COVID-19 related poor mental health and sleep disorders in rheumatic patients: a citizen science project

Abstract

Background Patients with chronic rheumatic diseases (RDs) are more vulnerable and the containment measures related to the COVID-19 pandemic might have severe psychological consequences. We investigated the presence of and risk factors associated with poor mental health, sleep disorders among RDs during the pandemic. Methods This cross-sectional Italian citizen science project evaluated the psychological impact of the COVID-19 pandemic in patients with RDs. Between May and September 2020, eleven RD patients’ associations sent the survey by using their mailing list and the related webpage and social network. 507 RD patients completed an ad-hoc anonymous online survey including the Perceived Stress Scale (PSS) and Impact Event Scale-Revised (IES-R). Results The mean scores on the PSS-10 and the IES-R were 18.1 and 29.7, respectively. Higher PSS scores were associated with younger age (p < 0.01), female gender (p < 0.01), overweight/obesity (p = 0.01), psychiatric pharmacotherapy (p < 0.01), and anxiety for loss of income (p < 0.01). Higher IES-R scores were associated with female gender (p < 0.01), intestinal diseases (p = 0.03), anxiety (p < 0.01), and health concern (p < 0.01). Among 375 patients with inflammatory arthritis, 246 (65.6%) had trouble staying asleep, 238 (63.5%) falling asleep, and 112 (29.9%) had dreams about the pandemic. Older age (OR = 1.038, CI 1.002–1.076), psychiatric pharmacotherapy (OR = 25.819, CI 11.465–58.143), and COVID infection (OR = 2.783, CI 1.215–6.372) were predictive of insomnia during the pandemic. Conclusions A considerable COVID-19 related psychosocial burden has been detected in RDs. Different factors were predictive of poor mental health and sleep disorders in these patients. Focused supportive strategies should be implemented to improve the psychological well-being of fragile patients during pandemics.

Synovial Fluid-Derived Extracellular Vesicles of Patients with Arthritides Contribute to Hippocampal Synaptic Dysfunctions and Increase with Mood Disorders Severity in Humans

“…With regard to psychiatric aspects of the total sample, it is not surprising that at least mild clinically significant affective symptoms are present in about one-third of our patients being affected by inflammatory diseases and pain. This is particularly true for those with RA or SpA as reported in previous investigations by our group on different samples [ 14 , 81 ]. Similarly, increased BMI has been already found to be associated with the onset and severity of depressive symptoms as a result of impaired lipid metabolism [ 82 ], weakness of antioxidant defenses [ 83 ], and increased inflammation [ 84 ].…”

Functional and psychosocial impact of COVID-19 pandemic on rheumatic patients’ quality of life in Saudi Arabia

“…Sleeping abnormalities are commonly experienced by rheumatic patients [ 14 ]. Some studies conducted during the pandemic found that 30–40% of the participants experienced insomnia during isolation [ 9 , 15 ].…”

Prevalence and Risk Factors of Depression in Patients with Rheumatic Disease in South Korea during the COVID-19 Pandemic

“…Patients with RDs who were unemployed and had a lower monthly income were at a higher risk for depression than those who were employed and had a higher monthly income. Previous reports found that temporary unemployment, decrease in monthly income, and drug discontinuation owing to the pandemic were associated with reduced quality of life among patients with RDs [ 10 ] and that patients with RDs with higher anxiety due to reduced income since the pandemic experienced higher levels of stress [ 14 ]. This indirectly supports the argument that patients who are unemployed and have a lower income may be more vulnerable to depression.…”

“…As patients with RDs must adapt to their disease and comply with treatment regimens for the rest of their lives, depression is a common mental health disorder observed in this population owing to increased disease activity, suboptimal treatment adherence, reduced treatment response, and decreased quality of life [ 8 , 9 ]. Fear of health risk, stress, social isolation [ 10 ], anxiety [ 11 ], disease activity [ 12 ], physical symptoms [ 13 ], and insomnia [ 14 ] during the current pandemic can elevate the risk of depression or exacerbate depression symptoms among patients with RDs. Prior studies have reported that the unprecedented changes in the social environment caused by social distancing, restricted social gatherings, working from home, online-centered lifestyle, and quarantine during the pandemic posed serious mental health threats to patients with RDs.…”