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Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?

BACKGROUND: Coronavirus Disease-19 (COVID-19) convalescents are at risk of developing a de novo mental health disorder or worsening of a pre-existing one. COVID-19 outpatients have been less well characterized than their hospitalized counterparts. The objectives of our study were to identify indicat...

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Autores principales: Hüfner, Katharina, Tymoszuk, Piotr, Ausserhofer, Dietmar, Sahanic, Sabina, Pizzini, Alex, Rass, Verena, Galffy, Matyas, Böhm, Anna, Kurz, Katharina, Sonnweber, Thomas, Tancevski, Ivan, Kiechl, Stefan, Huber, Andreas, Plagg, Barbara, Wiedermann, Christian J., Bellmann-Weiler, Rosa, Bachler, Herbert, Weiss, Günter, Piccoliori, Giuliano, Helbok, Raimund, Loeffler-Ragg, Judith, Sperner-Unterweger, Barbara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964263/
https://www.ncbi.nlm.nih.gov/pubmed/35360744
http://dx.doi.org/10.3389/fmed.2022.792881
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author Hüfner, Katharina
Tymoszuk, Piotr
Ausserhofer, Dietmar
Sahanic, Sabina
Pizzini, Alex
Rass, Verena
Galffy, Matyas
Böhm, Anna
Kurz, Katharina
Sonnweber, Thomas
Tancevski, Ivan
Kiechl, Stefan
Huber, Andreas
Plagg, Barbara
Wiedermann, Christian J.
Bellmann-Weiler, Rosa
Bachler, Herbert
Weiss, Günter
Piccoliori, Giuliano
Helbok, Raimund
Loeffler-Ragg, Judith
Sperner-Unterweger, Barbara
author_facet Hüfner, Katharina
Tymoszuk, Piotr
Ausserhofer, Dietmar
Sahanic, Sabina
Pizzini, Alex
Rass, Verena
Galffy, Matyas
Böhm, Anna
Kurz, Katharina
Sonnweber, Thomas
Tancevski, Ivan
Kiechl, Stefan
Huber, Andreas
Plagg, Barbara
Wiedermann, Christian J.
Bellmann-Weiler, Rosa
Bachler, Herbert
Weiss, Günter
Piccoliori, Giuliano
Helbok, Raimund
Loeffler-Ragg, Judith
Sperner-Unterweger, Barbara
author_sort Hüfner, Katharina
collection PubMed
description BACKGROUND: Coronavirus Disease-19 (COVID-19) convalescents are at risk of developing a de novo mental health disorder or worsening of a pre-existing one. COVID-19 outpatients have been less well characterized than their hospitalized counterparts. The objectives of our study were to identify indicators for poor mental health following COVID-19 outpatient management and to identify high-risk individuals. METHODS: We conducted a binational online survey study with adult non-hospitalized COVID-19 convalescents (Austria/AT: n = 1,157, Italy/IT: n = 893). Primary endpoints were positive screening for depression and anxiety (Patient Health Questionnaire; PHQ-4) and self-perceived overall mental health (OMH) and quality of life (QoL) rated with 4 point Likert scales. Psychosocial stress was surveyed with a modified PHQ stress module. Associations of the mental health and QoL with socio-demographic, COVID-19 course, and recovery variables were assessed by multi-parameter Random Forest and Poisson modeling. Mental health risk subsets were defined by self-organizing maps (SOMs) and hierarchical clustering algorithms. The survey analyses are publicly available (https://im2-ibk.shinyapps.io/mental_health_dashboard/). RESULTS: Depression and/or anxiety before infection was reported by 4.6% (IT)/6% (AT) of participants. At a median of 79 days (AT)/96 days (IT) post-COVID-19 onset, 12.4% (AT)/19.3% (IT) of subjects were screened positive for anxiety and 17.3% (AT)/23.2% (IT) for depression. Over one-fifth of the respondents rated their OMH (AT: 21.8%, IT: 24.1%) or QoL (AT: 20.3%, IT: 25.9%) as fair or poor. Psychosocial stress, physical performance loss, high numbers of acute and sub-acute COVID-19 complaints, and the presence of acute and sub-acute neurocognitive symptoms (impaired concentration, confusion, and forgetfulness) were the strongest correlates of deteriorating mental health and poor QoL. In clustering analysis, these variables defined subsets with a particularly high propensity of post-COVID-19 mental health impairment and decreased QoL. Pre-existing depression or anxiety (DA) was associated with an increased symptom burden during acute COVID-19 and recovery. CONCLUSION: Our study revealed a bidirectional relationship between COVID-19 symptoms and mental health. We put forward specific acute symptoms of the disease as “red flags” of mental health deterioration, which should prompt general practitioners to identify non-hospitalized COVID-19 patients who may benefit from early psychological and psychiatric intervention. CLINICAL TRIAL REGISTRATION: [ClinicalTrials.gov], identifier [NCT04661462].
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spelling pubmed-89642632022-03-30 Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management? Hüfner, Katharina Tymoszuk, Piotr Ausserhofer, Dietmar Sahanic, Sabina Pizzini, Alex Rass, Verena Galffy, Matyas Böhm, Anna Kurz, Katharina Sonnweber, Thomas Tancevski, Ivan Kiechl, Stefan Huber, Andreas Plagg, Barbara Wiedermann, Christian J. Bellmann-Weiler, Rosa Bachler, Herbert Weiss, Günter Piccoliori, Giuliano Helbok, Raimund Loeffler-Ragg, Judith Sperner-Unterweger, Barbara Front Med (Lausanne) Medicine BACKGROUND: Coronavirus Disease-19 (COVID-19) convalescents are at risk of developing a de novo mental health disorder or worsening of a pre-existing one. COVID-19 outpatients have been less well characterized than their hospitalized counterparts. The objectives of our study were to identify indicators for poor mental health following COVID-19 outpatient management and to identify high-risk individuals. METHODS: We conducted a binational online survey study with adult non-hospitalized COVID-19 convalescents (Austria/AT: n = 1,157, Italy/IT: n = 893). Primary endpoints were positive screening for depression and anxiety (Patient Health Questionnaire; PHQ-4) and self-perceived overall mental health (OMH) and quality of life (QoL) rated with 4 point Likert scales. Psychosocial stress was surveyed with a modified PHQ stress module. Associations of the mental health and QoL with socio-demographic, COVID-19 course, and recovery variables were assessed by multi-parameter Random Forest and Poisson modeling. Mental health risk subsets were defined by self-organizing maps (SOMs) and hierarchical clustering algorithms. The survey analyses are publicly available (https://im2-ibk.shinyapps.io/mental_health_dashboard/). RESULTS: Depression and/or anxiety before infection was reported by 4.6% (IT)/6% (AT) of participants. At a median of 79 days (AT)/96 days (IT) post-COVID-19 onset, 12.4% (AT)/19.3% (IT) of subjects were screened positive for anxiety and 17.3% (AT)/23.2% (IT) for depression. Over one-fifth of the respondents rated their OMH (AT: 21.8%, IT: 24.1%) or QoL (AT: 20.3%, IT: 25.9%) as fair or poor. Psychosocial stress, physical performance loss, high numbers of acute and sub-acute COVID-19 complaints, and the presence of acute and sub-acute neurocognitive symptoms (impaired concentration, confusion, and forgetfulness) were the strongest correlates of deteriorating mental health and poor QoL. In clustering analysis, these variables defined subsets with a particularly high propensity of post-COVID-19 mental health impairment and decreased QoL. Pre-existing depression or anxiety (DA) was associated with an increased symptom burden during acute COVID-19 and recovery. CONCLUSION: Our study revealed a bidirectional relationship between COVID-19 symptoms and mental health. We put forward specific acute symptoms of the disease as “red flags” of mental health deterioration, which should prompt general practitioners to identify non-hospitalized COVID-19 patients who may benefit from early psychological and psychiatric intervention. CLINICAL TRIAL REGISTRATION: [ClinicalTrials.gov], identifier [NCT04661462]. Frontiers Media S.A. 2022-03-14 /pmc/articles/PMC8964263/ /pubmed/35360744 http://dx.doi.org/10.3389/fmed.2022.792881 Text en Copyright © 2022 Hüfner, Tymoszuk, Ausserhofer, Sahanic, Pizzini, Rass, Galffy, Böhm, Kurz, Sonnweber, Tancevski, Kiechl, Huber, Plagg, Wiedermann, Bellmann-Weiler, Bachler, Weiss, Piccoliori, Helbok, Loeffler-Ragg and Sperner-Unterweger. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Hüfner, Katharina
Tymoszuk, Piotr
Ausserhofer, Dietmar
Sahanic, Sabina
Pizzini, Alex
Rass, Verena
Galffy, Matyas
Böhm, Anna
Kurz, Katharina
Sonnweber, Thomas
Tancevski, Ivan
Kiechl, Stefan
Huber, Andreas
Plagg, Barbara
Wiedermann, Christian J.
Bellmann-Weiler, Rosa
Bachler, Herbert
Weiss, Günter
Piccoliori, Giuliano
Helbok, Raimund
Loeffler-Ragg, Judith
Sperner-Unterweger, Barbara
Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?
title Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?
title_full Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?
title_fullStr Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?
title_full_unstemmed Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?
title_short Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?
title_sort who is at risk of poor mental health following coronavirus disease-19 outpatient management?
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964263/
https://www.ncbi.nlm.nih.gov/pubmed/35360744
http://dx.doi.org/10.3389/fmed.2022.792881
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