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Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study.

Authors :
Guo, Qian
Zheng, Yuchen
Shi, Jia
Wang, Jijun
Li, Guanjun
Li, Chunbo
Fromson, John A.
Xu, Yong
Liu, Xiaohua
Xu, Hua
Zhang, Tianhong
Lu, Yunfei
Chen, Xiaorong
Hu, Hao
Tang, Yingying
Yang, Shuwen
Zhou, Han
Wang, Xiaoliang
Chen, Haiying
Wang, Zhen
Source :
Brain, Behavior & Immunity. Aug2020, Vol. 88, p17-27. 11p.
Publication Year :
2020

Abstract

• Considerable portion of COVID-19 patients presented depression and anxiety symptoms. • CRP levels correlated with the scores of PHQ-9 in patients with depression features. • The more improvement of CRP level resulted in lower level of depression. • Stigma and uncertainty of the disease were two main concerns among COVID-19 patients. Since the end of 2019, Corona Virus Disease 2019 (COVID-19) has been the cause of a worldwide pandemic. The mental status of patients with COVID-19 who have been quarantined and the interactions between their psychological distress and physiological levels of inflammation have yet to be analyzed. Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. The severity of depression, anxiety, and post-traumatic stress symptoms (PTSS) was measured via an on-line survey. Using a convenience sampling technique, qualitative data were collected until the point of data saturation. In addition, a semi-structured interview was conducted among five patients with COVID-19. Peripheral inflammatory markers were also collected in patients, both at baseline and within ± three days of completing the on-line survey. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). A gender effect was observed in the score of "Perceived Helplessness", the subscale of PSS-10, with female patients showing higher scores compared to male patients (Z = 2.56, P = 0.010), female (Z = 2.37, P = 0.018) and male controls (Z = 2.87, P = 0.004). Levels of CRP, a peripheral inflammatory indicator, correlated positively with the PHQ-9 total score (R = 0.37, P = 0.003, Spearman's correlation) of patients who presented symptoms of depression. Moreover, the change of CRP level from baseline inversely correlated with the PHQ-9 total score (R = -0.31, P = 0.002), indicative of improvement of depression symptoms. Qualitative analysis revealed similar results with respect to patient reports of negative feelings, including fear, guilt, and helplessness. Stigma and uncertainty of viral disease progression were two main concerns expressed by COVID-19 patients. Our results indicate that significant psychological distress was experienced by hospitalized COVID-19 patients and that levels of depressive features may be related to the inflammation markers in these patients. Thus, we recommend that necessary measures should be provided to address depression and other psychiatric symptoms for COVID-19 patients and attention should be paid to patient perceived stigma and coping strategies when delivering psychological interventions. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
08891591
Volume :
88
Database :
Academic Search Index
Journal :
Brain, Behavior & Immunity
Publication Type :
Academic Journal
Accession number :
144802450
Full Text :
https://doi.org/10.1016/j.bbi.2020.05.038