVID-19 infection are more or less serious according to patients. Many risk factors exist and psychological support may be necessary to a better health care. Objective: Identify prevalence and risk factors of anxiety, depression, stress disorders and quality of life alteration after a COVID-19 infection. Methods: All patients hospitalized in the post-intensive unit care department after a COVID-19 infection were included, and we collected data’s concerning socio-demographic parameters, psychiatric disorders and clinical signs. Anxiety and depression were assessed using the Hamilton scales and post-traumatic stress according to the DSM-5 recommendations. The Hospital anxiety and depression scale (HADS) was equally used to evaluate anxio-depressive symptoms probability. Quality of life was evaluated by the SF-36 questionnaire. IBM statistics SPSS 20 was used for statistical analysis. Results: Our study included 41 patients, with a mean age of 55 ± 18 (17 - 85) years, and a sex ratio F/M of 0.95. A minor to severe anxiety was found in 26.8% of patients and a depression in 31.7% of patients. The HADS showed a confirmed anxiety and depression in 24.4% of patients, with a previous intubation related to symptoms (p = 0.007). An acute stress was identified in 34.1% of patients with a higher prevalence in women (p = 0.052). A poor general health was related to older ages (p = 0.049), to hypertension (p = 0.01) and to female gender (p = 0.043). Conclusion: Prevalence of anxiety and depression after a COVID 19 infection is near on for three patients. Risk factors were older age, female gender, hypertension and a previous intubation. These psychological disorders lead to quality-of-life alteration needing a screening and a structured follow-up with a psychological support.
References
[1]
Alexander, J. L., Dennerstein, L., Kotz, K., & Richardson, G. (2007). Women, Anxiety and Mood: A Review of Nomenclature, Comorbidity and Epidemiology. Expert Review of Neurotherapeutics, 7, S45-S58. https://doi.org/10.1586/14737175.7.11s.S45
[2]
Anderson, W. G., Arnold, R. M., Angus, D. C., & Bryce, C. L. (2009). Passive Decision-Making Preference Is Associated with Anxiety and Depression in Relatives of Patients in the Intensive Care Unit. Journal of Critical Care, 24, 249-254. https://doi.org/10.1016/j.jcrc.2007.12.010
[3]
Asly, M., & Hazim, A. (2020). Rehabilitation of Post-COVID-19 Patients. The Pan African Medical Journal, 36, Article 168. https://doi.org/10.11604/pamj.2020.36.168.23823
[4]
Asmundson, G. J. G., & Taylor, S. (2020). Coronaphobia: Fear and the 2019-nCoV Outbreak. Journal of Anxiety Disorders, 70, Article ID: 102196. https://doi.org/10.1016/j.janxdis.2020.102196
[5]
Atkinson, M. J., Sinha, A., Hass, S. L., Colman, S. S., Kumar, R. N., Brod, M., & Rowland, C. R. (2004). Validation of a General Measure of Treatment Satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), Using a National Panel Study of Chronic Disease. Health and Quality of Life Outcomes, 2, Article No. 12. https://doi.org/10.1186/1477-7525-2-12
[6]
Banerjee, D., & Rai, M. (2020). Social Isolation in Covid-19: The Impact of Loneliness. International Journal of Social Psychiatry, 66, 525-527. https://doi.org/10.1177/0020764020922269
[7]
Blendon, R. J., Benson, J. M., DesRoches, C. M., Raleigh, E., & Taylor-Clark, K. (2004). The Public’s Response to Severe Acute Respiratory Syndrome in Toronto and the United States. Clinical Infectious Diseases, 38, 925-931. https://doi.org/10.1086/382355
[8]
Bo, H. X., Li, W., Yang, Y., Wang, Y., Zhang, Q., Cheung, T., Wu, X., & Xiang, Y. T. (2021). Posttraumatic Stress Symptoms and Attitude toward Crisis Mental Health Services among Clinically Stable Patients with COVID-19 in China. Psychological Medicine, 51, 1052-1053. https://doi.org/10.1017/S0033291720000999
[9]
Braunack-Mayer, A., Tooher, R., Collins, J. E., Street, J. M., & Marshall, H. (2013). Understanding the School Community’s Response to School Closures during the H1N1 2009 Influenza Pandemic. BMC Public Health, 13, Article No. 344. https://doi.org/10.1186/1471-2458-13-344
[10]
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence. The Lancet, 395, 912-920. https://doi.org/10.1016/S0140-6736(20)30460-8
[11]
Bryant, R. A., Friedman, M. J., Spiegel, D., Ursano, R., & Strain, J. (2001). A Review of Acute Stress Disorder in DSM-5. Depression and Anxiety, 28, 802-817. https://doi.org/10.1002/da.20737
[12]
Cava, M. A., Fay, K. E., Beanlands, H. J., McCay, E. A., & Wignall, R. (2005). The Experience of Quarantine for Individuals Affected by SARS in Toronto. Public Health Nursing, 22, 398-406. https://doi.org/10.1111/j.0737-1209.2005.220504.x
[13]
Chen, Q., Liang, M., Li, Y., Guo, J., Fei, D., Wang, L., He, L., Sheng, C., Cai, Y., Li, X., Wang, J., & Zhang, Z. (2020). Mental Health Care for Medical Staff in China during the COVID-19 Outbreak. The Lancet Psychiatry, 7, e15-e16. https://doi.org/10.1016/S2215-0366(20)30078-X
[14]
Duan, L., & Zhu, G. (2020). Psychological Interventions for People Affected by the COVID-19 Epidemic. The Lancet Psychiatry, 7, 300-302. https://doi.org/10.1016/S2215-0366(20)30073-0
[15]
Endomba, F. T., Wouna, D. L. A., & Danwang, C. (2020). Mental Health during the Coronavirus Disease 2019 (Covid-19) Pandemic: More Is Still to Be Done. The Pan African Medical Journal, 35, 7. https://doi.org/10.11604/pamj.supp.2020.35.2.22605
[16]
Erzen, E., & Çikrikci, Ö. (2018). The Effect of Loneliness on Depression: A Meta-Analysis. International Journal of Social Psychiatry, 64, 427-435. https://doi.org/10.1177/0020764018776349
[17]
Fawaz, M., & Samaha, A. (2020). COVID-19 Quarantine: Post-Traumatic Stress Symptomatology among Lebanese Citizens. International Journal of Social Psychiatry, 66, 666-674. https://doi.org/10.1177/0020764020932207
[18]
Guigoz, Y. (2006). The Mini Nutritional Assessment (MNA) Review of the Literature— What Does It Tell Us? Journal of Nutrition, Health and Aging, 10, 466-487.
[19]
Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra R. (2004). SARS Control and Psychological Effects of Quarantine, Toronto, Canada. Emerging Infectious Diseases, 10, 1206-1212. https://doi.org/10.3201/eid1007.030703
[20]
Horesh, D., & Brown, A. D. (2020). Traumatic Stress in the Age of COVID-19: A Call to Close Critical Gaps and Adapt to New Realities. Psychological Trauma, 12, 331-335. https://doi.org/10.1037/tra0000592
[21]
Jahanshahi, A. A., Dinani, M. M., & Madavani, A. M. (2020). The Distress of Iranian Adults during the Covid-19 Pandemic—More Distressed than the Chinese and with Different Predictors. Brain, Behavior, and Immunity, 87, 124-125. https://doi.org/10.1016/j.bbi.2020.04.081
[22]
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of the Illness in the Aged. The Index of ADL: A Standardized Measure of BIOLOGICAl and Psychological Function. JAMA, 185, 914-919. https://doi.org/10.1001/jama.1963.03060120024016
[23]
Killgore, W. D. S., Cloonan, S. A., Taylor, E. C., Fernandez, F., Grandner, M. A., & Dailey, N. S. (2020). Suicidal Ideation during the COVID-19 Pandemic: The Role of Insomnia. Psychiatry Research, 290, Article ID: 113134. https://doi.org/10.1016/j.psychres.2020.113134
[24]
Köse, I., Zincircioglu, Ç., Öztürk, Y. K., Çakmak, M., Güldogan, E. A., Demir, H. F., Şenoglu, N., Erbay, R. H., & Gonullu, M. (2016). Factors Affecting Anxiety and Depression Symptoms in Relatives of Intensive Care Unit Patients. Journal of Intensive Care Medicine, 31, 611-617. https://doi.org/10.1177/0885066615595791
[25]
Lei, L., Huang, X., Zhang, S., Yang, J., Yang, L., & Xu, M. (2020). Comparison of Prevalence and Associated Factors of Anxiety and Depression among People Affected by versus People Unaffected by Quarantine during the COVID-19 Epidemic in Southwestern China. Medical Science Monitor, 26, e924609. https://doi.org/10.12659/MSM.924609
[26]
Li, W., Yang, Y., Liu, Z. H., Zhao, Y. J., Zhang, Q., Zhang, L., Cheung, T., & Xiang, Y. T. (2020). Progression of Mental Health Services during the COVID-19 Outbreak in China. International Journal of Biological Sciences, 16, 1732-1738. https://doi.org/10.7150/ijbs.45120
[27]
Lora, A., & Sharan, P. (2015). Information for Global Mental Health. Global Mental Health, 2, e17. https://doi.org/10.1017/gmh.2015.15
[28]
Morrocan Health Ministry Website. http://www.covidmaroc.ma/Pages/AccueilAR.aspx
[29]
Mukhtar, S. (2020). Psychological Health during the Coronavirus Disease 2019 Pandemic Outbreak. International Journal of Social Psychiatry, 66, 512-516. https://doi.org/10.1177/0020764020925835
[30]
National Center for Post-Traumatic Stress Disorders. http://www.ptsd.va.gov
[31]
Ngo, C. Q., Phan, P. T., Vu, G. V., Pham, Q. L. T., Nguyen, L. H., Vu, G. T., Tran, T. T., Nguyen, H. L. T., Tran, B. X., Latkin, C. A. Ho, C. S. H., & Ho, R. C. M. (2019). Effects of Different Comorbidities on Health-Related Quality of Life among Respiratory Patients in Vietnam. Journal of Clinical Medicine, 8, Article 214. https://doi.org/10.3390/jcm8020214
[32]
Nguyen, H. C., Nguyen, M. H., Do, B. N., Tran, C. Q., Nguyen, T. T. P., Pham, K. M., Pham, L. V., Tran, K. V., Duong, T. T., Tran, T. V., Duong, T. H., Nguyen, T. T., Nguyen, Q. H., Hoang, T. M., Nguyen, K. T., Pham, T. T. M., Yang, S. H., Chao, J. C., & Duong, T. V. (2020). People with Suspected COVID-19 Symptoms Were More Likely Depressed and Had Lower Health-Related Quality of Life: The Potential Benefit of Health Literacy. Journal of Clinical Medicine, 9, Article 965. https://doi.org/10.3390/jcm9040965
[33]
Ohrnberger, J., Fichera, E., & Sutton, M. (2017). The Relationship between Physical and Mental Health: A Mediation Analysis. Social Science & Medicine, 195, 42-49. https://doi.org/10.1016/j.socscimed.2017.11.008
[34]
Özdin, S., & Bayrack Özdin, S. (2020). Levels and Predictors of Anxiety, Depression and Health Anxiety during COVID-19 Pandemic in Turkish Society: The Importance of Gender. International Journal of Social Psychiatry, 66, 504-511. https://doi.org/10.1177/0020764020927051
[35]
Pochard, F., Azoulay, E., Chevret, S., Lemaire, F., Hubert, P., Canoui, P., Grassin, M., Zittoun, R., le Gall, J. R., Dhainaut, J. F., & Schlemmer, B., French FAMIREA Group (2001). Symptoms of Anxiety and Depression in Family Members of Intensive Care Unit Patients: Ethical Hypothesis Regarding Decision-Making Capacity. Critical Care Medicine, 29, 1893-1897. https://doi.org/10.1097/00003246-200110000-00007
[36]
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A Nationwide Survey of Psychological Distress among Chinese People in the COVID-19 Epidemic: Implications and Policy Recommendations. General Psychiatry, 33, e100213. https://doi.org/10.1136/gpsych-2020-100213
[37]
Rajkumar, R. P. (2020). COVID-19 and Mental Health: A Review of the Existing Literature. Asian Journal of Psychiatry, 52, Article ID: 102066. https://doi.org/10.1016/j.ajp.2020.102066
[38]
Reynolds, D. L., Garay, J. R., Deamond, S. L., Moran, M. K., Gold, W., & Styra, R. (2008). Understanding, Compliance and Psychological Impact of the SARS Quarantine Experience. Epidemiology & Infection, 136, 997-1007. https://doi.org/10.1017/S0950268807009156
[39]
Robertson, E., Hershenfield, K., Grace, S. L., & Stewart, D. E. (2004). The Psychosocial Effects of Being Quarantined Following Exposure to SARS: A Qualitative Study of Toronto Health Care Workers. The Canadian Journal of Psychiatry, 49, 403-407. https://doi.org/10.1177/070674370404900612
[40]
Terkawi, A. S., Tsang, S., AlKahtani, G. J., Al-Mousa, S. H., Al Musaed, S., Al Zoraigi, U. S., Alasfar, E. M., Doais, K. S., Abdulrahman, A., & Altirkawi, K. A. (2017). Development and Validation of Arabic Version of the Hospital Anxiety and Depression Scale. Saudi Journal of Anaesthesia, 11, S11-S18. https://doi.org/10.4103/sja.SJA_43_17
[41]
Thompson, E. (2015). Hamilton Rating Scale for Anxiety (HAM-A). Occupational Medicine, 65, 601. https://doi.org/10.1093/occmed/kqv054
[42]
Tol, W. A. (2015). Stemming the Tide: Promoting Mental Health and Preventing Mental Disorders in Low and Middle Income Countries. Global Mental Health, 2, e11. https://doi.org/10.1017/gmh.2015.9
[43]
Torales, J., O’Higgins, M., Castaldelli-Maia, J. M., & Ventriglio, A. (2020). The Outbreak of COVID-19 Coronavirus and Its Impact on Global Mental Health. International Journal of Social Psychiatry, 66, 317-320. https://doi.org/10.1177/0020764020915212
[44]
Ullah, R., & Amin, S. (2020). The Psychological Impact of COVID-19 on Medical Students. Psychiatry Research, 288, Article ID: 113020. https://doi.org/10.1016/j.psychres.2020.113020
[45]
Wadoum, R. E. G., & Clarke, A. (2020). How Prepared Is Africa to Face COVID-19? The Pan African Medical Journal, 35, 1. https://doi.org/10.11604/pamj.supp.2020.35.2.22665
[46]
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. International Journal of Environmental Research and Public Health, 17, article 1729. https://doi.org/10.3390/ijerph17051729
[47]
Wang, S., Mosher, C., Perkins, A. J., Gao, S., Lasiter, S., Khan, S., Boustani, M., & Khan, B. (2017). Post-Intensive Care Unit Psychiatric Comorbidity and Quality of Life. Journal of Hospital Medicine, 12, 831-835. https://doi.org/10.12788/jhm.2827
[48]
Wang, Y., Di, Y., Ye, J., & Wei, W. (2021). Study on the Public Psychological States and Its Related Factors during the Outbreak of Coronavirus Disease 2019 (COVID-19) in Some Regions of China. Psychology, Health & Medicine, 26, 13-22. https://doi.org/10.1080/13548506.2020.1746817
[49]
Ware Jr., J. E., & Sherbourne, C. D. (1992). The MOS 36-Item Short-Form Health Survey (SF-36). Conceptual Framework and Item Selection. Medical Care, 30, 473-483. https://doi.org/10.1097/00005650-199206000-00002
[50]
World Health Organization (2019). Coronavirus Disease (COVID-19) Dashboard. https://covid19.who.int/
[51]
World Health Organization (2020). Clinical Management of COVID-19: Interim Guidance. https://covid19.who.int
[52]
Wu, K. K., Chan, S. K., & Ma, T. M. (2005). Posttraumatic Stress after SARS. Emerging Infectious Diseases, 11, 1297-1300. https://doi.org/10.3201/eid1108.041083
[53]
Xiao, C. (2020). A Novel Approach of Consultation on 2019 Novel Coronavirus (COVID-19)-Related Psychological and Mental Problems: Structured Letter Therapy. Psychiatry Investigation, 17, 175-176. https://doi.org/10.30773/pi.2020.0047
[54]
Zhong, B.-L., Luo, W., Li, H.-M., Zhang, Q.-Q., Liu, X.-G., Li, W.-T., & Li, Y. (2020). Knowledge, Attitudes, and Practices towards COVID-19 among Chinese Residents during the Rapid Rise Period of the COVID-19 Outbreak: A Quick Online Cross-Sectional Survey. International Journal of Biological Sciences, 16, 1745-1752. https://doi.org/10.7150/ijbs.45221
[55]
Zhou, X. (2020). Psychological Crisis Interventions in Sichuan Province during the 2019 Novel Coronavirus Outbreak. Psychiatry Research, 286, Article ID: 112895. https://doi.org/10.1016/j.psychres.2020.112895
[56]
Zimmerman, M., Martinez, J. H., Young, D., Chelminski, I., & Dalrymple, K. (2013). Severity Classification on the Hamilton Depression Rating Scale. Journal of Affective Disorders, 150, 384-388. https://doi.org/10.1016/j.jad.2013.04.028
