key: cord-0919948-k1klfa1v
authors: Benzakour, L.; Braillard, O.; Mazzola, V.; Gex, D.; Nehme, M.; Perone, S. Aebischer; Agoritsas, T.; Kopp, G.; Cereghetti, S.; Bondolfi, G.; Lador, F.
title: P.0805 Impact of peritraumatic dissociation in hospitalized patients with COVID-19 pneumonia: a longitudinal study
date: 2021-12-30
journal: Eur Neuropsychopharmacol
DOI: 10.1016/j.euroneuro.2021.10.666
sha: 18e64f0262d48ed1111f87383454ce9002285e33
doc_id: 919948
cord_uid: k1klfa1v

Background: Psychiatric impact of COVID-19 is still explored and previous data suggest potential long-term risks of anxiety, depression and PTSD related to COVID-19 1,2,3. We aimed to explore the predictive value of risk factors during hospitalization for COVID-19 for anxiety, depression and PTSD and at three months because they could differ over these two time points. Methods: We performed a screening of mental suffering in hospitalized patients for COVID-19, as well as specialized care and three months longitudinal follow-up. We evaluated the prevalence of anxiety, depression and PTSD in survivors who benefited from early detection and treatment, during hospitalization for COVID-19 (T0) and three months after (T1) and assessed possible risk factors in adults surviving COVID-19 between the 30th March and the 1st of July 2020. Univariate and multivariate regressive linear model have been built to assess the factors associated with the post-traumatic stress disorder scale 5 (PCL5) and Hospital Anxiety and Depression Scale (HADS) at T0, and T1. For the univariate model of HADS and post-traumatic stress disorder scale 5 (PCL5) at T1, we also included HADS and PCL5 at T0. We used STATA 15 for the statistical analyses. Results: A total of 364 patients were hospitalized between the 30th of March and 1st of July 2020 and of these, 109 patients were screened at T0 and 61 of these were reassessed at T1. During hospitalization, we found 44.9% pathological score on PDEQ, 14.6% with a score of PCL5 > 31 and three months after hospitalization, 10.6% of PCL5 score >31. Finally, PDEQ score at T0 was positively correlated to PCL5 score at T1 (β=0.26, p=0.01) and that was confirmed in multivariate analysis (β=0.04, p=0.02 for the log of PCL5 per point on the PDEQ). Female gender was associated with higher HADS-Depression score during hospitalization in both univariate and multivariate regression models (β=0.58 for the log of HADS-D, p=0.019, data not shown, available upon request). Age ≥ 65 years old was associated with lower HADS-Depression at T0 (p=0.027) only in the univariate analysis. Psychiatric follow-up recorded at 1 month following hospitalization was associated with higher HADS-Anxiety score at T1 (β=0.52, p=0.028) only in the multivariate analysis. In univariate analysis, PDEQ, HADS-Anxiety, HADS-Depression and PCL5 scores during hospitalization were correlated with PCL5 score at T1. Patients requiring an ICU stay, compared to those who did not, had significantly higher PDEQ score during hospitalization (24.1 versus 15.6, p = 0.0014), but a lower HADS-A score three months after hospitalization (5.3 vs 2.3, p=0.01) and a lower HADS-D score at T0 (5.4 vs 2.6, p=0.01). In the multivariate analysis using the log of the outcomes, ICU stay was associated with a lower PCL5 at T1 (β=-1.24, p=0.012), a lower HADS-A at T1 (β=-0.77, p=0.019), and lower HADS-D at T0 (β=-1.03, p=0.004), and T1 (β-1.06, p=0.023). Conclusion: Screening of psychiatric symptoms during hospitalization for COVID-19 should be systematic, especially peritraumatic dissociation to offer an early treatment and prevent PTSD, which seemed frequent for hospitalized patients for COVID-19 at three months. No conflict of interest

European Neuropsychopharmacology 53 (2021) S585-S672 els) and right posterior insula (MNI X/Y/Z = 40,0,-16; SDM-Z = -2.147, p = 0.023, 3 voxels). Final findings and metaregressions will be presented in October 2021. Conclusions: Our preliminary results show that psychotherapy for PTSD leads to decreased activation in the putamen/pallidum and posterior insula, areas related to emotion processing, interoception, and behavior selection. These findings may lead to a better understanding of how psychotherapy works for PTSD. Background: Psychiatric impact of COVID-19 is still explored and previous data suggest potential long-term risks of anxiety, depression and PTSD related to COVID-19 1 , 2 , 3 . We aimed to explore the predictive value of risk factors during hospitalization for COVID-19 for anxiety, depression and PTSD and at three months because they could differ over these two time points. Methods: We performed a screening of mental suffering in hospitalized patients for COVID-19, as well as specialized care and three months longitudinal follow-up. We evaluated the prevalence of anxiety, depression and PTSD in survivors who benefited from early detection and treatment, during hospitalization for COVID-19 (T0) and three months after (T1) and assessed possible risk factors in adults surviving COVID-19 between the 30th March and the 1st of July 2020. Univariate and multivariate regressive linear model have been built to assess the factors associated with the post-traumatic stress disorder scale 5 (PCL5) and Hospital Anxiety and Depression Scale (HADS) at T0, and T1. For the univariate model of HADS and post-traumatic stress disorder scale 5 (PCL5) at T1, we also included HADS and PCL5 at T0. We used STATA 15 for the statistical analyses. Results: A total of 364 patients were hospitalized between the 30th of March and 1st of July 2020 and of these, 109 patients were screened at T0 and 61 of these were reassessed at T1. During hospitalization, we found 44.9% pathological score on PDEQ, 14.6% with a score of PCL5 > 31 and three months after hospitalization, 10.6% of PCL5 score > 31. Finally, PDEQ score at T0 was positively correlated to PCL5 score at T1 ( β= 0.26, p = 0.01) and that was confirmed in multivariate analysis ( β= 0.04, p = 0.02 for the log of PCL5 per point on the PDEQ). Female gender was associated with higher HADS-Depression score during hospitalization in both univariate and multivariate regression models ( β= 0.58 for the log of HADS-D, p = 0.019, data not shown, available upon request). Age ≥ 65 years old was associated with lower HADS-Depression at T0 (p = 0.027) only in the univariate analysis. Psychiatric follow-up recorded at 1 month following hospitalization was associated with higher HADS-Anxiety score at T1 ( β= 0.52, p = 0.028) only in the multivariate analysis. In univariate analysis, PDEQ, HADS-Anxiety, HADS-Depression and PCL5 scores during hospitalization were correlated with PCL5 score at T1. Patients requiring an ICU stay, compared to those who did not, had significantly higher PDEQ score during hospitalization (24.1 versus 15.6, p = 0.0014), but a lower HADS-A score three months after hospitalization (5.3 vs 2.3, p = 0.01) and a lower HADS-D score at T0 (5.4 vs 2.6, p = 0.01). In the multivariate analysis using the log of the outcomes, ICU stay was associated with a lower PCL5 at T1 ( β= -1.24, p = 0.012), a lower HADS-A at T1 ( β= -0.77, p = 0.019), and lower HADS-D at T0 ( β= -1.03, p = 0.004), and T1 ( β-1.06, p = 0.023). Conclusion: Screening of psychiatric symptoms during hospitalization for COVID-19 should be systematic, especially peritraumatic dissociation to offer an early treatment and prevent PTSD, which seemed frequent for hospitalized patients for COVID-19 at three months. 

COVID-19 pandemic and mental health consequences: Systematic review of the current evidence

Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors

Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet Psychiatry