The aim of this study was to investigate the correlation between psychological distress and taste and sense of smell dysfunctions on healthcare workers (HCW) who contracted the COVID-19 infection in the midst of the disease outbreak. Reports of sudden loss of taste and smell which persist even after recovery from COVID-19 infection are increasingly recognized as critical symptoms for COVID-19 infections. Therefore, we conducted a cross-sectional study on COVID-19 HCW (N = 104) who adhered to respond to a phone semistructured interview addressing the virus symptoms and associated psychological distress. Data were collected from June to September 2020. Findings confirm the association between experienced taste/olfactory loss and emotional distress and suggest that dysfunctions of taste and smell correlate positively with anxiety and depression. Furthermore, their psychological impact tends to persist even after the recovery from the disease, suggesting the need for appropriate psychological interventions to prevent people from developing more serious or long-lasting psychological disorders and, as far as HCW, to reduce the risk of work-related distress.
Objectives: Parents have a central role in the management of children with inflammatory bowel disease (IBD). Alterations in parental psychological well-being may affect the patient's health-related quality of life (HRQoL). This study aimed to evaluate the correlation between maternal and paternal distress, anxiety, depression and pain catastrophizing and the HRQoL of patients with IBD. Methods: Children with IBD ages 8 to 18 years and their parents were prospectively recruited. Children answered questionnaires on HRQoL while parents completed an assessment of distress, anxiety, depression, and pain catastrophizing. Univariate and multivariate regression models analysis were used to evaluate correlations between parental measures and patient's HRQoL and between the factors related to children health and parental psychological suffering. Results: One hundred patients (45 Crohn disease, 55 ulcerative colitis), 90 mothers and 62 fathers were enrolled. Parents had high levels of distress while anxiety, depression, and pain catastrophizing levels were relatively low. Parental distress had the most substantial correlation with children's HRQoL and was associated with patients’ disease activity and recent flares. On multivariate regression analysis, parental factors explained less than 20% of the variance in the children's HRQoL scores. Mothers suffered from psychological alterations more frequently than fathers, but the parental inter-rater agreement was strong in regards to distress and anxiety. Conclusions: Parental distress is high and correlates with the HRQoL of children with IBD. Interventions aimed at evaluating and managing parental distress should be considered during the management of children with IBD.
Objectives: Inflammatory bowel disease (IBD) can be particularly challenging during the pediatric age with a relevant impact on patient's health-related quality of life (HRQoL). Disease activity accounts for only a small part of the variability in HRQoL, and psychological factors can play a significant role. We aimed to evaluate the impact of patient's distress and pain catastrophizing on children and adolescents with IBD. Methods: We prospectively recruited children aged 8 to 18 with IBD and recorded demographic and disease characteristics. Patients answered questionnaires on HRQoL (IMPACT III), distress (distress thermometer [DT]), and pain catastrophizing (Pain Catastrophizing Scale-Children [PCS-C]). Univariate and multivariate regression models analysis were used to evaluate correlations between patients’ characteristics, disease activity, distress, pain catastrophizing, and HRQoL. Results: Seventy-one patients were enrolled (median age 13.6, 49.3% Crohn disease, 50.7% ulcerative colitis). Median HRQoL, DT, and PCS-C scores were 78.6 (interquartile range 68.0–87.1), 3.0 (1.0–5.0), and 12.0 (4.0–23.0), respectively. Patient's distress and pain catastrophizing levels significantly correlated with HRQoL. Pain catastrophizing had the strongest impact on HRQoL (Spearman correlation coefficient, ρ = 0.73), followed by distress (ρ = 0.67), and ulcerative colitis severity (ρ = 0.67). The DT and the PCS-C scores were significantly associated (ρ = 0.46). Conclusions: Distress and pain catastrophizing have a significative impact on HRQoL in young patients with IBD. Physicians should recognize the role of these psychological factors and consider cognitive-behavioral therapy to optimize the patient's health.
Background Roughly 50% of patients with IBD have symptoms of psychological distress (Mikocka-Walus et al. 2019) but only 15.2% receive attention for their mental health although the effect on disease severity can be profound. It is necessary to have an easy-to-administer psychological distress screening tool. The distress thermometer (DT) is a single-item distress screening scale with 11-likert response widely used in oncological patients. The aim of study was to determine whether the single-item DT compared favourably with IBD clinical indices and time consuming measures currently used to screen for distress. Methods Two hundered and twenty IBD patients (51.43% male) who were recruited in eight Italian hospitals completed the DT and identified the presence or absence of 34 problems using standardised problem list (PL). They completed the 14-item Hospital Anxiety and Depression Scale (HADS) and the 32-item Inflammatory Bowel Disease Questionnaire (IBDQ). Disease clinical indices have been collected for each patient (Mayo score, Harvey–Bradshaw Index–HBI, years of illness, and exacerbation in the last year). Using receiver operating characteristic (ROC) analyses validated the use of the DT in Italian IBD population. Results 47.6% reported anxiety and depression symptoms (HADS ≥15) and needs emotional care. Anxiety is much more associated (43.8%) than depressive problems (26.2%). Data are confirmed by responses to DT and PL: 44.5% of patients reported moderate–severe emotional distress (TD ≥ 5), 43.1% of patients report nervousness and worry, 27.1% reported depression. We observed a strong positive correlation between IBDQ and HADS (r = 0.74, p < 0.001) and DT (r = 0.58, p < 0.001), while there was a slightly smaller association with Mayo score (r = 0.46, p < 0.001) and HBI (r = 0.39, p < 0.001). There was not a statistical significant correlation between disease indices and the emotional distress as measured by HADS or DT. ROC analyses showed that a DT cutoff score of 5 or higher had optimal sensitivity (83%) and specificity (68%) relative to the HADS score as ‘gold’ standard. DT scores yielded area under the curve estimates relative to the HADS cutoff score indicative of good overall accuracy (AUC = 0.81–95% CI: 0.77–0.85). Conclusion Our study confirms that anxiety and depression symptoms are associated with IBD. This is the first study that demonstrated that DT is an easy-to-administer screening tool of psychosocial distress in IBD population. We propose that gastroenterologists use DT to identify patients with psychological distress: an early psychological support and a multidisclinar equipe can determinate a patient’s better disease course (Mawdsley et al. 2005). Our analyses indicated that using a DT’s cutoff of 5 to indicate high levels of distress.
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