The Clinical Trial of COVID-19 Patients: The Effectiveness of Emotion-Focused Therapy on Post- Traumatic Stress and Depression

Abstract

Background: At the end of 2019, the world faced a phenomenon that plunged all human beings into extreme fear and anxiety. A new type of coronavirus began to spread among people around the world, and this was the beginning of one of the greatest pandemics and its problems in the world. Objectives: The present study aimed to study the effect of Emotion-Focused Therapy (EFT) on reducing post-traumatic stress and depression among Covid-19 patients. The statistical population was all English language students at the University of Tehran who had recovered from Covid-19. A total of three students (with a mean age of 22±2 years old) were selected from those who had recovered from Covid-19 using convenience sampling. Results: The data were analyzed using visual inspection, Reliable Change Index (RCI), and percentage change formula. The results of the study indicated that the mean improvement of post-traumatic stress variable for the three patients in the post-treatment and follow-up was 42.39% and 41.54%, respectively. Additionally, this value for the depression variable was 60.78 and 60.22% in the post-treatment and the follow-up. Conclusion: Based on the results of the study, EFT was effective on post-traumatic stress and depression in students infected with Covid-19. Therefore, it is recommended to use this treatment to reduce post-traumatic stress and depression in patients with Covid-19.

Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review

“…Most of the studies had been conducted in China ( n = 15) ( 30 , 33 , 34 , 45 , 50 , 52–55 , 63 , 64 , 66–69 ), Iran ( n = 6) ( 38 , 47 , 48 , 58 , 61 , 62 ), Italy ( n = 5) ( 29 , 31 , 41 , 44 , 57 ), India ( n = 4) ( 36 , 46 , 56 , 59 ), United States ( n = 2) ( 28 , 35 ), and Korea ( n = 2) ( 49 , 65 ). The remaining studies had been developed in Saudi Arabia ( n = 1) ( 27 ), Nigeria ( n = 1) ( 32 ), Indonesia ( n = 1) ( 39 ), France ( n = 1) ( 42 ), Turkey ( n = 1) ( 43 ), Thailand ( n = 1) ( 51 ), Latvia ( n = 1) ( 40 ), Ghana ( n = 1) ( 37 ), and Poland ( n = 1) ( 60 ).…”

“…The difference in the severity of COVID-19 symptoms is clearly appreciated across the studies. On the one hand, some studies focused on mildly-affected patients, namely participants who had recovered from COVID-19 symptoms ( n = 5) ( 31 , 32 , 38 , 47 , 59 ), who were asymptomatic ( n = 2) ( 39 , 56 ), presented mild COVID-19 symptoms ( n = 2) ( 54 , 55 ) or were out of hospital ( n = 3) ( 48 , 58 , 61 ). On the other hand, other interventions had been provided to COVID-19 patients who were hospitalized in isolation wards ( n = 20) ( 29 , 30 , 33–37 , 43 , 46 , 49–53 , 60 , 63–66 , 68 ) or patients with severe symptoms in Intensive Care Units ( n = 3) ( 42 , 66 , 67 ).…”

“…Regarding emotional disorders or symptoms addressed, the vast majority of studies were focused on depressive symptoms alone ( 30 ) or combined with anxiety ( n = 15) ( 33 , 34 , 40–42 , 44 , 47 , 48 , 50–52 , 55–57 , 60 ), panic attacks ( n = 6) ( 59 , 62 , 64 , 66–68 ), suicidal ideation or self-harming attempts ( n = 2) ( 36 , 37 ) or post-traumatic stress disorder (PTSD) ( n = 1) ( 38 ). On the other hand, six studies were focused on patients who presented with anxiety symptoms alone ( 43 , 46 , 53 , 54 , 58 , 61 ) or combined it with panic attacks ( 29 , 35 ).…”

“…Other interventions had an interpersonal / relation approach ( n = 4) [Interpersonal Therapy ( 33 ); emotion focused therapy based on interpersonal relationships ( 38 , 41 ); relational intervention ( 57 )]. Additional interventions included relaxation alone ( n = 3) ( 53 , 62 , 66 ) or combined with mindfulness ( 64 ).…”

“…Different measures were used across studies to assess changes in psychological outcomes after the intervention. Instruments used to assess depressive symptoms included the PHQ ( 28 , 29 , 33 , 40 , 41 , 64–67 ), HAMD-D ( 33 , 34 , 55 , 64 ), the BDI ( 38 , 47–49 , 57 ), the HADS-D ( 42 , 49 , 50 ), the SDS ( 44 , 45 , 69 ) and the MADRS ( 34 ). Similarly, seven different instruments were used to assess anxiety symptoms, namely, HAMA ( 33 , 34 , 55 , 57 , 64 ), GAD ( 28 , 29 , 41 , 46 , 64–67 ), HADS-A ( 42 , 49 , 50 , 60 , 68 ), STAI ( 53 , 54 , 58 , 61 ), BAI ( 43 , 47 , 48 , 61 ), and SAS ( 44 , 45 , 63 , 69 ).…”