Please wait a minute...
J Zhejiang Univ (Med Sci)  2020, Vol. 49 Issue (2): 203-208    DOI: 10.3785/j.issn.1008-9292.2020.03.02
    
Clinical analysis of suspected COVID-19 patients with anxiety and depression
LI Xin1(),DAI Tian2,WANG Hong1,*(),SHI Junnian1,YUAN Wei1,LI Jing1,CHEN Lijun1,ZHANG Tianming1,ZHANG Shanshan1,KONG Yan1,YUE Ning1,SHI Hui1,HE Yuping1,HU Huifang1,LIU Furong1,YANG Caixia1
1. Fever Isolation Ward, Lanzhou University Second Hospital, Lanzhou 730030, China
2. School of Public Health, Lanzhou University, Lanzhou 730000, China
Download: HTML( 65 )   PDF(1055KB)
Export: BibTeX | EndNote (RIS)      

Abstract  

Objective: To explore the risk factors of anxiety and depression in patients with suspected coronavirus disease 2019 (COVID-19) so as to achieve early intervention and better clinical prognosis. Methods: Seventy-six patients with suspected COVID-19 in fever isolation wards of Second Hospital of Lanzhou University were enrolled From January 31, 2020 to February 22, 2020. Their clinical baseline data were collected. The anxiety of patients was assessed by Hamilton Anxiety Scale, and the depression of patients was assessed by Hamilton Depression Scale. Multivariate Logistic regression analysis was performed to explore the risk factors of anxiety and depression in these patients. Results: Female patients are more likely to have anxiety (OR=3.206, 95%CI:1.073-9.583, P < 0.05) and depression (OR=9.111, 95%CI:2.143-38.729, P < 0.01) than male patients; patients with known contact history of epidemic area and personnel in epidemic area are more likely to have depression (OR=3.267, 95%CI:1.082-9.597, P < 0.05). Conclusion: During the isolation treatment of suspected COVID-19 patients, early psychological intervention should be carried out for the female patients with known contact history of epidemic area and personnel in epidemic area, and drug treatment should be given in advance if necessary.



Key wordsCoronavirus disease 2019      Severe acute respiratory syndrome coronavirus 2      Novel coronavirus pneumonia      Anxiety      Depression      Logistic models     
Received: 27 February 2020      Published: 06 March 2020
CLC:  R749.2  
Corresponding Authors: WANG Hong     E-mail: xin830910@163.com;1311098171@qq.com
Cite this article:

LI Xin,DAI Tian,WANG Hong,SHI Junnian,YUAN Wei,LI Jing,CHEN Lijun,ZHANG Tianming,ZHANG Shanshan,KONG Yan,YUE Ning,SHI Hui,HE Yuping,HU Huifang,LIU Furong,YANG Caixia. Clinical analysis of suspected COVID-19 patients with anxiety and depression. J Zhejiang Univ (Med Sci), 2020, 49(2): 203-208.

URL:

http://www.zjujournals.com/med/10.3785/j.issn.1008-9292.2020.03.02     OR     http://www.zjujournals.com/med/Y2020/V49/I2/203


2019冠状病毒病(COVID-19)疑似患者合并焦虑和抑郁的临床分析

目的: 分析2019冠状病毒病(COVID-19)疑似患者伴发焦虑、抑郁的危险因素以便早期干预以改善临床预后。方法: 收集2020年1月31日至2月22日兰州大学第二医院发热隔离病房收治的COVID-19疑似患者76例,收集其临床资料并采用汉密尔顿焦虑量表评测患者焦虑情况,汉密尔顿抑郁量表评测患者抑郁情况,行多因素Logistic回归分析COVID-19疑似患者出现焦虑或抑郁的危险因素。结果: 女性患者较男性患者更易伴发焦虑(OR=3.206,95%CI:1.073~9.583,P < 0.05)和抑郁情绪(OR=9.111,95%CI:2.143~38.729,P < 0.01);患者存在已知疫区及疫区人员接触史更容易伴发抑郁情绪(OR=3.267,95%CI:1.082~9.597,P < 0.05)。结论: 在COVID-19疑似患者隔离治疗期间,对于存在已知疫区及疫区人员接触史的女性患者应该早期进行心理干预,必要时提早给予药物治疗,以改善患者预后。


关键词: 2019冠状病毒病,  严重急性呼吸综合征冠状病毒2,  新型冠状病毒肺炎,  焦虑,  抑郁,  Logistic模型 
组 别 n 女 性 年龄(岁) 受教育程度
(本科及以上)
已 婚 已知疫区及疫区
人员接触史
已知外出旅行史或
聚众性场所活动史
既往确诊
精神疾病史
  “—”无相关数据.COVID-19:2019冠状病毒病.
伴发焦虑组 36 21(58.3) 38±18 16(44.4) 36(100.0) 8(22.2) 12(33.3) 4(11.1)
不伴发焦虑组 40 14(35.0) 34±12 21(52.5) 36(90.0) 7(17.5) 6(15.0) 4(10.0)
t/χ2 4.152 -0.959 0.492 2.059 0.267 3.523 0.000
P <0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
Tab 1 General characteristics of suspected COVID-19 patients with and without anxiety   [n(%)或\begin{document}$\bar x \pm s$\end{document}]
组 别 n 女 性 年龄(岁) 受教育程度
(本科及以上)
已 婚 已知疫区及疫区
人员接触史
已知外出旅行史或
聚众性场所活动史
既往确诊
精神疾病史
  “—”无相关数据.COVID-19:2019冠状病毒病.
伴发抑郁组 23 19(82.6) 38±16 10(43.5) 19(82.6) 10(43.5) 6(26.1) 3(13.0)
不伴发抑郁组 53 16(30.2) 35±15 37(69.8) 53(100.0) 5(9.4) 12(22.6) 5(9.4)
t/χ2 17.740 -0.874 0.358 6.554 9.684 0.105 0.004
P <0.01 >0.05 >0.05 <0.05 <0.01 >0.05 >0.05
Tab 2 General characteristics of suspected COVID-19 patients with and without depression  [n(%)或\begin{document}$\bar x \pm s$\end{document}]
变 量 β S.E. Wald P OR(95%CI)
  因婚姻状况中未婚者所占比例过小,且婚姻状况与年龄存在一定的共线性,遂未将婚姻状况纳入多因素Logistic回归分析.COVID-19:2019冠状病毒病.
女性 1.165 0.559 4.350 <0.05 3.206(1.073~9.583)
年龄 -0.005 0.020 0.055 >0.05 0.995(0.957~1.035)
受教育程度(本科及以上) -0.588 0.534 1.213 >0.05 0.556(0.195~1.581)
已知疫区及疫区人员接触史 0.315 0.810 0.151 >0.05 1.370(0.280~6.706)
已知外出旅行史或聚众性场所活动史 1.040 0.625 2.771 >0.05 2.829(0.832~9.623)
既往确诊精神疾病史 -0.778 0.922 0.712 >0.05 0.459(0.075~2.799)
Tab 3 Multivariate logistic regression analysis of anxiety in patients with suspected COVID-19
变 量 β S.E. Wald P OR(95%CI)
  因婚姻状况中未婚者所占比例过小,且婚姻状况与年龄存在一定的共线性,遂未将婚姻状况纳入多因素Logistic回归分析.COVID-19:2019冠状病毒病.
女性 2.209 0.738 8.955 <0.01 9.111(2.143~38.729)
年龄 0.004 0.025 0.022 >0.05 1.004(0.956~1.054)
受教育程度(本科及以上) 0.233 0.721 0.104 >0.05 1.262(0.307~5.188)
已知疫区及疫区人员接触史 1.156 0.539 4.340 <0.05 3.267(1.082~9.597)
已知外出旅行史或聚众性场所活动史 0.739 0.764 0.934 >0.05 2.093(0.468~9.361)
既往确诊精神疾病史 -0.363 0.994 0.133 >0.05 0.695(0.099~4.883)
Tab 4 Multivariate logistic regression analysis of depression in patients with suspected COVID-19
[1]   WANG C , HORBY P W , HAYDEN F G et al. A novel coronavirus outbreak of global health concern[J]. Lancet, 2020, 395 (10223): 470- 473
doi: 10.1016/S0140-6736(20)30185-9
[2]   PAULESC I , MARSTON H D , FAUCI A S . Coronavirus infection-more than just the common cold[J]. JAMA, 2020,
doi: 10.1001/jama.2020.075710
[3]   MUNSTER V J , KOOPMANS M , VAN DOREMALEN N et al. A novel coronavirus emerging in China-key questions for impact assessment[J]. N Engl J Med, 2020, 382 (8): 692- 694
doi: 10.1056/NEJMp2000929
[4]   CHAN J F , YUAN S , KOK K H et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission:a study of a family cluster[J]. Lancet, 2020, 395 (10223): 514- 523
doi: 10.1016/S0140-6736(20)30154-9
[5]   杨蕴萍, 马征, 王传跃 . 重症急性呼吸综合征患者应激相关障碍及其心理干预的初步分析[J]. 中华精神科杂志, 2003, 36 (3): 183
YANG Yunping , MA Zheng , WANG Chuanyue . A preliminary analysis of stress-related disorders and psychological intervention in patients with severe acute respiratory syndrome[J]. Chinese Journal of Psychiatry, 2003, 36 (3): 183
doi: 10.3760/j:issn:1006-7884.2003.03.024
[6]   马征, 杜万君, 郭俊花 et al. 与重症急性呼吸综合征有关精神异常的临床观察[J]. 中华精神科杂志, 2004, 37 (2): 119- 120
MA Zheng , DU Wanjun , GUO Junhua et al. Clinical observation on severe acute respiratory syndrome associated mental disorders[J]. Chinese Journal of Psychiatry, 2004, 37 (2): 119- 120
doi: 10.3760/j:issn:1006-7884.2004.02.025
[7]   中华人民共和国国家卫生健康委员会办公厅, 国家中医药管理局办公室.新型冠状病毒感染的肺炎诊疗方案(试行第六版)[A/OL].国卫办医涵[2020] 145号.(2020-02-18)[2020-02-28].http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2.shtml.
General Office of National Health Commission of the People's Republic of China, Office of National Administration of Traditional Chinese Medicine. Diagnosis and treatment of novel coronavirus pneumonia (trial version 6)[A/OL]. No.145[2020] of the General Office of the National Health Commission. (2020-02-18)[2020-02-28]. http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2.shtml. (in Chinese)
[8]   张明园.精神科评定量表手册[M].长沙: 湖南科学技术出版社, 2003: 121-126.
ZHANG Mingyuan. Manual of psychiatric rating scale[M]. Changsha: Hunan Science & Technology Press, 2003: 121-126. (in Chinese)
[9]   HUANG C , WANG Y , LI X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395 (10223): 497- 506
doi: 10.1016/S0140-6736(20)30183-5
[10]   ZHU N , ZHANG D Y , WANG W L et al. A novel coronavirus from patients with pneumonia in China, 2019[J]. N Engl J Med, 2020, 382 (8): 727- 733
doi: 10.1056/NEJMoa2001017
[11]   LI Q , GUAN X H , WU P et al. Early transmission dynamics in Wuhan, China, of novel coronavirus infected pneumonia[J]. N Engl J Med, 2020, 382 (13): 1199- 1207
doi: 10.1056/NEJMoa2001316
[12]   陈大明, 赵晓勤, 缪有刚 et al. 全球冠状病毒研究态势分析及其启示[J]. 中国临床医学, 2020, 27 (1): 1- 12
CHEN Daming , ZHAO Xiaoqin , MIAO Yougang et al. Analysis of the global coronavirus related research status and its enlightenment for the present and future[J]. Chinese Journal of Clinical Medicine, 2020, 27 (1): 1- 12
doi: 10.12025/j.issn.1008-6358.2020.20200199
[13]   SHELINE Y I , FREEDLAND K E , CARNEY R M . How safe are serotonin reuptake inhibitors for depression in patients with coronary heart disease?[J]. Am J Med, 1997, 102 (1): 54- 59
doi: 10.1016/s0002-9343(96)00374-9
[14]   敖明强, 潘扬, 马文琦 et al. 心脏科住院心房颤动患者焦虑抑郁情绪调查及其对生活质量的影响[J]. 东南大学学报(医学版), 2017, 36 (4): 637- 640
AO Mingqiang , PAN Yang , MA Wenqi et al. Investigation of anxiety and depression in hospitalized patients with atrial fibrillation and its impact on quality of life[J]. Journal of Southeast University (Medical Science Edition), 2017, 36 (4): 637- 640
doi: 10.3969/j.issn.1671-6264.2017.04.029
[15]   MAUNDER R , HUNTER J , VINCENT L et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital[J]. CMAJ, 2003, 168 (10): 1245- 1251
[16]   程刚, 肖友琴 . 社交焦虑障碍的性别差异及其生物学解释[J]. 中国健康心理学杂志, 2015, 23 (2): 307- 312
CHENG Gang , XIAO Youqin . Sex differences and biological reasons in social anxiety disorder[J]. China Journal of Health Psychology, 2015, 23 (2): 307- 312
doi: 10.13342/j.cnki.cjhp.2015.02.040
[1] WANG Jincheng,LIU Jinpeng,WANG Yuanyuan,LIU Wei,CHEN Xiaoqun,SUN Chao,SHEN Xiaoyong,WANG Qidong,WU Yaping,LIANG Wenjie,RUAN Lingxiang. Dynamic changes of chest CT imaging in patients with COVID-19[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 191-197.
[2] ZHANG Xiaoyan, SUN Wei, SHANG Shiqiang, MAO Jianhua, FU Junfen, SHU Qiang, JIANG Kewen. Principles and suggestions on biosafety protection of biological specimen preservation during prevalence of COVID-19[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 170-177.
[3] CAO Shengli,FENG Peihua,SHI Pengpeng. Study on the epidemic development of COVID-19 in Hubei province by a modified SEIR model[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 178-184.
[4] CHEN Jun,LIU Danping,LIU Li,LIU Ping,XU Qingnian,XIA Lu,LING Yun,HUANG Dan,SONG Shuli,ZHANG Dandan,QIAN Zhiping,LI Tao,SHEN Yinzhong,LU Hongzhou. A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 215-219.
[5] CHEN Zhimin,FU Junfen,SHU Qiang,WANG Wei,CHEN Yinghu,HUA Chunzhen,LI Fubang,LIN Ru,TANG Lanfang,WANG Tianlin,WANG Yingshuo,XU Weize,YANG Zihao,YE Sheng,YUAN Tianming,ZHANG Chenmei,ZHANG Yuanyuan. Diagnosis and treatment recommendation for pediatric COVID-19 (the second edition)[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 139-146.
[6] XU Kaijin,CAI Hongliu,SHEN Yihong,NI Qin,CHEN Yu,HU Shaohua,LI Jianping,WANG Huafen,YU Liang,HUANG He,QIU Yunqing,WEI Guoqing,FANG Qiang,ZHOU Jianying,SHENG Jifang,LIANG Tingbo,LI Lanjuan. Management of COVID-19: the Zhejiang experience[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 147-157.
[7] JIANG Saiping,LI Lu,RU Renping,ZHANG Chunhong,RAO Yuefeng,LIN Bin,WANG Rongrong,CHEN Na,WANG Xiaojuan,CAI Hongliu,SHENG Jifang,ZHOU Jianying,LU Xiaoyang,QIU Yunqing. Pharmaceutical care for severe and critically ill patients with COVID-19[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 158-169.
[8] LUO Song,YANG Lijuan,WANG Chun,LIU Chuanmiao,LI Dianming. Clinical observation of 6 severe COVID-19 patients treated with plasma exchange or tocilizumab[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 227-231.
[9] HONG Dongsheng,NI Jian,SHAN Wenya,LI Lu,HU Xi,YANG Hongyu,ZHAO Qingwei,ZHANG Xingguo. Establishment of a rapid identification of adverse drug reaction program in R language implementation based on monitoring data[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 253-259.
[10] ZHONG Qi,LI Zhi,SHEN Xiaoyong,XU Kaijin,SHEN Yihong,FANG Qiang,CHEN Feng,LIANG Tingbo. CT imaging features of patients with different clinical types of COVID-19[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 198-202.
[11] KANG Xianhui,ZHANG Rong,HE Huiliang,YAO Yongxing,ZHENG Yueying,WEN Xiaohong,ZHU Shengmei. Anesthesia management in cesarean section for patient with COVID-19: a case report[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 249-252.
[12] CHEN Xu,LI Yang,WANG Jinxi,CAI Hongliu,CAO Hongcui,SHENG Jifang. Pregnant women complicated with COVID-19: a clinical analysis of 3 cases[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 240-244.
[13] SHEN Lihua,HUANG Fei,CHEN Xiang,XIONG Zuan,YANG Xiaoyu,LI Hui,CHENG Feng,GUO Jian,GONG Guofu. Diagnostic efficacy of three test kits for SARS-CoV-2 nucleic acid detection[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 185-190.
[14] ZHAGN Sheng,LI Danping,CHEN Huazhong,ZHENG Dan,ZHOU Yiping,CHEN Baoguo,SHI Weiwu,LIN Ronghai. Dynamic inflammatory response in a critically ill COVID-19 patient treated with corticosteroids[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 220-226.
[15] LI Youjiang,HU Yingying,ZHANG Xiaodong,YU Yuanyuan,LI Bin,WU Jianguo,WU Yingping,XIA Xiaoping,XU Jian. Follow-up testing of viral nucleic acid in discharged patients with moderate type of COVID-19[J]. J Zhejiang Univ (Med Sci), 2020, 49(2): 270-274.