Prevalence of Psychiatric Morbidity and their Clinical Correlates in Patients Post COVID-19: A Cross-sectional Study from Rural Northern India
Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/59074.17230
Abhishek Pathak, Rohit Pathak, Nitin Ranjan Gupta, Piyush Chopra
1. Associate Professor, Department of Psychiatry, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.
2. Assistant Professor, Department of Respiratory Medicine, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.
3. Professor, Department of Medicine, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.
4. Junior Resident, Department of Medicine, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.
Correspondence
Dr. Piyush Chopra,
Junior Resident, Department of Medicine, Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India.
E-mail: piyushchoprahims@gmail.com
Introduction: Myriad of complications were observed in post Coronavirus Disease (COVID-19) survivors, psychiatric morbidities among one of them. Recent body of research has shown that significant number of patients developed psychological symptoms following COVID-19. Most of the Indian studies have assessed psychological morbidity among COVID-19 patients during admission. However, very few Indian studies have assessed the psychological impact of COVID-19 during the follow-up period, especially in rural northern India.
Aim: The study aimed to determine the prevalence of depression and anxiety and evaluate related socio-demographic (age, gender, education, occupation and marital status) and clinical factors (severity of COVID-19, presence of medical co-morbidity, Oxygen requirement, Intensive Care Unit (ICU) referral, duration of admission) in patients post COVID-19.
Materials and Methods: This was a cross-sectional study conducted at Hind Institute of Medical Sciences, Sitapur, Uttar Pradesh, India, among 96 patients, post COVID-19 after their discharge from the hospital. Data collection was done between July 2021 to September 2021, using a semi-structured proforma and a psychiatric diagnosis was made (based on International Classification of Diseases- 10th Edition Diagnostic Criteria for Research criteria and clinically approved by two qualified psychiatrists). Rating scales such as Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) were used for severity assessment. Data was analysed using Microsoft Statistical Package for Social Sciences (SPSS) version 20.0. A p-value of <0.05 was considered significant.
Results: In 96 patients, 70 (72.91%) were males. 38 patients (39.58%) were of the age group 45-60 years. A total of 36 (37.50%) patients had depression. Anxiety was seen in 40 (41.66%) participants. Among the clinical variables, the severity of the COVID-19 infection (p-value <0.01), presence of co-morbidity (p-value <0.01), and ICU referral (p-value <0.01), were found to be associated significantly with the presence of depression in the participants. Among 36 depressive patients, mild depression was present in 17 (47%), moderate depression in 12 (33%), severe depression in 5 (14%) and very severe in 2 (6%) of the participants. Anxiety was associated significantly with the gender (p-value=0.02), co-morbidity (p-value <0.01), severity of illness (p-value <0.01), oxygen requirement (p-value=0.04) and ICU admission (p-value <0.01). Mild anxiety was observed in 18 (45%), moderate anxiety in 16 (40%) and severe anxiety in 6 (15%).
Conclusion: The prevalence of depression and anxiety is high in patients, post COVID-19. The severity of these disorders is significantly associated with presence of medical co-morbidity and severity of COVID-19. Hence, thorough evaluation and management of these disorders in post COVID-19 patients can help in improving the overall outcome.
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