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1.
J Geriatr Psychiatry Neurol ; 35(2): 229-236, 2022 03.
Article in English | MEDLINE | ID: covidwho-1731438

ABSTRACT

AIMS: The negative effect of the COVID-19 pandemic on sleep quality of clinically stable psychiatric patients is unknown. This study examined the prevalence of sleep disturbances and their association with quality of life (QOL) in clinically stable older psychiatric patients during the COVID-19 pandemic. METHODS: This multicenter, cross-sectional study involved older patients attending maintenance treatment at outpatient departments of four major psychiatric hospitals in China. Patients' socio-demographic and clinical characteristics were collected. Sleep disturbances, depressive symptoms, and QOL were assessed with the Insomnia Severity Index, the 9-item Patient Health Questionnaire, and 2 items of the World Health Organization Quality of Life-Brief version, respectively. Binary logistic regression analysis was conducted to examine the independent associations of socio-demographic and clinical variables with sleep disturbances, while the association between sleep disturbances and QOL was explored with analysis of covariance. RESULTS: A total of 941 patients were recruited. The prevalence of sleep disturbances was 57.1% (95% CI: 53.9-60.2%). Analysis of covariance revealed that QOL was significantly lower in patients with sleep disturbances compared to those without. Multivariate logistic regression analysis showed that sleep disturbances were positively and independently associated with more severe depressive symptoms (OR = 1.32, 95% CI: 1.26-1.37). Compared to patients with major depressive disorder, those with other psychiatric diagnoses had a significantly higher prevalence of sleep disturbances (OR = 1.44, 95% CI: 1.00-2.08). CONCLUSION: Sleep disturbances were common among clinically stable older psychiatric patients during the COVID-19 pandemic. Considering the negative association with QOL, this subpopulation needs regular assessment and timely treatment to reduce their sleep disturbances and improve their QOL.


Subject(s)
COVID-19 , Depressive Disorder, Major , Aged , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Humans , Pandemics , Prevalence , Quality of Life/psychology , SARS-CoV-2 , Sleep
2.
J Geriatr Psychiatry Neurol ; 35(2): 196-205, 2022 03.
Article in English | MEDLINE | ID: covidwho-1731434

ABSTRACT

OBJECTIVES: The Coronavirus Disease 2019 (COVID-19) pandemic has profound negative effects on the mental health of clinically stable older patients with psychiatric disorders. This study examined the influential nodes of psychiatric problems and their associations in this population using network analysis. METHODS: Clinically stable older patients with psychiatric disorders were consecutively recruited from four major psychiatric hospitals in China from May 22 to July 15, 2020. Depressive and anxiety syndromes (depression and anxiety hereafter), insomnia, posttraumatic stress symptoms (PTSS), pain, and fatigue were measured using the Patient Health Questionnaire, General Anxiety Disorder, Insomnia Severity Index, Posttraumatic Stress Disorder Checklist - Civilian Version, and Numeric Rating Scales for pain and fatigue, respectively. RESULTS: A total of 1063 participants were included. The network analysis revealed that depression was the most influential node followed by anxiety as indicated by the centrality index of strength. In contrast, the edge connecting depression and anxiety was the strongest edge, followed by the edge connecting depression and insomnia, and the edge connecting depression and fatigue as indicated by edge-weights. The network structure was invariant by gender based on the network structure invariance test (M = .14, P = .20) and global strength invariance tests (S = .08, P = .30). CONCLUSIONS: Attention should be paid to depression and its associations with anxiety, insomnia, and fatigue in the screening and treatment of mental health problems in clinically stable older psychiatric patients affected by the COVID-19 pandemic.


Subject(s)
COVID-19 , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-Traumatic , Anxiety/epidemiology , Anxiety Disorders/epidemiology , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Disease Outbreaks , Fatigue/epidemiology , Fatigue/etiology , Humans , Pain , Pandemics , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology , Stress Disorders, Post-Traumatic/epidemiology
3.
J Geriatr Psychiatry Neurol ; 35(2): 237-244, 2022 03.
Article in English | MEDLINE | ID: covidwho-1731432

ABSTRACT

AIMS: The pattern of suicidality in older patients with psychiatric disorders during the COVID-19 pandemic is not clear. This study examined the prevalence of suicidality and its association with quality of life (QOL) among older clinically stable patients with psychiatric disorders during the COVID-19 pandemic. METHODS: A multicenter, cross-sectional study was conducted from May 22 to July 15, 2020, among four major tertiary psychiatric hospitals in China. Suicidality was assessed by asking 3 standardized questions. Depressive symptoms, pain, and QOL were assessed with the 9-item Patient Health Questionnaire (PHQ-9), the numeric pain rating scale (NPRS), and the World Health Organization Quality of Life Questionnaire-brief version, respectively. RESULTS: A total of 1063 clinically stable patients participated and completed the assessment. The prevalence of suicidality was 11.8% (95% CI: 9.9%-13.7%) during the COVID-19 pandemic. Multiple logistic regression analysis revealed that poor treatment adherence (P = .009, OR = 1.86, 95% CI: 1.17-2.96) and perceived illness worsening during the COVID-19 outbreak (P = .02, OR = 2.07, 95% CI: 1.15-3.73), being diagnosed with major depressive disorder (P < .001, OR = 2.79, 95% CI: 1.68-4.64), PHQ-9 total score (P < .001, OR = 1.20, 95% CI: 1.15-1.24) and NPRS total score (P = .002, OR = 1.17, 95% CI: 1.06-1.29) were associated with higher risk of suicidality. After controlling for covariates, older psychiatric patients with suicidality had lower QOL compared to those without (F(1, 1063) =16.5, P<.001). CONCLUSIONS: Suicidality was common in older patients with clinically stable psychiatric disorders during the COVID-19 pandemic. Considering its negative impact on QOL and personal suffering, routine screening and preventive suicide measures should be implemented for older psychiatric patients.


Subject(s)
COVID-19 , Depressive Disorder, Major , Mental Disorders , Suicide , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Depressive Disorder, Major/epidemiology , Humans , Mental Disorders/epidemiology , Pandemics , Prevalence , Quality of Life , SARS-CoV-2 , Suicide/psychology
4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325514

ABSTRACT

Background: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Methods: : This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. Results: : A total of 1,063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1% - 50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P=0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR=1.15, P<0.001), insomnia symptoms (OR=1.08, P<0.001) and pain (OR=1.43, P<0.001) were significantly associated with fatigue. Conclusions: : Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.

6.
IUBMB Life ; 73(5): 739-760, 2021 05.
Article in English | MEDLINE | ID: covidwho-1135107

ABSTRACT

Gastrointestinal symptoms and liver injury are common in patients with coronavirus disease 2019 (COVID-19). However, profiles of different pharmaceutical interventions used are relatively underexplored. Chinese herbal medicine (CHM) has been increasingly used for patients with COVID-19, but the efficacy of CHM used in COVID-19 on gastrointestinal symptoms and liver functions has not been well studied with definitive results based on the updated studies. The present study aimed at testing the efficacy of CHM on digestive symptoms and liver function (primary outcomes), the aggravation of COVID-19, and the time to viral assay conversion (secondary outcomes), among patients with COVID-19, compared with standard pharmacotherapy. The literature search was undertaken in 11 electronic databases from December 1, 2019 up to November 8, 2020. Appraisal of the evidence was conducted with Cochrane risk of bias tool or Newcastle Ottawa Scale. A random-effects model or subgroup analysis was conducted when significant heterogeneity was identified in the meta-analysis. The certainty of the evidence was assessed with the grading of recommendations assessment, development, and evaluation approach. Forty-eight included trials involving 4,704 participants were included. Meta-analyses favored CHM plus standard pharmacotherapy for COVID-19 on reducing the aggravation of COVID-19 and the time to viral assay conversion compared with standard pharmacotherapy. However, the present CHM as a complementary therapy for treating COVID-19 may not be beneficial for improving most gastrointestinal symptoms and liver function based on the current evidence. More well-conducted trials are warranted to confirm the potential efficacy of CHM furtherly.


Subject(s)
COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Gastrointestinal Diseases/drug therapy , Liver Diseases/drug therapy , Adolescent , Adult , Aged , Anorexia/virology , COVID-19/etiology , Diarrhea/drug therapy , Diarrhea/virology , Drugs, Chinese Herbal/pharmacology , Female , Gastrointestinal Diseases/virology , Humans , Liver Diseases/etiology , Liver Diseases/virology , Liver Function Tests , Male , Middle Aged , Nausea/drug therapy , Nausea/virology , Young Adult
7.
Transl Psychiatry ; 11(1): 75, 2021 01 26.
Article in English | MEDLINE | ID: covidwho-1049959

ABSTRACT

The impact of the COVID-19 pandemic on clinically stable older patients with psychiatric disorders is unclear. This study examined the prevalence of depressive and anxiety symptoms, and their associations with quality of life (QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. This was a multicenter, cross-sectional study. Depressive and anxiety symptoms, insomnia, pain, and QOL were assessed with standardized instruments. A total of 1063 patients were included. The prevalence of depressive and anxiety symptoms, and combined depressive and anxiety symptoms were 62.3% (95%CI = 59.4-65.2%), 52.4% (95%CI = 49.3-55.4%), and 45.9% (95%CI = 42.9-48.9%), respectively. Patients with depressive and anxiety symptoms had significantly lower QOL than those without (P < 0.01). Binary logistic regression analyses revealed that having depressive symptoms was positively associated with more severe insomnia (OR = 1.29, P < 0.01) and pain (OR = 1.14, P < 0.01), and was negatively associated with other psychiatric diagnoses (except for major depressive disorder, schizophrenia, and organic mental disorder; OR = 0.50, P < 0.01), while having anxiety symptoms was positively associated with severe physical diseases (OR = 1.57, P = 0.02), poor adherence to treatment (OR = 1.50, P < 0.01), and more severe insomnia (OR = 1.15, P < 0.01) and pain (OR = 1.11, P < 0.01). Having combined depression and anxiety symptoms was positively associated with poor adherence to treatment (OR = 1.42, P = 0.02) and more severe insomnia (OR = 1.19, P < 0.01) and pain (OR = 1.15, P < 0.01), and was negatively associated with the diagnosis of schizophrenia (OR = 0.50, P = 0.04) and others (OR = 0.53, P < 0.01). Depressive and anxiety symptoms were common in clinically stable older patients with psychiatric disorders during the COVID-19 pandemic. Considering the negative impact of these symptoms on QOL, regular screening and appropriate treatment are recommended for this population.


Subject(s)
COVID-19 , Mental Disorders/epidemiology , Pain/epidemiology , Quality of Life , Sleep Initiation and Maintenance Disorders/epidemiology , Treatment Adherence and Compliance/statistics & numerical data , Aged , China/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Prevalence , Severity of Illness Index
8.
Global Health ; 16(1): 119, 2020 12 18.
Article in English | MEDLINE | ID: covidwho-992508

ABSTRACT

BACKGROUND: The pattern of fatigue in older psychiatric patients during the COVID-19 outbreak was unknown. This study examined the prevalence of fatigue and its association with overall quality of life (overall QOL) in clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. METHODS: This was a multicenter, cross-sectional study. Fatigue, depressive symptoms, pain, insomnia symptoms, and overall QOL were assessed with standardized instruments. RESULTS: A total of 1063 patients were recruited. The prevalence of fatigue was 47.1% (95%CI: 44.1-50.1%). An analysis of covariance revealed that overall QOL was significantly lower in patients with fatigue compared to those without (P = 0.011). A multiple logistic regression analysis revealed that more severe depressive symptoms (OR = 1.15, P < 0.001), insomnia symptoms (OR = 1.08, P < 0.001) and pain (OR = 1.43, P < 0.001) were significantly associated with fatigue. CONCLUSIONS: Fatigue is common among clinically stable older patients with psychiatric disorders during the COVID-19 outbreak. Considering its negative impact on overall QOL, regular assessment of fatigue and appropriate treatment warrant attention in this subpopulation.


Subject(s)
COVID-19/complications , Fatigue/complications , Mental Disorders/complications , Pain/complications , Quality of Life , Severity of Illness Index , Sleep Initiation and Maintenance Disorders/complications , Age Factors , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/complications , Depression/epidemiology , Depressive Disorder/complications , Depressive Disorder/epidemiology , Disease Outbreaks , Fatigue/epidemiology , Female , Humans , Logistic Models , Male , Mental Disorders/epidemiology , Middle Aged , Pain/epidemiology , Prevalence , SARS-CoV-2 , Sleep Initiation and Maintenance Disorders/epidemiology , Social Isolation/psychology , Surveys and Questionnaires
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