Post-Traumatic Stress Disorder in Patients with Rheumatic Diseases During the COVID-19 Outbreak​ (preprint)

Background: The COVID-19 pandemic is not only a traumatic event, but a collective stressor unfolding over time, causing alarming implications for the mental health. This study aims to shed light on the mental health status of patients with rheumatic disease (RD) during the massive outbreak of COVID-19 in China, especially the prevalence and severity of post-traumatic stress disorder (PTSD) compared with the levels in healthy people. Methods: A questionnaire survey was conducted in a cross-sectional study of 486 RD patients and 486 healthy control subjects. We collected participants’ demographic and clinical characteristics and surveyed the prevalence and severity of PTSD and sleep quality in the samples using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Findings: Compared with healthy control subjects (n=486), RD patients (n=486) had a higher prevalence of PTSD (12·1% vs. 4·1%; p<0·001). They also had higher total scores on the PCL-5 and on all four items from the PSQI (p≤ 0·001). Female gender, old age, poor sleep quality, long duration of RD, poor subjective evaluation of the disease and pessimistic subjective perception of the epidemic were identified as risk factors for PTSD in RD patients during the COVID-19 epidemic. Interpretation: During the COVID-19 outbreak, RD patients presented a higher prevalence and severity of PTSD and more sleep disturbances. Our findings confirm the importance of psychological assessment and mental health care in addition to regular clinical care for RD patients during the pandemic. Funding: National Natural Science Foundation of China, China Ministry of Science and Technology, Shanghai Municipal Key Clinical Specialty Fund.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: This study was approved by the Human Research Ethics Committee of Changzheng Hospital, and informed consent was obtained from all participants.

High risk of infection caused posttraumatic stress symptoms in individuals with poor sleep quality: A study on influence of coronavirus disease (COVID-19) in China (preprint)

The influence of the outbreak of coronavirus disease (COVID-19) on mental health was poorly understood. The present study aimed to exam sleep problems and posttraumatic stress symptoms (PTSS) in Chinese immediately after the massive outbreak of COVID-19. A total of 2027 Chinese participated in the present study. Wuhan-expose history, sleep quality and PTSS were measured with self-rating scales. Results showed that there were significant differences of PCL-5 and of sleep quality scores in different data-collection dates (ps<0.05). There were significant differences of PCL-5 scores (p<0.05) and latency onset of sleep (p<0.05) between participants with and without Wuhan-expose history. The interaction effect of Wuhan exposure history x sleep quality significantly influenced PCL-5 (ps<0.05). These results indicate that keeping good sleep quality in individuals with high infectious risk is a way to prevent PTSS.