1
|
Chang S, Kim WH, Jung YE, Roh D, Kim D, Chae JH, Park JE. Clinical Utility of Impact of Event Scale-Revised for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition Posttraumatic Stress Disorder. Psychiatry Investig 2024; 21:870-876. [PMID: 39086162 PMCID: PMC11321870 DOI: 10.30773/pi.2024.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/09/2024] [Accepted: 06/10/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE The Impact of Event Scale-Revised (IES-R) is a widely used self-report for assessing posttraumatic stress disorder (PTSD), originally aligned with Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnostic criteria. This study aimed to evaluate the applicability of the IES-R under the DSM-5 guidelines and establish a cutoff point for DSM-5 PTSD diagnosis. METHODS A total of 238 participants recruited from multiple psychiatric centers, including 67 patients with PTSD, 72 patients with psychiatric controls, and 99 healthy controls, were included in the study. All participants completed the Korean version of the Structured Clinical Interview for the DSM-5 research version to confirm the presence of PTSD, the Korean version of PTSD Checklist for DSM-5 (PCL-5), the Beck Depression Inventory-II, the Beck Anxiety Inventory, and the Spielberger State Trait Anxiety Inventory. RESULTS The IES-R demonstrated good internal consistency and a high correlation with the PCL-5. Through factor analysis, 5 distinct dimensions emerged within the IES-R: sleep disturbance, intrusion, hyperarousal, avoidance, and numbness-dissociation. A proposed cutoff score of 25 on the IES-R was suggested for identifying patients with PTSD. CONCLUSION These findings underscore the scale's concurrent validity with the DSM-5 PTSD criteria and its effectiveness as a screening tool. Implementing a cutoff score of 25 on the IES-R can enhance its utility in identifying DSM-5 PTSD cases.
Collapse
Affiliation(s)
- Soyeon Chang
- Department of Psychiatry, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
| | - Young-Eun Jung
- Department of Psychiatry, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Daeyoung Roh
- Department of Psychiatry, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Daeho Kim
- Department of Psychiatry, Hanyang University Guri Hospital, Hanyang University Medical School, Guri, Republic of Korea
| | - Jeong-Ho Chae
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Joo Eon Park
- Department of Psychiatry, Keyo Hospital, Uiwang, Republic of Korea
| |
Collapse
|
2
|
Li D, Zhang X, Lu Y, Jing L, Hu H, Song Y, Wu S, Zhu W. Post-sepsis psychiatric disorder: Pathophysiology, prevention, and treatment. Neurol Sci 2024; 45:3093-3105. [PMID: 38381393 PMCID: PMC11176234 DOI: 10.1007/s10072-024-07409-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/14/2024] [Indexed: 02/22/2024]
Abstract
Post-sepsis psychiatric disorder, encompassing anxiety, depression, post-traumatic stress disorder and delirium, is a highly prevalent complication secondary to sepsis, resulting in a marked increase in long-term mortality among affected patients. Regrettably, psychiatric impairment associated with sepsis is frequently disregarded by clinicians. This review aims to summarize recent advancements in the understanding of the pathophysiology, prevention, and treatment of post-sepsis mental disorder, including coronavirus disease 2019-related psychiatric impairment. The pathophysiology of post-sepsis psychiatric disorder is complex and is known to involve blood-brain barrier disruption, overactivation of the hypothalamic-pituitary-adrenal axis, neuroinflammation, oxidative stress, neurotransmitter dysfunction, programmed cell death, and impaired neuroplasticity. No unified diagnostic criteria for this disorder are currently available; however, screening scales are often applied in its assessment. Modifiable risk factors for psychiatric impairment post-sepsis include the number of experienced traumatic memories, the length of ICU stay, level of albumin, the use of vasopressors or inotropes, daily activity function after sepsis, and the cumulative dose of dobutamine. To contribute to the prevention of post-sepsis psychiatric disorder, it may be beneficial to implement targeted interventions for these modifiable risk factors. Specific therapies for this condition remain scarce. Nevertheless, non-pharmacological approaches, such as comprehensive nursing care, may provide a promising avenue for treating psychiatric disorder following sepsis. In addition, although several therapeutic drugs have shown preliminary efficacy in animal models, further confirmation of their potential is required through follow-up clinical studies.
Collapse
Affiliation(s)
- Dayong Li
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Xujie Zhang
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Yuru Lu
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Liang Jing
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Hongjie Hu
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Yaqin Song
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Shuhui Wu
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China
| | - Wei Zhu
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- Department of Intensive Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, China.
| |
Collapse
|
3
|
T’ng K, Kenardy J, Hartanto A. Evaluating Mental Health Outcomes in COVID-19 ICU Survivors: A Scoping Review of Measurement Tools. J Clin Med 2024; 13:3191. [PMID: 38892906 PMCID: PMC11172430 DOI: 10.3390/jcm13113191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Objective: The objective of this scoping review was to map the range of measurement tools used to study the prevalence of common mental health conditions in COVID-19 ICU survivors. Introduction: Increased rates of admission to and survivorship from intensive care units (ICUs) have been observed in recent years, particularly during the global pandemic. ICU patients are at a higher risk of developing depressive, anxiety, and PTSD symptoms. Due to the high burden of disease, an accurate understanding of long-term mental health challenges for this population is key. Unfortunately, there is significant variability in reported prevalence rates. Heterogeneity in measurement tools potentially contribute to this. Inclusion criteria: Studies were eligible if they (a) reported mental health outcomes of adult patients diagnosed with COVID-19 and admitted to an ICU, (b) used standardised mental health outcome measures, and (3) were peer-reviewed. Methods: Searches were conducted in PubMed, PsycInfo, and Scopus. The initial search retrieved 1234 publications. After de-duplication and title and abstract screening, 72 full-text articles were examined for eligibility and 44 articles were excluded, leaving 28 eligible studies. Reference lists of the eligible studies were screened, and four other studies were added. 32 studies were ultimately included in this review. Results: Significant heterogeneity of measurement tools and clinical thresholds were observed. Only 6.25% of the studies compared changes in mental health outcomes to baseline measurements. Between five and nine unique measurement tools were used to study depression, anxiety, and PTSD, respectively. Studies were also observed to use up to 19 different thresholds to establish the prevalence of PTSD. Conclusions: The heterogeneity of measurement tools and thresholds continues to confound prevalence rate estimations of mental health complications post-ICU admission. Future research will benefit from consistency in the use of recommended outcome measures and the use of psychometrically comparable cut-off points between key measures.
Collapse
Affiliation(s)
- Kimberly T’ng
- School of Psychology, University of Queensland, Brisbane, QLD 4072, Australia;
| | - Justin Kenardy
- School of Psychology, University of Queensland, Brisbane, QLD 4072, Australia;
| | - Andree Hartanto
- School of Social Sciences, Singapore Management University, 10 Canning Rise, Level 5, Singapore 179873, Singapore;
| |
Collapse
|
4
|
Wozniak H, Beckmann TS, Dos Santos Rocha A, Pugin J, Heidegger CP, Cereghetti S. Long-stay ICU patients with frailty: mortality and recovery outcomes at 6 months. Ann Intensive Care 2024; 14:31. [PMID: 38401034 PMCID: PMC10894177 DOI: 10.1186/s13613-024-01261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/09/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Prolonged intensive care unit (ICU) stay is associated with physical, cognitive, and psychological disabilities. The impact of baseline frailty on long-stay ICU patients remains uncertain. This study aims to investigate how baseline frailty influences mortality and post-ICU disability 6 months after critical illness in long-stay ICU patients. METHODS In this retrospective cohort study, we assessed patients hospitalized for ≥ 7 days in the ICU between May 2018 and May 2021, following them for up to 6 months or until death. Based on the Clinical Frailty Scale (CFS) at ICU admissions, patients were categorized as frail (CFS ≥ 5), pre-frail (CFS 3-4) and non-frail (CFS 1-2). Kaplan-Meier curves and a multivariate Cox model were used to examine the association between frailty and mortality. At the 6 month follow-up, we assessed psychological, physical, cognitive outcomes, and health-related quality of life (QoL) using descriptive statistics and linear regressions. RESULTS We enrolled 531 patients, of which 178 (33.6%) were frail, 200 (37.6%) pre-frail and 153 (28.8%) non-frail. Frail patients were older, had more comorbidities, and greater disease severity at ICU admission. At 6 months, frail patients presented higher mortality rates than pre-frail and non-frail patients (34.3% (61/178) vs. 21% (42/200) vs. 13.1% (20/153) respectively, p < 0.01). The rate of withdrawing or withholding of care did not differ significantly between the groups. Compared with CFS 1-2, the adjusted hazard ratios of death at 6 months were 1.7 (95% CI 0.9-2.9) for CFS 3-4 and 2.9 (95% CI 1.7-4.9) for CFS ≥ 5. At 6 months, 192 patients were seen at a follow-up consultation. In multivariate linear regressions, CFS ≥ 5 was associated with poorer physical health-related QoL, but not with poorer mental health-related QoL, compared with CFS 1-2. CONCLUSION Frailty is associated with increased mortality and poorer physical health-related QoL in long-stay ICU patients at 6 months. The admission CFS can help inform patients and families about the complexities of survivorship during a prolonged ICU stay.
Collapse
Affiliation(s)
- Hannah Wozniak
- Division of Critical Care, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland.
- Division of Critical Care Medicine, University of Toronto, Toronto, Canada.
| | - Tal Sarah Beckmann
- Division of Anesthesiology, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Andre Dos Santos Rocha
- Division of Anesthesiology, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Jérôme Pugin
- Division of Critical Care, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Claudia-Paula Heidegger
- Division of Critical Care, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| | - Sara Cereghetti
- Division of Critical Care, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland
| |
Collapse
|
5
|
Suganuma S, Idei M, Nakano H, Koyama Y, Hashimoto H, Yokoyama N, Takaki S, Nakamura K. Impact of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome during Intensive Care Admission on Each Post-Intensive Care Syndrome Component in a PICS Clinic. J Clin Med 2023; 12:5427. [PMID: 37629468 PMCID: PMC10455637 DOI: 10.3390/jcm12165427] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/12/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Persistent inflammation, immunosuppression, and catabolism syndrome (PIICS) is known as a prolonged immunodeficiency that occurs after severe infection. Few studies have demonstrated a direct relationship between PIICS and physical dysfunction in post-intensive care syndrome (PICS). We herein investigated how each component of PICS was affected by the diagnosis of PIICS during hospitalization and examined the relationship between PIICS and PICS using PICS assessments performed at the Hitachi General Hospital PICS Clinic. METHODS The 273 patients who visited the PICS clinic at one month after discharge from the ICU at Hitachi General Hospital were included in the study. We used the diagnostic criteria for PIICS described in previous studies. At least two of the following blood test values on day 14 of hospitalization had to be met for a diagnosis of PIICS: C-reactive protein (CRP) > 2.0 mg/dL, albumin (Alb) < 3.0 g/dL, and lymphocytes (Lym) < 800/μL. Blood test values closest to day 14 out of 11-17 days of hospitalization were used. The primary outcome was a Barthel Index (BI) < 90, while secondary outcomes were the results of various PICS assessments, including mental and cognitive impairments, performed at the PICS clinic. We supplemented missing data with multiple imputations by chained equations. We performed a nominal logistic regression analysis with age, sex, BMI, SOFA, and the presence of PIICS as variables for BI < 90. RESULTS Forty-three out of two hundred seventy-three PICS outpatients met the diagnostic criteria for PIICS during hospitalization. In comparisons with non-PIICS patients, significantly higher severity scores for APACHE II and SOFA and a longer hospital stay were observed in PIICS patients, suggesting a higher clinical severity. The primary outcome, BI, was lower in the PIICS group (97.5 (58.5, 100) vs. 100 (95, 100), p = 0.008), as were the secondary outcomes (FSS-ICU: 35 (31, 35) vs. 35 (35, 35), MRC score: 55 (50.25, 58) vs. 58 (53, 60), grip strength: 16.45 (9.2, 25.47) vs. 20.4 (15.3, 27.7)). No significant differences were noted in mental or cognitive function assessments, such as HADS, IES-R, and SMQ. A multivariable analysis supplemented with missing data revealed that PIICS (odds ratio: 1.23 (1.08-1.40 p = 0.001) and age (odds ratio: 1.007 (1.004-1.01), p < 0.001) correlated with BI < 90, independent of clinical severity such as sequential organ failure assessment (SOFA). Similar results were obtained in the sensitivity analysis excluding missing data. CONCLUSIONS The present study revealed a strong relationship between PIICS and post-discharge PICS physical dysfunction in patients requiring intensive care.
Collapse
Affiliation(s)
- Shinya Suganuma
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (S.S.); (M.I.); (N.Y.); (S.T.)
| | - Masafumi Idei
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (S.S.); (M.I.); (N.Y.); (S.T.)
| | - Hidehiko Nakano
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1, Jonan-cho, Hitachi 317-0077, Japan; (H.N.); (Y.K.); (H.H.)
| | - Yasuaki Koyama
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1, Jonan-cho, Hitachi 317-0077, Japan; (H.N.); (Y.K.); (H.H.)
| | - Hideki Hashimoto
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1, Jonan-cho, Hitachi 317-0077, Japan; (H.N.); (Y.K.); (H.H.)
| | - Nobuyuki Yokoyama
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (S.S.); (M.I.); (N.Y.); (S.T.)
| | - Shunsuke Takaki
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (S.S.); (M.I.); (N.Y.); (S.T.)
| | - Kensuke Nakamura
- Department of Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan; (S.S.); (M.I.); (N.Y.); (S.T.)
- Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1, Jonan-cho, Hitachi 317-0077, Japan; (H.N.); (Y.K.); (H.H.)
| |
Collapse
|
6
|
Kovaleva MA, Jones AC, Kimpel CC, Lauderdale J, Sevin CM, Stollings JL, Jackson JC, Boehm LM. Patient and caregiver experiences with a telemedicine intensive care unit recovery clinic. Heart Lung 2023; 58:47-53. [PMID: 36399862 PMCID: PMC9992018 DOI: 10.1016/j.hrtlng.2022.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Intensive Care Unit Recovery Clinics (ICU-RCs) were founded to address post-intensive care syndrome among ICU survivors. Telemedicine ICU-RCs may facilitate access for more ICU survivors, however, patient and caregiver experiences with telemedicine ICU-RCs have not been explored qualitatively. OBJECTIVE To explore patient and informal caregiver experiences with a telemedicine ICU-RC. METHODS Our qualitative exploratory cross-sectional study was guided by qualitative description methodology. Telemedicine ICU-RC visits were conducted at 3- and 12-weeks post-discharge following critical illness. Patients, and caregivers when available, met with an ICU pharmacist, ICU physician, and a neuropsychologist via Zoom. Thereafter, we conducted qualitative (1:1) telephone interviews with 14 patients and 12 caregivers recruited purposefully. Data were analyzed using conventional content analysis. RESULTS Five themes were identified: (1) general impressions of the intervention; (2) intervention organization and delivery; (3) intervention substance; (4) caregiver participation; and (5) ways to improve the intervention. Participants found the telemedicine delivery acceptable, convenient, time-saving, and conducive to thorough discussions. Participants appreciated the information, reassurance, and validation. Attention to mental health during the visits was strongly endorsed. Caregiver involvement depended on patient self-management and technical ability. Suggestions included scheduling a 1-week post-discharge visit, more follow-up visits, and individualizing content for in-depth discussions, including mental health evaluation. CONCLUSIONS The study results enhance the understanding of patient and caregiver experiences with a telemedicine ICU-RC. Participants' narratives helped to formulate recommendations to improve telemedicine ICU-RC delivery and content. Acceptability of this intervention indicates the potential for wider implementation of telemedicine ICU-RCs to reach more ICU survivors.
Collapse
Affiliation(s)
- Mariya A Kovaleva
- University of Nebraska Medical Center College of Nursing, Omaha, NE.
| | - Abigail C Jones
- Yale University School of Nursing, Orange, CT; Vanderbilt University School of Nursing, Nashville, TN
| | - Christine Cleary Kimpel
- Vanderbilt University School of Nursing, Nashville, TN; Tennessee Valley Health Care System, Nashville, TN, USA
| | | | | | - Joanna L Stollings
- Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN, USA; Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN
| | - James C Jackson
- Vanderbilt University Medical Center, Nashville, TN; Critical Illness, Brain dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN; Department of Medicine, Division of Pulmonary and Critical Care, Vanderbilt University Medical Center, Nashville, TN; Geriatrics Research, Education, and Clinical Center, Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN
| | | |
Collapse
|
7
|
Abas MA, Müller M, Gibson LJ, Derveeuw S, Dissanayake N, Smith P, Verhey R, Danese A, Chibanda D. Prevalence of post-traumatic stress disorder and validity of the Impact of Events Scale - Revised in primary care in Zimbabwe, a non-war-affected African country. BJPsych Open 2023; 9:e37. [PMID: 36794523 PMCID: PMC9970167 DOI: 10.1192/bjo.2022.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND A critical step in research on the epidemiology of post-traumatic stress disorder (PTSD) in low-resource settings is the validation of brief self-reported psychometric tools available in the public domain, such as the Impact Event Scale - Revised (IES-R). AIMS We aimed to investigate the validity of the IES-R in a primary healthcare setting in Harare, Zimbabwe. METHOD We analysed data from a survey of 264 consecutively sampled adults (mean age 38 years; 78% female). We estimated the area under the receiver operating characteristic curve and sensitivity, specificity and likelihood ratios for different cut-off points of the IES-R, against a diagnosis of PTSD made using the Structured Clinical Interview for DSM-IV. We performed factor analysis to evaluate construct validity of the IES-R. RESULTS The prevalence of PTSD was 23.9% (95% CI 18.9-29.5). The area under the curve for the IES-R was 0.90. At a cut-off of ≥47, the sensitivity of the IES-R to detect PTSD was 84.1 (95% CI 72.7-92.1) and specificity was 81.1 (95% CI 75.0-86.3). Positive and negative likelihood ratios were 4.45 and 0.20, respectively. Factor analysis revealed a two-factor solution, with both factors showing good internal consistency (Cronbach's factor-1 α = 0.95, factor-2 α = 0.76). In a post hoc analysis, we found the brief six-item IES-6 also performed well, with an area under the curve of 0.87 and optimal cut-off of 15. CONCLUSIONS The IES-R and IES-6 had good psychometric properties and performed well for indicating possible PTSD, but at higher cut-off points than those recommended in the Global North.
Collapse
Affiliation(s)
- Melanie A Abas
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Monika Müller
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Clinic for Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Bern, Switzerland
| | - Lorna J Gibson
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK
| | - Sarah Derveeuw
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nirosha Dissanayake
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Patrick Smith
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, UK
| | - Dixon Chibanda
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK; Friendship Bench, Harare, Zimbabwe; and Department of Psychiatry, University of Zimbabwe, Zimbabwe
| |
Collapse
|
8
|
Chu Y, Thompson DR, Eustace‐Cook J, Timmins F. Instruments to measure post‐intensive care syndrome: A scoping review. Nurs Crit Care 2023. [DOI: 10.1111/nicc.12885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Yuan Chu
- School of Nursing, Midwifery and Health Systems University College Dublin Dublin Ireland
| | - David R. Thompson
- School of Nursing, Midwifery and Health Systems University College Dublin Dublin Ireland
- School of Nursing and Midwifery Queen's University Belfast Belfast UK
| | | | - Fiona Timmins
- School of Nursing, Midwifery and Health Systems University College Dublin Dublin Ireland
| |
Collapse
|
9
|
Blagev DP, Callahan SJ, Harris D, Collingridge DS, Hopkins RO, Eve JR, Waddoups L, Aston V, Brown S, Lanspa MJ. Prospectively Assessed Long-Term Outcomes of Patients with E-Cigarette- or Vaping-associated Lung Injury. Ann Am Thorac Soc 2022; 19:1892-1899. [PMID: 35533314 PMCID: PMC9667811 DOI: 10.1513/annalsats.202201-049oc] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Rationale: E-cigarette- or vaping-associated lung injury (EVALI) was first identified in 2019. The long-term respiratory, cognitive, mood disorder, and vaping behavior outcomes of patients with EVALI remain unknown. Objectives: To determine the long-term respiratory, cognitive, mood disorder, and vaping behavior outcomes of patients with EVALI. Methods: We prospectively enrolled patients with EVALI from two health systems. We assessed outcomes at 1 year after onset of EVALI using validated instruments measuring cognitive function, depression, anxiety, post-traumatic stress, respiratory disability, coronavirus disease (COVID-19) infection, pulmonary function, and vaping behaviors. We used multivariable regression to identify risk factors of post-EVALI vaping behaviors and to identify whether admission to the intensive care unit (ICU) was associated with cognitive, respiratory, or mood symptoms. Results: Seventy-three patients completed 12-month follow-up. Most patients were male (66.7%), young (mean age, 31 ± 11 yr), and White (85%) and did not need admission to the ICU (59%). At 12 months, 39% (25 of 64) had cognitive impairment, whereas 48% (30 of 62) reported respiratory limitations. Mood disorders were common, with 59% (38 of 64) reporting anxiety and/or depression and 62% (39 of 63) having post-traumatic stress. Four (6.4%) of 64 reported a history of COVID-19 infection. Despite the history of EVALI, many people continued to vape. Only 38% (24 of 64) reported quitting all vaping and smoking behaviors. Younger age was associated with reduced vaping behavior after EVALI (odds ratio, 0.93; P = 0.02). ICU admission was not associated with cognitive impairment, dyspnea, or mood symptoms. Conclusions: Patients with EVALI, despite their youth, commonly have significant long-term respiratory disability; cognitive impairment; symptoms of depression, anxiety, post-traumatic stress; and persistent vaping.
Collapse
Affiliation(s)
- Denitza P. Blagev
- Pulmonary and Critical Care Medicine Division, Department of Medicine
- Department of Research
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah; and
| | - Sean J. Callahan
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah; and
| | - Dixie Harris
- Pulmonary and Critical Care Medicine Division, Department of Medicine
- Telecritical Care Division, Department of Intermountain Telehealth, and
| | | | - Ramona O. Hopkins
- Neuroscience Center, Department of Psychology, Brigham Young University, Provo, Utah
| | - Jacqueline R. Eve
- Enterprise Analytics, Intermountain Healthcare, Salt Lake City, Utah
| | - Lindsey Waddoups
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah; and
| | | | - Samuel Brown
- Pulmonary and Critical Care Medicine Division, Department of Medicine
- Department of Research
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah; and
| | - Michael J. Lanspa
- Pulmonary and Critical Care Medicine Division, Department of Medicine
- Department of Research
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah; and
| |
Collapse
|
10
|
Psychological Attachment Orientation and Long-Term Posttraumatic Stress Symptoms Among Family Members of ICU Patients. Crit Care Explor 2022; 4:e0753. [PMID: 36050994 PMCID: PMC9426807 DOI: 10.1097/cce.0000000000000753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine the degree to which an ICU patient’s family member having an “anxious” psychologic attachment orientation is a risk factor for developing long-term posttraumatic stress disorder (PTSD) symptoms following patient ICU discharge or death.
Collapse
|
11
|
Yang X, Zuo Y. Study of anxiety and job burnout, and awareness among young anesthetists during COVID-19 pandemic. IBRAIN 2022; 8:338-345. [PMID: 37752986 PMCID: PMC9539207 DOI: 10.1002/ibra.12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/13/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2022]
Abstract
To describe the psychological impact of coronavirus disease 2019 (COVID-19) on young doctors and their job burnout in the Department of Anesthesiology during the initial days of the pandemic and examine their awareness and familiarity with this pneumonia. We conducted a cross-sectional study in West China Hospital in February 2020. A self-designed questionnaire was sent to all young doctors working in the department of anesthesiology. Impact of Event Scale-Revised and Maslach Burnout Inventory General Survey were used to evaluate the psychological impact and degree of job burnout. Another questionnaire was conducted to explore the awareness and familiarity of COVID-19. All participants were divided into five groups according to the time of clinical practice: Postgraduate year (PGY) 0.5 (less than 0.5 year), 0.6-1 (0.6-1 year), 1-2 (1-2 years), 2-3 (2-3 years), 3 (more than 3 years) groups. The results were collected and analyzed subsequently. A total of 188 questionnaires were collected. There were significant differences in distress level between PGY 0.5 and PGY 0.6-1 (17.60 ± 12.53 vs. 12.05 ± 10.65; p = 0.029), and PGY 3 and PGY 0.6-1 (19.92 ± 11.88 vs. 12.05 ± 10.65; p = 0.031). As for job burnout, there were no differences among the five subgroups. Most participants (86.70%) were kept in good working condition, and 25 participants showed a mild level of job burnout. Although all of the respondents had high awareness of the basic elements of COVID-19, they had little knowledge about the details, such as lab tests, release criteria, and recommended therapy, and this result had no significant difference among the five groups. COVID-19 had caused a mild level of distress and work burnout in young anesthetists. Most of the participants were not clear about the diagnostic, release criteria, and therapeutic method, which will become key teaching points in the future.
Collapse
Affiliation(s)
- Xi Yang
- Department of Anesthesiology, West China School of MedicineSichuan UniversityChengduSichuanChina
| | - Yunxia Zuo
- Department of Anesthesiology, West China School of MedicineSichuan UniversityChengduSichuanChina
| |
Collapse
|
12
|
Koca S, Koca E, Okten IN, Orengül FF, Oztürk A, Ozçelik M, Oyman A, Çil I, Gümüş M. Psychological impacts of COVID-19 pandemic in cancer patients on active treatment. Heliyon 2022; 8:e10142. [PMID: 35996550 PMCID: PMC9385601 DOI: 10.1016/j.heliyon.2022.e10142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/30/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Although cancer patients have a high risk of exposing COVID-19 and developing severe complications, they have to receive active treatment. We aimed to determine the psychological conditions of cancer patients and shed light on the establishment of early psychological intervention and intervention policies by making specific recommendations. Method We consecutively evaluated 385 cancer patients under treatment. Post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, stress, and associated sociodemographic/clinical characteristics were investigated. In addition, we applied depression-anxiety-stress-scale-21 (DASS-21) for the mental states of patients and Impact of Event-Scale-Revised (IES-R) for the psychological effects of Covid-19. Results The mean age was 58 (18-88). 47.2% were psychologically distressful per DASS-21, and 39.3% were traumatic per IES-R scores. 71.9% stated the risk of getting COVID-19 was high since they had cancer, and 82% stated serious complications would develop if they had COVID-19 infection. Patients diagnosed for more than one year were more stressed, anxious, and depressive (p-value = 0.001,0.003,0.049, respectively). Singles were more stressed, depressed, and traumatized than couples (p-value = 0.001, 0.011, 0.001). In multivariate analysis, a significant correlation with being under psychiatric treatment before the pandemic was found for depression (OR: 3.743, 95 %CI: 1.790-7.827) anxiety (OR: 3.776-95 %CI: 1.945-7.332) and stress levels (OR: 4.129, 95 %CI: 1.728-9.866). Having relatives who died or received treatment for COVID-19(OR: 0.515,0.296-0.895) and being unmarried (OR: 2.445-95% CI: 1.260-4.747) predicts PTSD development. Conclusions When the psychological effects of the COVID-19 pandemic are manifesting strongly, cancer patients' anxiety and exposure levels are high. It is of great importance that clinicians understand needs, recognize psychological distress, and direct them to relevant departments for supportive care.
Collapse
Affiliation(s)
- Sinan Koca
- Department of Medical Oncology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Esra Koca
- Department of Mental Health and Psychiatry, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Ilker N Okten
- Department of Medical Oncology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Fatma Fc Orengül
- Department of Mental Health and Psychiatry, Haseki Education Research Hospital, Istanbul, Turkey
| | - Akın Oztürk
- Department of Medical Oncology, Istanbul Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey
| | - Melike Ozçelik
- Department of Medical Oncology, University of Health Sciences Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Abdilkerim Oyman
- Department of Medical Oncology, University of Health Sciences Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim Çil
- Department of Medical Oncology, University of Health Sciences Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Gümüş
- Department of Medical Oncology, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| |
Collapse
|
13
|
The Prevalence of Spiritual and Social Support Needs and Their Association With Postintensive Care Syndrome Symptoms Among Critical Illness Survivors Seen in a Post-ICU Follow-Up Clinic. Crit Care Explor 2022; 4:e0676. [DOI: 10.1097/cce.0000000000000676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
14
|
Stamatis CA, Broos HC, Hudiburgh SE, Dale SK, Timpano KR. A longitudinal investigation of COVID-19 pandemic experiences and mental health among university students. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:385-404. [PMID: 34850405 DOI: 10.1111/bjc.12351] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/09/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Previous studies have established a link between the COVID-19 pandemic and poor mental health. They further suggest that young adults may be especially vulnerable to worsened mental health during the pandemic, but few studies have investigated which specific aspects of the COVID-19 experience affect psychological well-being over time. To better understand concrete predictors of poor mental health outcomes in this population, we identified several pandemic-related experiences and evaluated their effects on mental health symptoms (depression, anxiety, stress, alcohol, and substance use) in a sample of U.S. college students (N = 176). METHODS Both mental health symptoms and pandemic-related experiences were evaluated at the start of quarantine (March/April 2020, Time 1) and the end of the Spring 2020 semester (May 2020, Time 2). Given the limited literature on specific predictors of mental health during a pandemic, we used elastic net regression, a novel analytic method that helps with variable selection when theoretical background is limited, to narrow our field of possible predictors. RESULTS While mental health symptoms were elevated at both timepoints, there were no clinically significant changes from Time 1 to Time 2 and few differences between sociodemographic groups. Both disruption due to the pandemic (β = .25, p = .021) and limited confidence in the federal government's response (β = -.14, p = .038) were significant predictors of depression symptoms at the end of the semester, even when controlling for baseline depression. Further, predictions that the pandemic would continue to impact daily life further into the future were linked with pandemic stress response symptoms (β = .15, p = .032) at Time 2, beyond the effects of baseline symptoms. Alcohol (β = -.22, p = .024) and substance use (β = -.26, p = .01) were associated with reduced adherence to COVID-19 guidelines. CONCLUSIONS Our findings indicate that specific aspects of the pandemic experience may be influencing internalizing symptoms and alcohol/substance use in college students, pointing to potential avenues for targeted support and intervention. PRACTITIONER POINTS A range of factors may influence university student mental health during the COVID-19 pandemic. Students who expect the pandemic will continue to impact daily life further into the future maybe more likely to report stress symptoms. Disruption due to the pandemic and limited confidence in the federal government's response may be associated with depression symptoms. Alcohol and substance use are associated with lower COVID-19 guideline adherence in university students.
Collapse
Affiliation(s)
- Caitlin A Stamatis
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, USA.,Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Hannah C Broos
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | | | - Sannisha K Dale
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
15
|
Chen LYA, Wu CY, Lee MB, Lin CH, Kao SC, Tu CC, Chen RC. Predictors for psychological distress of young burn survivors across three years: A cohort study of a burn disaster in Taiwan. J Nurs Scholarsh 2021; 54:56-63. [PMID: 34841644 PMCID: PMC9299193 DOI: 10.1111/jnu.12703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
Purpose The study aims to investigate long‐term psychological distress and its risk factors in the burn survivors. Design A longitudinal study with follow‐up interviews was conducted from November 2015–June 2018. A post‐burn baseline interview was conducted 6 months after the event, followed by annual surveys for three years. Methods The burn survivors received structured assessment through telephone in the four‐wave interviews, including the five‐item Brief Symptom Rating Scale (BSRS‐5); two‐item Patient Health Questionnaire (PHQ‐2); four‐item Startle, Physiological Arousal, Anger, and Numbness Scale (SPAN‐4); and six‐item Impact of Event Scale (IES‐6) alongside demographic data and other health‐related assessment. Findings A total of 180 respondents with the mean age of 23 years old completed the four waves of interview. Using the BSRS‐5 as the outcome, each variable had different input in psychological distress during the follow‐up years. The main finding was that the SPAN‐4 score could predict more than 62% of psychological distress between 6 months and 3 years after the disaster. The generalized estimating equation demonstrated that SPAN‐4, IES‐6, family functioning impairment, hypnotics use, adaptation to the event, and PHQ‐2 could predict psychological distress. However, the variable of follow‐up year did not exemplify significant estimation in the model. Conclusions The results indicated that different factors had various influences on psychological distress across the four follow‐up stages. PTSD‐like symptoms, depression, and anxiety were the most common psychological problems experienced by the young burn cohort in the longitudinal post‐traumatic period. Clinical relevance Healthcare providers should be aware of psychological consequences of traumatic events within up to a 3‐year post‐burn period, particularly post‐traumatic stress, depression, and anxiety symptoms.
Collapse
Affiliation(s)
- Lu-Yen Anny Chen
- Institute of Clinical Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Second Degree Bachelor of Science in Nurisng, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Yi Wu
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.,Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, Shin-Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chi-Hung Lin
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Microbiology and Immunology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shu-Chen Kao
- Department of Health, New Taipei City Government, Banqiao, Taiwan
| | - Chung-Chieh Tu
- Department of Health, New Taipei City Government, Banqiao, Taiwan
| | - Ran-Chou Chen
- Department of Health, New Taipei City Government, Banqiao, Taiwan
| |
Collapse
|
16
|
Castro-Ávila AC, Merino-Osorio C, González-Seguel F, Camus-Molina A, Leppe J. Impact on Mental, Physical and Cognitive functioning of a Critical care sTay during the COVID-19 pandemic (IMPACCT COVID-19): protocol for a prospective, multicentre, mixed-methods cohort study. BMJ Open 2021; 11:e053610. [PMID: 34497087 PMCID: PMC8438573 DOI: 10.1136/bmjopen-2021-053610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION The ongoing pandemic could affect the duration, variety and severity of the mental, physical, and cognitive impairments intensive care unit (ICU) survivors and their families frequently present. We aim to determine the impact of the COVID-19 pandemic on the mental, physical, and cognitive health of survivors, the experience of their families and their treating healthcare professionals. METHODS AND ANALYSIS Prospective, multicentre, mixed-methods cohort study in seven Chilean ICUs. SAMPLE 450 adults, able to walk independently prior to admission, in ICU and mechanical ventilation >48 hours with and without COVID-19. Clinical Frailty Scale, Charlson comorbidity index, mobility (Functional Status Score for the Status Score for the Intensive Care Unit) and muscle strength (Medical Research Council Sum Score) will be assessed at ICU discharge. Cognitive functioning (Montreal Cognitive Assessment-blind), anxiety and depression (Hospital Anxiety and Depression Scale), post-traumatic stress (Impact of Event Scale-Revised) symptoms, disability (WHO Disability Assessment Schedule 2.0), quality of life (European Quality of Life Health Questionnaire), employment and survival will be assessed at ICU discharge, 3 months and 6 months. A sample will be assessed using actigraphy and the Global Physical Activity Questionnaire at 6 months after ICU discharge. Trajectories of mental, physical, and cognitive impairments will be estimated using multilevel longitudinal modelling. A sensitivity analysis using multiple imputations will be performed to account for missing data and loss-to-follow-up. Survival will be analysed using Kaplan-Meier curves. The perceptions of family members regarding the ICU stay and the later recovery will be explored 3 months after discharge. Healthcare professionals will be invited to discuss the challenges faced during the pandemic using semistructured interviews. Interviews will be thematically analysed by two independent coders to identify the main themes of the experience of family members and healthcare professionals. ETHICS AND DISSEMINATION The study was approved by the Clinica Alemana Universidad del Desarrollo Ethics Committee (2020-78) and each participating site. Study findings will be published in peer-reviewed journals and disseminated through social media and conference meetings. TRIAL REGISTRATION NUMBER NCT04979897.
Collapse
Affiliation(s)
- Ana Cristina Castro-Ávila
- School of Physical Therapy, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
- Department of Health Sciences, University of York, Heslington, UK
| | - Catalina Merino-Osorio
- School of Physical Therapy, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Felipe González-Seguel
- School of Physical Therapy, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
- Servicio de Medicina Física y Rehabilitación and Departamento de Paciente Crítico, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Agustín Camus-Molina
- School of Physical Therapy, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
- Servicio de Medicina Física y Rehabilitación and Departamento de Paciente Crítico, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Jaime Leppe
- School of Physical Therapy, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| |
Collapse
|
17
|
Grip Strength Correlates with Mental Health and Quality of Life after Critical Care: A Retrospective Study in a Post-Intensive Care Syndrome Clinic. J Clin Med 2021; 10:jcm10143044. [PMID: 34300209 PMCID: PMC8304889 DOI: 10.3390/jcm10143044] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 12/29/2022] Open
Abstract
Post-intensive care syndrome (PICS) is characterized by several prolonged symptoms after critical care, including physical and cognitive dysfunctions as well as mental illness. In clinical practice, the long-term follow-up of PICS is initiated after patients have been discharged from the intensive care unit, and one of the approaches used is a PICS clinic. Although physical dysfunction and mental illness often present in combination, they have not yet been examined in detail in PICS patients. Grip strength is a useful physical examination for PICS, and is reported to be associated with mental status in the elderly. We herein investigated the relationship between grip strength and the mental status using data from our PICS clinic. We primarily aimed to analyze the correlation between grip strength and the Hospital Anxiety and Depression Scale (HADS) score. We also analyzed the association between grip strength and the EuroQol 5 Dimension (EQ5D) score as quality of life (QOL). Subjects comprised 133 patients who visited the PICS clinic at one month after hospital discharge between August 2019 and December 2020. Total HADS scores were 7 (4, 13) and 10 (6, 16) (p = 0.029) and EQ5D scores were 0.96 (0.84, 1) and 0.77 (0.62, 0.89) (p ≤ 0.0001) in the no walking disability group and walking disability group, respectively. Grip strength negatively correlated with HADS and EQ5D scores. Correlation coefficients were r = -0.25 (p = 0.011) and r = -0.47 (p < 0.0001) for HADS and EQ5D scores, respectively. Grip strength was a useful evaluation that also reflected the mental status and QOL.
Collapse
|
18
|
Wang C, Tripp C, Sears SF, Xu L, Tan Y, Zhou D, Ma W, Xu Z, Chan NA, Ho C, Ho R. The impact of the COVID-19 pandemic on physical and mental health in the two largest economies in the world: a comparison between the United States and China. J Behav Med 2021; 44:741-759. [PMID: 34128179 PMCID: PMC8202541 DOI: 10.1007/s10865-021-00237-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 06/08/2021] [Indexed: 12/11/2022]
Abstract
The broad impact of the COVID-19 on self-reported daily behaviors and health in Chinese and US samples remains unknown. This study aimed to compare physical and mental health between people from the United States (U.S.) and China, and to correlate mental health parameters with variables relating to physical symptoms, knowledge about COVID-19, and precautionary health behaviors. To minimize risk of exposure, respondents were electronically invited by existing study respondents or by data sourcing software and surveys were completed via online survey platforms. Information was collected on demographics, physical symptoms, contact history, knowledge about COVID-19, psychologic parameters (i.e. IES-R; DASS-21), and health behaviors. The study included a total of 1445 respondents (584 U.S.; 861 China). Overall, Americans reported more physical symptoms, contact history, and perceived likelihood of contracting COVID-19. Americans reported more stress and depressive symptoms, while Chinese reported higher acute-traumatic stress symptoms. Differences were identified regarding face mask use and desires for COVID-19 related health information, with differential mental health implications. Physical symptoms that were possibly COVID-19 related were associated with adverse mental health. Overall, American and Chinese participants reported different mental and physical health parameters, health behaviors, precautionary measures, and knowledge of COVID-19; different risk and protective factors were also identified.
Collapse
Affiliation(s)
- Cuiyan Wang
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Connor Tripp
- Department of Psychology, East Carolina University, Greenville, NC, 27858-4353, USA
| | - Samuel F Sears
- Department of Psychology, East Carolina University, Greenville, NC, 27858-4353, USA.
| | - Linkang Xu
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Yilin Tan
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Danqing Zhou
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Wenfang Ma
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Ziqi Xu
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Natalie A Chan
- Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK
| | - Cyrus Ho
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, 119228, Singapore
| |
Collapse
|
19
|
Facilitating communication for critically ill patients and their family members: Study protocol for two randomized trials implemented in the U.S. and France. Contemp Clin Trials 2021; 107:106465. [PMID: 34091062 DOI: 10.1016/j.cct.2021.106465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/14/2021] [Accepted: 05/31/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Critically-ill patients and their families suffer a high burden of psychological symptoms due, in part, to many transitions among clinicians and settings during and after critical illness, resulting in fragmented care. Communication facilitators may help. DESIGN AND INTERVENTION We are conducting two cluster-randomized trials, one in the U.S. and one in France, with the goal of evaluating a nurse facilitator trained to support, model, and teach communication strategies enabling patients and families to secure care consistent with patients' goals, beginning in ICU and continuing for 3 months. PARTICIPANTS We will randomize 376 critically-ill patients in the US and 400 in France to intervention or usual care. Eligible patients have a risk of hospital mortality of greater than15% or a chronic illness with a median survival of approximately 2 years or less. OUTCOMES We assess effectiveness with patient- and family-centered outcomes, including symptoms of depression, anxiety, and post-traumatic stress, as well as assessments of goal-concordant care, at 1-, 3-, and 6-months post-randomization. The primary outcome is family symptoms of depression over 6 months. We also evaluate whether the intervention improves value by reducing utilization while improving outcomes. Finally, we use mixed methods to explore implementation factors associated with implementation outcomes (acceptability, fidelity, acceptability, penetration) to inform dissemination. Conducting the trial in U.S. and France will provide insights into differences and similarities between countries. CONCLUSIONS We describe the design of two randomized trials of a communication facilitator for improving outcomes for critically ill patients and their families in two countries.
Collapse
|
20
|
Traumatic impact of the COVID-19 pandemic in an international sample: Contribution of fatalism to psychological distress and behavior change. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [PMID: 37521947 PMCID: PMC9767364 DOI: 10.1016/j.ejtd.2021.100219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to assess the traumatic impact of the COVID-19 outbreak and to explore the contribution of fatalism to a) psychological distress and b) pandemic-related behavior change. Data for the study were collected via an anonymous online survey. The survey included questions about demographic characteristics, health status, pandemic-related stress, impact of COVID-19 on health and behavior, posttraumatic stress symptoms (PTSS), and fatalism. The sample included 465 participants from 30 countries (mean age = 36.87, SD = 13.39, age range = 18 - 76; 80% female). While none of the study participants have been diagnosed with COVID-19, almost 25% knew someone who had received the diagnosis. The overwhelming majority (79%) had to make changes to their daily routine, and 48.82% of the sample reported moderate to severe PTSS. Fatalism was found to be a statistically significant predictor of PTSS in a multiple regression model and was also associated with lack of behavior changes in response to the pandemic. Our findings indicate that the COVID-19 pandemic is a traumatic event with a potential to affect mental health and well-being of individuals and communities. Fatalism may contribute to severity of psychological distress and diminish individuals' ability to engage in health-protective behaviors.
Collapse
|
21
|
Al‐Ma'seb HB, Al‐Sejari MM. Psychometric properties of the Illness Attitude Toward COVID-19 Scale (IATCS). ACTA ACUST UNITED AC 2021; 71:69-79. [PMID: 34230682 PMCID: PMC8250579 DOI: 10.1111/issj.12264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/05/2021] [Accepted: 01/25/2021] [Indexed: 01/12/2023]
Abstract
This study examines the psychometric properties of the Illness Attitude Toward COVID‐19 Scale (IATCS). The IATCS was tested on a sample of individuals who were living in Kuwait during the COVID‐19 pandemic (n = 1413). The reliability and validity of the scale were examined to assess the scale's internal consistency reliability, criterion validity, and factorial validity. The results of the study showed alpha values that were satisfactory for the overall scale and for five subscales. The findings support the criterion and factorial validity of the scale. The findings also support the use of the scale in surveys and for educational and trainings purposes.
Collapse
|
22
|
Wang C, Chudzicka-Czupała A, Tee ML, Núñez ML, Tripp C, Fardin MA, Habib HA, Tran BX, Adamus K, Anlacan J, García MEA, Grabowski D, Hussain S, Hoang MT, Hetnał M, Le XT, Ma W, Pham HQ, Reyes PWC, Shirazi M, Tan Y, Tee CA, Xu L, Xu Z, Vu GT, Zhou D, Chan NA, Kuruchittham V, McIntyre RS, Ho CSH, Ho R, Sears SF. A chain mediation model on COVID-19 symptoms and mental health outcomes in Americans, Asians and Europeans. Sci Rep 2021; 11:6481. [PMID: 33742072 PMCID: PMC7979938 DOI: 10.1038/s41598-021-85943-7] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/03/2021] [Indexed: 01/31/2023] Open
Abstract
The novel Coronavirus-2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020, impacting the lifestyles, economy, physical and mental health of individuals globally. This study aimed to test the model triggered by physical symptoms resembling COVID-19 infection, in which the need for health information and perceived impact of the pandemic mediated the path sequentially, leading to adverse mental health outcomes. A cross-sectional research design with chain mediation model involving 4612 participants from participating 8 countries selected via a respondent-driven sampling strategy was used. Participants completed online questionnaires on physical symptoms, the need for health information, the Impact of Event Scale-Revised (IES-R) questionnaire and Depression, Anxiety and Stress Scale (DASS-21). The results showed that Poland and the Philippines were the two countries with the highest levels of anxiety, depression and stress; conversely, Vietnam had the lowest mean scores in these areas. Chain mediation model showed the need for health information, and the perceived impact of the pandemic were sequential mediators between physical symptoms resembling COVID-19 infection (predictor) and consequent mental health status (outcome). Excessive and contradictory health information might increase the perceived impact of the pandemic. Rapid COVID-19 testing should be implemented to minimize the psychological burden associated with physical symptoms, whilst public mental health interventions could target adverse mental outcomes associated with the pandemic.
Collapse
Affiliation(s)
- Cuiyan Wang
- grid.440755.70000 0004 1793 4061Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Agata Chudzicka-Czupała
- grid.433893.60000 0001 2184 0541Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | - Michael L. Tee
- grid.11159.3d0000 0000 9650 2179University of the Philippines Manila, Manila, Philippines
| | - María Inmaculada López Núñez
- grid.4795.f0000 0001 2157 7667Department of Social, Work and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Somosaguas Campus, Madrid, Spain
| | - Connor Tripp
- grid.255364.30000 0001 2191 0423Department of Psychology, East Carolina University, Greenville, NC USA
| | - Mohammad A. Fardin
- Department of Psychology, Zahedan Branch, Islamic Azad University, Zahedan, Iran
| | - Hina A. Habib
- grid.266518.e0000 0001 0219 3705Institute of Clinical Psychology, University of Karachi, Karachi, Pakistan
| | - Bach X. Tran
- grid.56046.310000 0004 0642 8489Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000 Vietnam ,grid.21107.350000 0001 2171 9311Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205 USA
| | - Katarzyna Adamus
- grid.433893.60000 0001 2184 0541Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | - Joseph Anlacan
- grid.11159.3d0000 0000 9650 2179University of the Philippines Manila, Manila, Philippines
| | - Marta E. Aparicio García
- grid.4795.f0000 0001 2157 7667Department of Social, Work and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Somosaguas Campus, Madrid, Spain
| | - Damian Grabowski
- grid.433893.60000 0001 2184 0541Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | | | - Men T. Hoang
- grid.444918.40000 0004 1794 7022Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Mateusz Hetnał
- grid.433893.60000 0001 2184 0541Faculty of Psychology, SWPS University of Social Sciences and Humanities, Katowice, Poland
| | - Xuan T. Le
- grid.56046.310000 0004 0642 8489Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Wenfang Ma
- grid.440755.70000 0004 1793 4061Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Hai Q. Pham
- grid.444918.40000 0004 1794 7022Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Patrick Wincy C. Reyes
- grid.11159.3d0000 0000 9650 2179University of the Philippines Manila, Manila, Philippines
| | - Mahmoud Shirazi
- grid.412796.f0000 0004 0612 766XDepartment of Psychology, University of Sistan and Baluchestan, Zahedan, Iran
| | - Yilin Tan
- grid.440755.70000 0004 1793 4061Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Cherica A. Tee
- grid.11159.3d0000 0000 9650 2179University of the Philippines Manila, Manila, Philippines
| | - Linkang Xu
- grid.440755.70000 0004 1793 4061Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Ziqi Xu
- grid.440755.70000 0004 1793 4061Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Giang T. Vu
- grid.473736.20000 0004 4659 3737Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Danqing Zhou
- grid.440755.70000 0004 1793 4061Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Natalie A. Chan
- grid.11835.3e0000 0004 1936 9262Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, UK
| | - Vipat Kuruchittham
- Southeast Asia One Health University Network (SEAOHUN), Chiang Mai, Thailand
| | - Roger S. McIntyre
- grid.17063.330000 0001 2157 2938Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Cyrus S. H. Ho
- grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger Ho
- grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Samuel F. Sears
- grid.255364.30000 0001 2191 0423Department of Psychology, East Carolina University, Greenville, NC USA
| |
Collapse
|
23
|
Wang C, Tee M, Roy AE, Fardin MA, Srichokchatchawan W, Habib HA, Tran BX, Hussain S, Hoang MT, Le XT, Ma W, Pham HQ, Shirazi M, Taneepanichskul N, Tan Y, Tee C, Xu L, Xu Z, Vu GT, Zhou D, Koh BJ, McIntyre RS, Ho C, Ho RC, Kuruchittham V. The impact of COVID-19 pandemic on physical and mental health of Asians: A study of seven middle-income countries in Asia. PLoS One 2021; 16:e0246824. [PMID: 33571297 PMCID: PMC7877638 DOI: 10.1371/journal.pone.0246824] [Citation(s) in RCA: 229] [Impact Index Per Article: 76.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 01/27/2021] [Indexed: 01/02/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic has impacted the economy, livelihood, and physical and mental well-being of people worldwide. This study aimed to compare the mental health status during the pandemic in the general population of seven middle income countries (MICs) in Asia (China, Iran, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). All the countries used the Impact of Event Scale–Revised (IES-R) and Depression, Anxiety and Stress Scale (DASS-21) to measure mental health. There were 4479 Asians completed the questionnaire with demographic characteristics, physical symptoms and health service utilization, contact history, knowledge and concern, precautionary measure, and rated their mental health with the IES-R and DASS-21. Descriptive statistics, One-Way analysis of variance (ANOVA), and linear regression were used to identify protective and risk factors associated with mental health parameters. There were significant differences in IES-R and DASS-21 scores between 7 MICs (p<0.05). Thailand had all the highest scores of IES-R, DASS-21 stress, anxiety, and depression scores whereas Vietnam had all the lowest scores. The risk factors for adverse mental health during the COVID-19 pandemic include age <30 years, high education background, single and separated status, discrimination by other countries and contact with people with COVID-19 (p<0.05). The protective factors for mental health include male gender, staying with children or more than 6 people in the same household, employment, confidence in doctors, high perceived likelihood of survival, and spending less time on health information (p<0.05). This comparative study among 7 MICs enhanced the understanding of metal health in the general population during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Cuiyan Wang
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Michael Tee
- College of Medicine, University of the Philippines, Manila, Philippines
| | | | - Mohammad A. Fardin
- Department of Psychology, Zahedan Branch, Islamic Azad University, Zahedan, Iran
| | - Wandee Srichokchatchawan
- College of Public Health Sciences, Chulalongkorn University, a member of Thailand One Health University Network (THOHUN), Bangkok, Thailand
| | - Hina A. Habib
- Institute of Clinical Psychology, University of Karachi, Karachi, Pakistan
| | - Bach X. Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | | | - Men T. Hoang
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | - Xuan T. Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Wenfang Ma
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Hai Q. Pham
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Mahmoud Shirazi
- Department of Psychology, University of Sistan and Baluchestan, Zahedan, Iran
| | - Nutta Taneepanichskul
- College of Public Health Sciences, Chulalongkorn University, a member of Thailand One Health University Network (THOHUN), Bangkok, Thailand
| | - Yilin Tan
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Cherica Tee
- College of Medicine, University of the Philippines, Manila, Philippines
| | - Linkang Xu
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Ziqi Xu
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Giang T. Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Danqing Zhou
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Bernard J. Koh
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Cyrus Ho
- Department of Psychological Medicine, National University Health System, Singapore, Singapore
| | - Roger C. Ho
- Institute for Health Innovation and Technology (iHealthtech), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- * E-mail:
| | - Vipat Kuruchittham
- Southeast Asia One Health University Network (SEAOHUN), Chiang Mai, Thailand
| |
Collapse
|
24
|
Tee CA, Salido EO, Reyes PWC, Ho RC, Tee ML. Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus. Open Access Rheumatol 2020; 12:215-222. [PMID: 33061689 PMCID: PMC7520098 DOI: 10.2147/oarrr.s269889] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are perceived to be more vulnerable to worse COVID-19 infection outcome. Furthermore, severe shortage in hydroxychloroquine supply was experienced. OBJECTIVE We presented the psychological responses of Filipino SLE and RA patients to the COVID-19 pandemic and shortage of hydroxychloroquine supply. METHODS A total of 512 completed online surveys from SLE and RA patients were gathered from May 19 to 26, 2020. The online survey collected data on socio-demographics, health status, contact history, health service utilization, use of hydroxychloroquine, COVID-19 knowledge and concerns, precautionary measures, information needs, the validated Impact of Events Scale-Revised (IES-R) and Depression, Anxiety and Stress Scales (DASS-21) ratings. RESULTS The psychological impact of COVID-19 outbreak was at least moderate in 20%. The mean IES-R score was higher among SLE (22.34, SD=14.39) than RA (18.85, SD=13.24) patients. Stress, anxiety and depression were moderate to severe in 12.3%, 38.7%, and 27.7% of respondents. The mean stress subscale score was 10.11 (SD=7.95), mean anxiety subscale score was 6.79 (SD=6.57) and mean depression subscale score was 9.03 (SD=8.77). The risk factors for adverse mental health during the COVID-19 pandemic include the presence of comorbidity of hypertension and asthma; being a healthcare worker; and presence of specific symptoms of myalgia, cough, breathing difficulty, dizziness and sore throat. The protective factors for mental health during the pandemic include satisfaction with available health information and wearing of face masks. CONCLUSION In the third month of the pandemic in the Philippines, 20% of the respondents with lupus and RA experienced moderate to severe psychological impact. There was moderate to severe anxiety in 38.7% and moderate to severe depression in 27%. Identification of factors that affect mental health in lupus and RA is useful in implementation of effective psychological support strategies.
Collapse
Affiliation(s)
- Cherica A Tee
- Department of Pediatrics, College of Medicine, University of the Philippines, Manila, Philippines
| | - Evelyn O Salido
- Department of Medicine, College of Medicine, University of the Philippines, Manila, Philippines
| | - Patrick Wincy C Reyes
- School of Statistics, University of the Philippines Diliman, Quezon City, Philippines
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Kent Ridge, Singapore
| | - Michael L Tee
- Department of Physiology, College of Medicine, University of the Philippines, Manila, Philippines
| |
Collapse
|
25
|
Jackson JL, Fox KR, Kovacs AH. Psychological Needs, Assessment, and Treatment in the Care of Adults with Congenital Heart Disease. Cardiol Clin 2020; 38:305-316. [PMID: 32622486 DOI: 10.1016/j.ccl.2020.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although the majority of congenital heart disease survivors are thriving, many are at risk for declining emotional well-being as they age. Emotional distress is a risk factor for poorer health outcomes and must be addressed. Primary care and cardiology teams may be the first line of defense in identifying and providing referral resources for symptoms of depression, anxiety, and medical trauma. The current review provides information about commonly used self-report measures of emotional distress to identify symptoms that warrant referral and describes multiple options for addressing these symptoms.
Collapse
Affiliation(s)
- Jamie L Jackson
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, NEOB, 3rd Floor, Columbus, OH 43205, USA.
| | - Kristen R Fox
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, NEOB, 3rd Floor, Columbus, OH 43205, USA
| | - Adrienne H Kovacs
- Oregon Health and Science University, Knight Cardiovascular Institute, 3181 Southwest Sam Jackson Park Road, UHN-62, Portland, OR 97239, USA
| |
Collapse
|
26
|
Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, Choo FN, Tran B, Ho R, Sharma VK, Ho C. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav Immun 2020; 87:40-48. [PMID: 32298802 PMCID: PMC7153528 DOI: 10.1016/j.bbi.2020.04.028] [Citation(s) in RCA: 1529] [Impact Index Per Article: 382.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 02/07/2023] Open
Abstract
In addition to being a public physical health emergency, Coronavirus disease 2019 (COVID-19) affected global mental health, as evidenced by panic-buying worldwide as cases soared. Little is known about changes in levels of psychological impact, stress, anxiety and depression during this pandemic. This longitudinal study surveyed the general population twice - during the initial outbreak, and the epidemic's peak four weeks later, surveying demographics, symptoms, knowledge, concerns, and precautionary measures against COVID-19. There were 1738 respondents from 190 Chinese cities (1210 first-survey respondents, 861 s-survey respondents; 333 respondents participated in both). Psychological impact and mental health status were assessed by the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21), respectively. IES-R measures PTSD symptoms in survivorship after an event. DASS -21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. This study found that there was a statistically significant longitudinal reduction in mean IES-R scores (from 32.98 to 30.76, p < 0.01) after 4 weeks. Nevertheless, the mean IES-R score of the first- and second-survey respondents were above the cut-off scores (>24) for PTSD symptoms, suggesting that the reduction in scores was not clinically significant. During the initial evaluation, moderate-to-severe stress, anxiety and depression were noted in 8.1%, 28.8% and 16.5%, respectively and there were no significant longitudinal changes in stress, anxiety and depression levels (p > 0.05). Protective factors included high level of confidence in doctors, perceived survival likelihood and low risk of contracting COVID-19, satisfaction with health information, personal precautionary measures. As countries around the world brace for an escalation in cases, Governments should focus on effective methods of disseminating unbiased COVID-19 knowledge, teaching correct containment methods, ensuring availability of essential services/commodities, and providing sufficient financial support.
Collapse
Affiliation(s)
- Cuiyan Wang
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Riyu Pan
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Xiaoyang Wan
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Yilin Tan
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Linkang Xu
- Institute of Cognitive Neuroscience, Faculty of Education, Huaibei Normal University, Huaibei, China
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Canada
| | - Faith N Choo
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Bach Tran
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States; Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119228, Singapore.
| | - Vijay K Sharma
- Division of Neurology, Department of Medicine, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cyrus Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Health System, Singapore
| |
Collapse
|