Mental Health Status And Influencing Factors Among Recovered COVID-19 Patients

ObjectivesIn the current study,we investigated the influencing factors of anxiety,depression and PTSD symptoms among the individuals recovered from COVID-19 infection from the first wave of the pandemic in Wuhan,China.In addition,we explored the mediating role of resilience in the relationship between stigma and anxiety,depression,PTSD symptoms among recovered COVID-19 patients.MethodsThe cross-sectional study was carried out among former COVID-19 patients in Jianghan District(Wuhan,China)from June 10 to July 25,2021,and 1541 out of 4122 registered recovered COVID-19 patients were recruited by convenience sampling.The socio-demographics and information related to COVID-19 infection were collected among the participants.The anxiety,depression and PTSD symptoms were measured by the Generalized Anxiety Disorder Scale(GAD-7),the Patient Health Questionnaire(PHQ-9)and the Impact of Events Scale-Revised(IES-R),respectively.The Resilience Scale and the Short Version of COVID-19 Stigma Scale of 12 items were used to estimate resilience and stigma of the participants.The influencing factors of anxiety,depression and PTSD symptoms were explored.Chi-square test and t-test were used in univariate analysis and Logistic regression was used in multivariate analysis.Based on Pearson correlation analysis and structural equation models(SEM),the relationship of stigma,resilience,anxiety,depression and PTSD symptoms were analyzed,and then the mediating role of resilience between stigma and psychological symptoms(anxiety,depression and PTSD)were estimated.ResultsAmong the 1541 participants,654(42.4%)were men,887(57.6%)were women and the mean age was 57.50±12.36 years,BMI was 24.50± 3.42.According to multivariate Logistic regression analysis,there were six influencing factors of anxiety symptoms,including educational level(OR=0.74,P=0.040),annual household income in 2020(OR=0.63,P=0.001),alcohol consumption(OR=0.56,P=0.021),hospitalization(OR=1.57,P=0.015),ICU treatment(OR=2.51,P=0.004)and psychological conditions during treatment(OR=0.32,P<0.001).Five factors were related to depressive symptoms,including annual household income in 2020(OR=0.63,P<0.001),alcohol consumption(OR=0.57,P=0.010),hospitalization(OR=1.40,P=0.039),psychological conditions during treatment(OR=0.40,P<0.001)and the severity of COVID-19 symptoms(moderate:OR=2.55,P=0.003;severe or critical:OR=1.88,P=0.042).Four factors were related to PTSD symptoms,including annual household income in 2020(OR=0.62,P=0.006),hospitalization(OR=1.77,P=0.028),psychological conditions during treatment(good:OR=0.46,P<0.001;General:OR=0.29,P<0.001)and the severity of COVID-19(moderate:OR=3.70,P=0.011;severe or critical:OR=3.38,P=0.017).Stigma of recovered COVID-19 patients correlates significantly with anxiety(r=0.335,P<0.001),depression(r=0.325,P<0.001)and PTSD symptoms(r=0.384,P<0.001).It has a direct effect on the participants’ anxiety(β=0.326,P<0.001),depression(p=0.314,P<0.001),PTSD(p=0.385,P<0.001)and their resilience(β=-0.114,P<0.01).Resilience partially mediated the association between stigma and anxiety(B=0.052;95%CI:0.023～0.093),depression(B=0.065;95%CI:0.029～0.118),PTSD symptoms(B=0.054,95%CI:0.024-0.102)among them.ConclusionsDuring the first wave of the COVID-19 pandemic,the prevalence of anxiety,depression and PTSD symptoms in recovered COVID-19 patients was higher than that in the general population,with the highest prevalence of depressive symptoms.The factors related to psychological symptoms(anxiety,depression and PTSD)included education level,income,alcohol consumption,hospitalization,ICU treatment,severity of COVID19 and psychological conditions during treatment.Resilience played a mediating role in the relationship between stigma and anxiety symptoms,depressive symptoms,PTSD symptoms among recovered COVID-19 patients.