P.0493 COVID-19 related perceived stress in patients with rheumatic diseases: an Italian cross-sectional study

ABSTRACT

Background: COVID-19 outbreak is a public emergency that forced people to a radical change in their daily life, generating great insecurities and concerns about health, work, and social relationships [1]. Quarantine measures were responsible for detrimental effects on mental health of the general population, leading to the exacerbation of stress, depression and anxiety [2]. Psychological impact might be even more severe on fragile people such as those suffering from rheumatic diseases (RDs), for whom previous evidence demonstrated a negative effect of psychological stressors on outcome disease [3]. Objective: The aim of the present study is to identify the factors associated with higher levels of perceived stress in patients affected by RDs during the COVID-19 pandemic. Methods: This cross-sectional study analyzed data from an anonymous online survey about mental health of people with RDs. Participants were enrolled through several RD patients’ associations between May and September 2020, after the first pandemic wave in Italy. They filled out a questionnaire including demographic and clinical information, mental health issues and the Perceived Stress Scale (PSS). Perceived stress levels were stratified as follows low (<14), moderate (14-26) and high (>27). Descriptive analyses were performed on the total sample;one-way analyses of variance (ANOVA) and Pearson's correlation were used to compare PSS scores between groups defined by qualitative and quantitative variables. Finally, multivariate regression analyses were performed to identify independent variables associated with higher PSS scores. Results: 507 patients with RDs participated in the survey 419 females (82.6%) and 88 males (17.4%) with a mean age of 53.06 years and mean disease duration of 13.74 years. As regard PSS scores, total sample mean (SD) was 18.1 ± 8.1. Specifically, 154 patients (30,4%) reported low, 264 (52.1%) moderate and 89 (17.6%) high levels of stress. PSS scores resulted significantly different with regard to gender (F=18.32, P<0.01), residence in Lombardy (F=14.90, P<0.01), diagnostic group (F=6.20, P<0.01), hypertension (F=4.06, P=0.04), gastritis (F=3.83, P=0.05), bowel diseases (F=9.74, P<0.01), overweight/obesity (F=5.96, P=0.02), COVID-19 infection (F=4.32, P=0.01), depressive symptoms (F=17.18, P<0.01), anxiety symptoms (F=19.79, P<0.01), prescription of psychiatric therapy before COVID-19 (F=30.90, P<0.01), type of pre-existing psychiatric symptoms (F=12.41, P<0.01), use of psychiatric compounds before COVID-19 (F=36.39, P<0.01), type of psychiatric compounds before COVID-19 (F=13.53, P<0.01), current prescription of psychiatric compounds (F=44.68, P<0.01), type of ongoing psychiatric compounds (F=15.18, P<0.01), anxiety sources (F=30.90, P<0.01). Independent variables associated with higher PSS scores were female gender (β=0.12, P<0.01), younger age (β=-0.23, P<0.01), residence outside Lombardy (β=-0.09, P=0.03), presence of overweight/obesity (β=0.11, P=0.01), current prescription of psychiatric compounds (β=0.26, P <0.01) and financial difficulties (β=0.19, P <0.01). Conclusion: Our findings highlight the considerable psychological impact derived from COVID-19 pandemic on people affected by RDs. In addition, different factors resulted to be predictive of significant levels of perceived stress in these patients. A multidisciplinary approach, including mental health support, should be considered in order to improve the psychological well-being of fragile patients during traumatic events such as pandemics. No conflict of interest