Evaluation of mental health status in patients with COVID-19

OBJECTIVE: The objective of this study is to evaluate mental health problems such as anxiety and depression in patients diagnosed with COVID-19 at Dokuz Eylül University Hospital, to prospectively monitor them, and to examine the factors affecting them. METHOD: In the study, phone calls were made to 345 people among 1504 people aged 18 and older who applied to Dokuz Eylül University Hospital and were diagnosed positive with SARS-CoV-2 PCR test between August 1, 2021, to September 30, 2021. The first interviews were held 15 days after the patient was diagnosed, and the second interviews were held 2 months later (Day 60). During the phone interview, patients' sociodemographic characteristics, CVs, history of psychiatric illness, characteristics and complaints about the period during which they were diagnosed with COVID-19, and perceived social support were learned. The Hospital Anxiety Depression Scale (HADS) was used to assess mental health status. For the second interviews, questions were added to the survey to evaluate the characteristics of the period after the first interview. It was learned whether a traumatic event affecting the patients psychologically happened and if happened what the reasons were fort he effects. With these collected data, variables that have an impact on mental health were evaluated with univariate and multivariate analyses. Statistical analyzes were performed using SPSS 24.0 program. RESULTS: The sample group consists of 345 people, the age range is 18-90 and the mean age is 40.9 (Standart deviation=15.1). Participants included 188 women (54.5%) and 157 men (45.5%). In the first interviews, a total of 51 (14.8%) out of 345 people had a high anxiety or depression score according to HADS. In the second interviews, a total of 28 (8.9%) people out of 317 had high anxiety or depression scores. Variables that were observed to increase the incidence of mental health problems statistically significantly in the first interviews were poor economic status, being divorced or widowed, insufficient social support from family, not being fully recovered, severe disease severity in terms of COVID-19, hospitalization, sleep problems during the disease process, being diagnosed with an active psychiatric disease, using psychiatric medication, having a history of psychiatric disease in the past, and having a family history of psychiatric disease (p<0.05). As a result of the logistic regression analyzes conducted for the first interviews, having a history of psychiatric illness (O.R.=3.37, 95% CI: 1.78-6.36) and severe illness severity (O.R.=2.49, 95% CI: 1.31-4.74) statistically increased the risk of mental health problems. Variables that statistically significantly increase the incidence of mental health problems in the second interviews were poor economic situation, severe COVID-19 disease severity, diagnosis of an active psychiatric disease, use of psychiatric medication, history of psychiatric disease in the past, family history of psychiatric disease and insufficient social support of friends (p<0.05). In the logistic regression analysis conducted for the second interviews, when history of psychiatric disease (O.R.=3.49, 95% CI: 1.55-7.84) and disease severity (O.R.=2.29, 95% CI: 1.02-5.13) were analyzed separately by adjusting for age and gender, both while it was found to be statistically significant, when the two variables were analyzed together, disease severity lost its significance and only history of psychiatric illness was found to be significant (O.R.=3.21, 95% CI: 1.42-7.28). CONCLUSION: It has been observed that patients diagnosed with COVID-19 may experience mental health problems in addition to physical complaints. Consistent with expectations mental health problems are more common, especially in the acute period. Although it is observed that the frequency of anxiety and depression decreases over time during the follow-up period, it is observed that these conditions continue for a long time in some people. The evaluations showed that the most important risk factors for experiencing mental health problems are a known history of psychiatric disease and severe disease in terms of COVID-19. After the acute period, it is seen that having a history of psychiatric illness is the most important variable that increases the risk of mental health problems. In terms of social support, an important distinction observed during the follow-up period is that family social support was significantly associated with mental health problems during the acute period, and friend social support was significantly associated with mental health problems in the later period. These results are valuable in terms of identifying risk groups and planning possible interventions. It would be valuable to increase efforts in terms of mental health in the provision of healthcare services and to prioritize people who are considered at risk and direct them to receive professional service. Keywords: depression, anxiety, COVID-19, mental health