Influence of Healthcare Delivery Type on Patients' Mental Health: Is Hospitalization Always a Stressful Factor? Can Allostatic Load Help Assess a Patient's Psychological Disorders?

Overview

Journal Clin Pract

Publisher MDPI

Specialty General Medicine

Date 2024 Jun 26

PMID 38921257

Authors

Ana Maria Gomez Garcia

Eduardo Garcia-Rico

Affiliations

Soon will be listed here.

Abstract

Background: Psychological distress is a predictor of future health and disease data, with consequent implications for both the patient and the healthcare system. Taking advantage of the unprecedented situation caused by the COVID-19 pandemic we aimed to assess whether the type of medical care received by patients during the initial months of the pandemic influenced their evolution, particularly at the psychological level. Additionally, we investigated whether allostatic load was associated not only with physical but also psychological alterations.

Methods: All the patients diagnosed with COVID-19 infection at HM Madrid Hospital during the month of March 2020 were studied, both those hospitalized (110) and those treated on an outpatient basis (46). They were psychologically evaluated using the Profile of Mood States (POMS) test. We calculated the allostatic load using different laboratory parameters.

Results: Outpatient patients had significantly higher scores than hospitalized ones in Tension-Anxiety (52 ± 19.3 vs. 38 ± 4.3; < 0.001). So, 36.9% of the outpatient patients exhibited anxiety. Allostatic load has not been correlated with patients' psychological alterations.

Conclusions: Psychological distress of outpatient patients should be taken into account in their management to improve mental health planning. This knowledge could provide comprehensive care to patients including their mental health, in the face of subsequent epidemics/pandemics.

References

Valdes-Florido M, Lopez-Diaz A, Palermo-Zeballos F, Martinez-Molina I, Martin-Gil V, Crespo-Facorro B . Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series. Rev Psiquiatr Salud Ment (Engl Ed). 2020; 13(2):90-94. PMC: 10068025. DOI: 10.1016/j.rpsm.2020.04.009. View

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X . 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2023; 401(10393):e21-e33. PMC: 10258565. DOI: 10.1016/S0140-6736(23)00810-3. View

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z . Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. PMC: 7270627. DOI: 10.1016/S0140-6736(20)30566-3. View

Graham E, Clark J, Orban Z, Lim P, Szymanski A, Taylor C . Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 "long haulers". Ann Clin Transl Neurol. 2021; 8(5):1073-1085. PMC: 8108421. DOI: 10.1002/acn3.51350. View

Craparo G, La Rosa V, Marino G, Vezzoli M, Cina G, Colombi M . Risk of post-traumatic stress symptoms in hospitalized and non-hospitalized COVID-19 recovered patients. A cross-sectional study. Psychiatry Res. 2021; 308:114353. PMC: 8688161. DOI: 10.1016/j.psychres.2021.114353. View

Dorman-Ilan S, Hertz-Palmor N, Brand-Gothelf A, Hasson-Ohayon I, Matalon N, Gross R . Anxiety and Depression Symptoms in COVID-19 Isolated Patients and in Their Relatives. Front Psychiatry. 2020; 11:581598. PMC: 7591814. DOI: 10.3389/fpsyt.2020.581598. View

Bao Y, Sun Y, Meng S, Shi J, Lu L . 2019-nCoV epidemic: address mental health care to empower society. Lancet. 2020; 395(10224):e37-e38. PMC: 7133594. DOI: 10.1016/S0140-6736(20)30309-3. View

Finlay S, Rudd D, McDermott B, Sarnyai Z . Allostatic load and systemic comorbidities in psychiatric disorders. Psychoneuroendocrinology. 2022; 140:105726. DOI: 10.1016/j.psyneuen.2022.105726. View

Westfall S, Iqbal U, Sebastian M, Pasinetti G . Gut microbiota mediated allostasis prevents stress-induced neuroinflammatory risk factors of Alzheimer's disease. Prog Mol Biol Transl Sci. 2019; 168:147-181. DOI: 10.1016/bs.pmbts.2019.06.013. View

10.

McEwen B . Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007; 87(3):873-904. DOI: 10.1152/physrev.00041.2006. View

11.

Del Valle D, Kim-Schulze S, Huang H, Beckmann N, Nirenberg S, Wang B . An inflammatory cytokine signature predicts COVID-19 severity and survival. Nat Med. 2020; 26(10):1636-1643. PMC: 7869028. DOI: 10.1038/s41591-020-1051-9. View

12.

Gonzalez-Sanguino C, Ausin B, Castellanos M, Saiz J, Lopez-Gomez A, Ugidos C . Mental Health Consequences of the Coronavirus 2020 Pandemic (COVID-19) in Spain. A Longitudinal Study. Front Psychiatry. 2020; 11:565474. PMC: 7680731. DOI: 10.3389/fpsyt.2020.565474. View

13.

Tansey C, Louie M, Loeb M, Gold W, Muller M, de Jager J . One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med. 2007; 167(12):1312-20. DOI: 10.1001/archinte.167.12.1312. View

14.

Pepera G, Tribali M, Batalik L, Petrov I, Papathanasiou J . Epidemiology, risk factors and prognosis of cardiovascular disease in the Coronavirus Disease 2019 (COVID-19) pandemic era: a systematic review. Rev Cardiovasc Med. 2022; 23(1):28. DOI: 10.31083/j.rcm2301028. View

15.

Hossain M, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L . Epidemiology of mental health problems in COVID-19: a review. F1000Res. 2020; 9:636. PMC: 7549174. DOI: 10.12688/f1000research.24457.1. View

16.

Lusida M, Salamah S, Jonatan M, Wiyogo I, Asyari C, Ali N . Prevalence of and risk factors for depression, anxiety, and stress in non-hospitalized asymptomatic and mild COVID-19 patients in East Java province, Indonesia. PLoS One. 2022; 17(7):e0270966. PMC: 9262201. DOI: 10.1371/journal.pone.0270966. View

17.

Ouanes S, Al-Amin H, Hussein N, Khan F, Al Shahrani A, David P . Physical and Psychosocial Well-Being of Hospitalized and Non-Hospitalized Patients With COVID-19 Compared to the General Population in Qatar. Front Psychiatry. 2021; 12:792058. PMC: 8710676. DOI: 10.3389/fpsyt.2021.792058. View

18.

Ahmed H, Patel K, Greenwood D, Halpin S, Lewthwaite P, Salawu A . Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis. J Rehabil Med. 2020; 52(5):jrm00063. DOI: 10.2340/16501977-2694. View

19.

Hu W, Su L, Li D, Zhou Y, Zhu J . Risk of First-Episode Schizophrenia in Aged Adults Increased During COVID-19 Outbreak. Int J Ment Health Addict. 2021; :1-11. PMC: 8508402. DOI: 10.1007/s11469-021-00671-3. View

20.

Rogers J, Chesney E, Oliver D, Pollak T, McGuire P, Fusar-Poli P . Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020; 7(7):611-627. PMC: 7234781. DOI: 10.1016/S2215-0366(20)30203-0. View