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. 2022 Jul 25;13(1):2095133.
doi: 10.1080/20008198.2022.2095133. eCollection 2022.

Recovering from COVID-19: psychological sequelae and post-traumatic growth six months after discharge

Federica Bonazza  1 , Chiara Luridiana Battistini  2 , Giulia Fior  3 , Emilio Bergamelli  3 , Federico Wiedenmann  3 , Armando D'Agostino  3 , Giuseppe Francesco Sferrazza Papa  4 , Lidia Borghi  1 , Kyrie Piscopo  2 , Elena Vegni  1   2 , Giulia Lamiani  1
Affiliations

Recovering from COVID-19: psychological sequelae and post-traumatic growth six months after discharge

Federica Bonazza et al. Eur J Psychotraumatol. .

Abstract
in English, Spanish, Chinese

Background: Clinical and scientific evidence has shown that a range of long-lasting symptoms can persist in the post-virological period. However, little is known about the psychological sequelae of patients hospitalized for coronavirus disease 2019 (COVID-19). Objective: This study aims to assess the prevalence of anxiety-depressive symptoms, post-traumatic stress disorder (PTSD), and post-traumatic growth among patients hospitalized for COVID-19 during the first wave of the pandemic 6 months after discharge, and to identify sociodemographic and clinical factors associated with psychological outcomes. Method: This cross-sectional cohort study enrolled recovered COVID-19 patients during a multidisciplinary follow-up screening. At 6 months post-discharge, participants underwent a remote assessment with the Mini-International Neuropsychiatric Interview Plus and completed the Hospital Anxiety and Depression Scale, PTSD Checklist for DSM-5, and Post-Traumatic Growth Inventory. Descriptive and regression analyses were conducted. Results: The sample was composed of 100 patients, mainly males (72%), with a mean ± SD age of 58.7 ± 11.8 years. Regarding psychological symptoms, 34% and 24% of patients, respectively, reported anxiety and depression over the clinical threshold, and 20% met the criteria for a possible PTSD diagnosis. Psychological symptoms were associated with the presence of a mood disorder in the patient's clinical history and having received a psychological consultation after discharge. Post-traumatic growth was associated with younger age and having received a psychological consultation after discharge. Conclusions: A high prevalence of anxiety and depressive symptoms, potentially indicative for a mood or anxiety disorder, and PTSD was confirmed among COVID-19 survivors after 6 months. Anxiety and depressive symptoms and PTSD were associated with a previous diagnosis of a mood disorder and having received psychological consultation. Post-traumatic growth was associated with younger age and having received psychological consultation. Tailored psychological interventions could help to elaborate the psychological suffering and foster post-traumatic growth after a traumatic experience such as COVID-19 hospitalization.

Highlights: A high prevalence of psychological symptoms has been observed among COVID-19 survivors 6 months after hospitalization.Tailored psychological interventions could help to contain the psychological sequelae and facilitate post-traumatic growth.

Antecedentes: La evidencia clínica y científica reciente ha demostrado que una variedad de síntomas duraderos pueden persistir incluso en el periodo post-virológico. Sin embargo, poco se sabe sobre las secuelas psicológicas de los pacientes hospitalizados por COVID-19.Objetivo: Este estudio tiene como objetivo evaluar la prevalencia de síntomas ansioso-depresivos, Trastorno de Estrés Postraumático (TEPT) y crecimiento postraumático entre pacientes hospitalizados por COVID-19 durante la primera ola de pandemia seis meses después del alta e identificar los factores socio-demográficos y clínicos asociados con los resultados psicológicos.Método: Este estudio de cohorte transversal inscribió a pacientes recuperados de COVID-19 durante un tamizaje de seguimiento multidisciplinario. A los seis meses del alta, los participantes se sometieron a una evaluación remota con la Entrevista Neuropsiquiátrica Internacional Mini Plus y completaron la Escala de Depresión y Ansiedad Hospitalaria, la Lista de chequeo-5 para Trastorno de Estrés Postraumático y el Inventario de Crecimiento Postraumático. Se condujeron análisis de regresión y descriptivos.Resultados: La muestra se compuso de 100 pacientes, principalmente varones (72%), con una edad promedio de 58.7 años (DE=11.8). En cuanto a los síntomas psicológicos, 34% y 24% de los pacientes reportaron ansiedad y depresión por encima del umbral clínico y 20% reunía los criterios para un posible diagnóstico de TEPT. Los síntomas psicológicos se asociaron con la presencia de un trastorno del ánimo en la historia clínica del paciente y el haber recibido una consulta psicológica tras el alta. El crecimiento postraumático se asoció con ser más joven y haber recibido una consulta psicológica tras el alta.`Conclusiones: Se confirmó una alta prevalencia de síntomas ansiosos y depresivos, potencialmente indicativo de un trastorno del estado de ánimo y TEPT entre los sobrevivientes al COVID-19 después de seis meses. Los síntomas ansiosos y depresivos y el TEPT se asociaron con un diagnóstico previo de un trastorno del ánimo y haber recibido consulta psicológica. Se encontró que el crecimiento postraumático se asociaba con ser más joven y haber recibido consulta psicológica. Las intervenciones psicológicas “a la medida” podrían ayudar a elaborar el sufrimiento psicológico y fomentar el crecimiento postraumático tras una experiencia traumática como la hospitalización por COVID-19.

背景：最近的临床和科学证据表明，即使在病毒学后时期，一系列长期症状也会持续存在。然而，对于 COVID-19 住院患者的心理后遗症知之甚少。目的：本研究旨在评估出院后第一次疫情期间因 COVID-19 住院患者的焦虑抑郁症状、创伤后应激障碍 (PTSD) 和创伤后成长的流行率，并确定与心理结果相关的社会人口统计学和临床因素。方法：这项横断面队列研究在多学科随访筛查期间招募了康复的 COVID-19 患者。在出院后六个月，参与者接受了迷你国际神经精神病学访谈增订版的远程评估，并完成了医院焦虑和抑郁量表、创伤后应激障碍清单 5 和创伤后成长清单。进行了描述性和回归分析。结果：样本由100名患者组成，以男性为主（72%），平均年龄58.7岁（SD=11.8）。关于心理症状，34% 和 24% 的患者报告焦虑和抑郁超过临床阈值，20% 符合可能的 PTSD 诊断标准。心理症状与患者临床病史中存在情绪障碍有关，并在出院后接受了心理咨询。创伤后成长与年龄较小有关，并且在出院后接受了心理咨询。结论：在六个月后的 COVID-19 幸存者中，焦虑和抑郁症状的高发率，可能预示着情绪或焦虑障碍，也确认了 PTSD。焦虑和抑郁症状以及 PTSD 与先前诊断为情绪障碍并接受过心理咨询有关。发现创伤后成长与年龄较小和接受过心理咨询有关。量身定制的心理干预有助于在如 COVID-19 住院等创伤经历后阐释心理痛苦并促进创伤后成长。.

Keywords: COVID-19; Post-COVID syndrome; anxiety; depression; post-traumatic growth; post-traumatic stress disorder.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

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