ABSTRACT
Objective: To identify factors associated with posttraumatic stress symptoms (PTSS) 3 and 6 months after the discharge of patients hospitalized for COVID-19.Methods: Patients hospitalized for COVID-19 between March 1 and July 31, 2020, were included in a longitudinal study. Clinical assessments were conducted with online auto-questionnaires. PTSS were assessed with the Posttraumatic Stress Disorder Checklist Scale (PCLS). We screened for several putative factors associated with PTSS, including socio-demographic status, hospitalization in an intensive care unit, history of psychiatric disorder, the Hospital Anxiety and Depression Scale, the Peritraumatic Dissociative Experiences Questionnaire, and the home-to-hospital distance. Bivariate and multilinear regression analyses were performed to evaluate their association with PTSS.Results: 119 patients were evaluated 3 months after hospital discharge, and a subset of 94 were evaluated 6 months after discharge. The prevalence of PTSS was 31.9% after 3 months and 30.9% after 6 months. Symptoms of anxiety and depression and history of psychiatric disorder were independently associated with PTSS. Additionally, dissociative experiences during hospitalization (ß = 0.35; P < .001) and a longer home-to-hospital distance (ß = 0.07; P = .017) were specifically associated with PTSS 3 and 6 months after discharge, respectively.Conclusions: Patients with COVID-19 showed persistent high scores of PTSS up to 6 months after discharge from the hospital. In this specific pandemic setting, PTSS were associated with high rates of dissociative experiences during hospitalization and a longer home-to-hospital distance due to the saturation of health care facilities. These results can foster early identification and better prevention of PTSS after hospitalization for COVID-19.Trial Registration: ClinicalTrials.gov identifier: NCT04362930.
Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , COVID-19/epidemiology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Longitudinal StudiesABSTRACT
On March 16, 2020, French schools suddenly closed due to the COVID-19 pandemic, and middle school students were asked to study from home with no direct interactions with teachers or classmates. However, school plays an important role in the development of social, intellectual, and mental competencies and can counteract the negative effects of adverse life events on learning and early school dropout. In this study, we investigated how the unusual context of school closure during the COVID-19 pandemic affected school engagement. Specifically, we focused on inter-individual differences in the motivational determinants of school engagement. We thus performed an online survey of 170 students focusing on the time spent on mathematics assignments, motivation regulation, implicit theories of intelligence, such as adopting a growth or a fixed mindset about his/her intellectual abilities, and optimism. Importantly, the students participated in the online survey during the first lockdown period, with schools closed (T1), and the second lockdown period, with schools remaining open (T2). During T1, identified motivation positively predicted the time spent on math homework assignments: the more the students thought that working on math exercises was useful for their future life, the more time they spent studying. Importantly, the link between identified motivation and school engagement was specific to T1, when schools were closed, as indicated by a significant interaction between identified motivations by type of lockdown. These results suggest that having self-determined motivation is of particular importance when students are deprived of social and intellectual interactions with classmates and teachers. This finding paves the way toward the development of wise rational interventions that target identified motivation and can be applied during challenging societal times and adverse, common life events to keep students engaged with school.