Is COVID-19 Associated With Posttraumatic Stress Disorder?

OBJECTIVE: To assess the prevalence of and risk factors for posttraumatic stress disorder (PTSD) in patients with COVID-19. METHODS: We conducted a cohort study between March and May 2020 at the Lille University Hospital (France), including all patients with laboratory-confirmed COVID-19. Psychological distress symptoms were measured 3 weeks after onset of COVID-19 symptoms using the Impact of Event Scale-6 items (IES-6). The evaluation of PTSD symptoms using the PTSD Checklist for DSM-5 (PCL-5) took place 1 month later. Bivariate analyses were performed to analyze the relationship between PCL-5 scores and the demographic and health variables. The significant variables were then introduced into a multivariable linear regression analysis to establish their relative contributions to the severity of PTSD symptoms. RESULTS: 180 patients were included in this study, and 138 patients completed the 2 evaluations. Among the 180 patients, 70.4% patients required hospitalization, and 30.7% were admitted to the intensive care unit. The prevalence of PTSD was 6.5%, and the predictive factors of PTSD included psychological distress at the onset of the illness and a stay in an intensive care unit. CONCLUSIONS: The prevalence of PTSD in patients with COVID-19 is not as high as that reported among patients during previous epidemics. Initial psychological responses were predictive of a PTSD diagnosis, even though most patients showing acute psychological distress (33.5% of the sample) improved in the following weeks. PTSD symptoms also increased following a stay in an intensive care unit. Future studies should assess the long-term consequences of COVID-19 on patients' mental health.

Persistent physical symptoms after COVID-19 infection and the risk of Somatic Symptom Disorder.

OBJECTIVE: Evidence shows that many patients with COVID-19 present persistent symptoms after the acute infection. Some patients may be at a high risk of developing Somatic Symptom Disorder (SSD), in which persistent symptoms are accompanied by excessive and disproportionate health-related thoughts, feelings and behaviors regarding these symptoms. This study assessed the frequency of persistent physical symptoms and SSD and their associated factors in patients with confirmed COVID-19. METHODS: We conducted a longitudinal retrospective study after the first two French lockdowns at the Lille University Hospital (France), including all patients with confirmed COVID-19. Persistent physical symptoms and excessive preoccupations for these symptoms were measured 8 to 10 months after the onset of COVID-19. The combination of the Patient Health Questionnaire-15 and the Somatic Symptom Disorder-B Criteria Scale was used to identify the individuals likely to present with SSD. Two linear regression models were performed to identify sociodemographic and medical risk factors of SSD. RESULTS: Among the 377 patients with a laboratory-confirmed diagnosis, 220 (58.4%) completed the questionnaires. Sixty-five percent of the 220 included patients required hospitalization, 53.6% presented at least one persistent physical symptom and 10.4% were considered to present SSD. Female sex, older age, infection during the second wave and having probable PTSD were significantly associated with the severity of SSD and SSD was associated with a significantly higher healthcare use. CONCLUSIONS: The identification of SSD should encourage clinicians to move beyond the artificial somatic/psychiatric dualism and contribute to a better alliance based on multi-disciplinary care.

Mental health among medical, healthcare, and other university students during the first COVID-19 lockdown in France.

Background The COVID-19 pandemic has raised concerns regarding its psychological effect on university students, especially healthcare students. We aimed at assessing the risk of mental health problems according to the type of university studies, by adjusting for potential confounders. Methods We used data from the COSAMe study, a national cross-sectional survey including 69,054 French university students during the first quarantine. The mental health outcomes evaluated were suicidal thoughts, severe self-reported distress (as assessed by the Impact of Events Scale-Revised), stress (Perceived Stress Scale), anxiety (State-Trait Anxiety Inventory, State subscale), and depression (Beck Depression Inventory). Multivariable logistic regression analyzes were performed to test the association between the type of university studies (healthcare studies: medical and non-medical, and non-healthcare studies) and poor mental health outcomes, adjusted for sociodemographic characteristics, precariousness indicators, health-related data, quality of social relationships, and data about media consumption. Results Compared to non-healthcare students (N = 59,404), non-medical healthcare (N = 5,431) and medical students (N = 4,193) showed a lower risk of presenting at least one poor mental health outcome (adjusted OR [95%CI] = 0.86[0.81-0.92] and 0.87[0.81-0.93], respectively). Compared to non-healthcare students, medical students were at lower risk of suicidal thoughts (0.83[0.74-0.93]), severe self-reported distress (0.75[0.69-0.82]) and depression (0.83[0.75-0.92]). Non-medical healthcare students were at lower risk of severe selfreported distress (0.79[0.73-0.85]), stress (0.92[0.85-0.98]), depression (0.83[0.76-0.91]), and anxiety (0.86[0.80-0.92]). Limitations This is a large but not representative cross-sectional study, limited to the first confinement. Conclusions Being a healthcare student is a protective factor for mental health problems among confined students. Mediating factors still need to be explored.

Conseils d’experts du sommeil pour bien dormer et garder le rythme chez les adultes et les enfants en cette période de confinement liée au CoVid-19

Résumé A la fois le confinement lié au virus Covid-19 et le stress induit par la pandémie peuvent entraîner des perturbations importantes des rythmes et du sommeil. Des experts du sommeil de la section Sommeil et rythmes biologiques en Psychiatrie (SoPsy) de l’Association Française de Psychiatrie Biologique et de Neuropsychopharmacologie (AFPBN) et de la Société Française de Recherche et Médecine du Sommeil (SFRMS), en partenariat avec le Réseau Morphée et l’Institut National du Sommeil et de la Vigilance (INSV), proposent ici des conseils pour bien dormir et garder ses rythmes. Des recommandations spécifiques sont adressées d’une part aux adultes et d’autre part aux parents pour leurs enfants. Les personnes avec un trouble de l’humeur (dépression, trouble bipolaire, etc) doivent particulièrement prêter attention et conserver des routines durant cette période afin de maintenir une humeur stable. Il est proposé des stratégies d’autogestion pour renforcer l’horloge biologique, tous les jours ! Les recommandations comportent des astuces simples et pratiques pour le jour et la nuit, mais aussi des conseils spécifiques à ce contexte pour limiter l’exposition au stress et mieux le gérer. Enfin, quelques sources et liens utiles sont proposés. Both, the confinement itself and the stress induces by the Covid-19 virus pandemic can lead to significant disruptions in habitual rhythms and sleep. Sleep experts from the Sleep and Biological Rhythms in Psychiatry section (SoPsy) of the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) and the French Society of Sleep Research and Medicine (SFRMS), in partnership with the Morphée network and the National Institute of Sleep and Vigilance (INSV), offer recommendations on how to sleep well and to keep your rhythms. Specific recommendations are addressed on the one hand to adults and on the other hand to parents for their children. People affected by mood disorders (depression, bipolar disorder, etc.) should particularly pay attention to maintaining routines during this period in order to maintain a stable mood. Self-management strategies are suggested to strengthen the biological clock, every day! The recommendations include tips for day and night, but also some specific advices for this context, to limit stress exposure and to improve its management. Finally, useful online ressources and links are suggested.