Describing post-traumatic stress disorder and its associations with depression, anxiety and insomnia: a descriptive study in Italian adults with Marfan syndrome during the COVID-19 third wave

Udugampolage N, Caruso R, Magon A, Conte G, Callus E, Taurino J, Pini A. Describing post-traumatic stress disorder and its associations with depression, anxiety and insomnia: a descriptive study in Italian adults with Marfan syndrome during the COVID-19 third wave. BMJ Open. 2022 Dec 12;12(12):e067024. doi: 10.1136/bmjopen-2022-067024. PMID: 36523249; PMCID: PMC9748516. Abstract <strong>Objective: </strong>The evaluation of post-traumatic stress disorder (PTSD), depression, anxiety and insomnia in patients with Marfan syndrome (MFS) during the third wave of the COVID-19 pandemic in a region of northern Italy (Lombardy) and the investigation of which mental health, sociodemographic and clinical factors were associated with PTSD. <strong>Design: </strong>Descriptive observational design with cross-sectional data collection procedure. <strong>Setting: </strong>A single Italian MFS-specific specialised and reference centre in Lombardy (Italy) between February and April 2021. <strong>Participants: </strong>112 adults with MFS. The majority of participants were female (n=64; 57.1%), with a high school diploma (n=52; 46.4%) and active workers (n=66; 58.9%). The mean age was 41.89 years (SD=14.00), and the mean time from diagnosis was 15.18 years (SD=11.91). <strong>Primary and secondary outcomes: </strong>Descriptive statistics described PTSD, which was the primary outcome, as well as depression, anxiety and insomnia, which were the secondary outcomes. Four linear regression models described the predictors of PTSD total score and its three domains: avoidance, intrusion and hyperarousal. <strong>Results: </strong>One out of 10 patients with MFS had mild psychological symptoms regarding depression, anxiety and insomnia, and scores of PTSD that indicated clinical worries about the mental health status. The presence of PTSD was mainly predicted by anxiety (β=0.647; p&lt;0.001), being older, taking psychoactive medication and being unemployed. <strong>Conclusion: </strong>Depression, anxiety and insomnia should be monitored in patients with MFS in order to minimise PTSD insurgence. Specific psychosocial interventions should be developed and tested for this population and adopted in clinical practice, given the relevance of mental health outcomes during the pandemic.Udugampolage N, Caruso R, Magon A, Conte G, Callus E, Taurino J, Pini A. 本研究标题为《描述意大利伦巴第大区马凡综合征（Marfan syndrome, MFS）成人在新冠疫情第三波期间的创伤后应激障碍（Post-traumatic stress disorder, PTSD）及其与抑郁、焦虑和失眠的关联》，发表于《BMJ Open》，2022年12月12日；12(12):e067024。DOI: 10.1136/bmjopen-2022-067024，PMID: 36523249；PMCID: PMC9748516。摘要如下：<strong>研究目的：</strong>本研究旨在评估意大利北部伦巴第大区某地区新冠疫情第三波期间，马凡综合征患者的创伤后应激障碍、抑郁、焦虑及失眠症状，并探究与创伤后应激障碍相关的心理健康、社会人口学及临床因素。<strong>研究设计：</strong>采用横断面数据收集流程的描述性观察研究设计。<strong>研究地点：</strong>本研究于2021年2月至4月期间，在意大利伦巴第大区的一家马凡综合征专科转诊中心开展。<strong>研究对象：</strong>共纳入112名成年马凡综合征患者。其中多数为女性（n=64；57.1%），拥有高中学历（n=52；46.4%）且为在职人员（n=66；58.9%）。受试者平均年龄为41.89岁（标准差SD=14.00），确诊后的平均病程为15.18年（SD=11.91）。<strong>主要及次要结局指标：</strong>本研究的主要结局指标为创伤后应激障碍的描述性统计结果，次要结局指标为抑郁、焦虑及失眠的相关统计。通过4个线性回归模型，分析创伤后应激障碍总分及其三个维度（回避、闯入症状、高觉醒）的预测因素。<strong>研究结果：</strong>每10名马凡综合征患者中即有1名存在轻度抑郁、焦虑及失眠症状，且其创伤后应激障碍评分提示其心理健康状态需引起临床关注。创伤后应激障碍的发生主要受焦虑（β=0.647；p<0.001）、年龄较大、服用精神活性药物及失业等因素预测。<strong>研究结论：</strong>临床中应加强对马凡综合征患者抑郁、焦虑及失眠症状的监测，以降低创伤后应激障碍的发生风险。鉴于疫情期间心理健康结局的重要性，需针对该人群开发并验证特定的社会心理干预方案，并将其应用于临床实践中。