Covid-19 pandemisinde toplum ruh sağlığı merkezlerinin hizmet şekli değişikliği ile şizofreni hastalarındaki anksiyete düzeyleri arasındaki ilişki

Year 2021, Volume: 46 Issue: 3, 966 - 974, 30.09.2021

Elif Özcan Tozoğlu Emre Alkan Gökhan Özpolat

https://doi.org/10.17826/cumj.903054

Cited By: 1

Abstract

Amaç: Bu çalışmada Covid-19 pandemisinde Toplum Ruh Sağlığı Merkezlerinin (TRSM) hizmet şekli ile şizofreni hastalarındaki anksiyete düzeyleri arasındaki ilişkiyi değerlendirmek amaçlanmıştır.
Gereç ve Yöntem: Erzurum Bölge Eğitim ve Araştırma Hastanesi TRSM’e düzenli olarak gelen 22-68 yaş arasındaki remisyondaki 26 şizofreni hastası çalışmaya dahil edilmiştir. Hastaların sosyodemografik özellikleri değerlendirmek için bir form kullanılmıştır. Hastalara pandemi öncesinde uygulanan Klinik Global İzlenim Ölçeği (KGİÖ) ve Durumluk ve Sürekli Kaygı Envanteri (STAI), pandemi sonrası görüşmelerin asgariye indirildiği dönemde 2. kez ve sonrasında yüz yüze düzenli görüşmelerin tekrar başladığı dönemde 3.kez uygulanmıştır.
Bulgular: STAI skorları en yüksek 2. görüşmede, en düşük 1. görüşmede saptanmıştır. Her 3 görüşmede de skorlar istatistiki olarak birbirinden anlamlı olarak farklıdır. KGİÖ değerleri her 3 görüşmede istatistiki olarak birbirinden anlamlı ölçüde farklı gözükmekle birlikte; yapılan post-hoc analizlerde bu fark istatistiki olarak anlamlı bulunmamıştır.
Sonuç: Çalışmamızdan elde ettiğimiz sonuçlar Covid-19 pandemisinin şizofreni hastalarının psikolojik durumu üzerinde olumsuz etkileri olabileceğini ve toplum ruh sağlığı hizmetlerinin ise bu etkiyi azaltmada katkı sağlayabileceğini göstermektedir.

Keywords

Toplum Ruh Sağlığı Merkezi, Şizofrenide Anksiyete, Covid-19 Pandemisi

The relationship between the service type change of community mental health centers and the anxiety levels in schizophrenia patients in the Covid-19 pandemic

Abstract

Purpose: The aim of this study was to evaluate the relationship between the service style of Community Mental Health Centers (CMHC) and anxiety levels in patients with schizophrenia in the Covid-19 pandemic.
Materials and Methods: Twenty-six patients with schizophrenia in remission between the ages of 22-68, who regularly attended the Erzurum Regional Training and Research Hospital TRSM, were included in the study. A form was used to evaluate the sociodemographic characteristics of the patients. The Clinical Global Impression Scale (CGI) and State and Trait Anxiety Inventory (STAI), which were applied to the patients before the pandemic, were administered for the second time during the period when the post-pandemic interviews were minimized, and administered for the third time, when regular face-to-face meetings resumed.
Results: The highest STAI scores were found in the second interview and the lowest in the first interview. The scores in all 3 interviews are statistically significantly different from each other. Although the CGI values seem to be statistically significantly different from each other in all 3 interviews; this difference was not found statistically significant in post-hoc analysis.
Conclusion: The results we have obtained from our study show that the Covid-19 pandemic may have negative effects on the psychological state of schizophrenia patients, and community mental health services can contribute to reducing this effect.

Keywords

Community Mental Health Center, anxiety in schizophrenia, Covid-19 pandemic

References

• Referans1. Taylor S. The psychology of pandemics: Preparing for the next global outbreak of infectious disease, Cambridge Scholars Publishing, 2019.
• Referans 2. Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (swine flu) pandemic. Cognit Ther Res. 2012; 36:210-8.
• Referans 3. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int Journal Environ Res Public Health. 2020; 17:1729.
• Referans 4. Choi EPH, Hui BPH, Wan EYF. Depression and anxiety in Hong Kong during COVID-19. Int Journal Environ Res Public Health. 2020; 17:3740.
• Referans 5. Blanchard JJ, Mueser KT, Bellack AS. Anhedonia, positive and negative affect, and social functioning in schizophrenia. Schizophr Bull. 1998; 24:413-24.
• Referans 6. Pallanti S, Quercioli L, Hollander E. Social anxiety in outpatients with schizophrenia: a relevant cause of disability. Am J Psychiatry. 2004; 161:53-8.
• Referans 7. Lysaker PH, Davis LW, Lightfoot J, Hunter N, Stasburger A. Association of neurocognition, anxiety, positive and negative symptoms with coping preference in schizophrenia spectrum disorders. Schizophr Res. 2005; 80:163-71.
• Referans 8. Davis LW, Strasburger AM, Brown LF. Mindfulness: an intervention for anxiety in schizophrenia. J Psychosoc Nurs Ment Health Serv. 2007; 45:22-9.
• Referans 9. Buonocore M, Bosinelli F, Bechi M, Spangaro M, Cocchi F, Bianchi L, et al. Daily functioning in schizophrenia: Is there room for anxiety? J Nerv Ment Dis. 2019; 207:615-9.
• Referans 10. Buonocore M, Bosia M, Bechi M, Spangaro M, Cavedoni S, Cocchi F, et al. Targeting anxiety to improve quality of life in patients with schizophrenia. Eur Psychiatry. 2017; 45:129-35.
• Referans 11. Johnstone EC, Ebmeier KP, Miller P, Owens DG, Lawrie SM. Predicting schizophrenia: findings from the Edinburgh high-risk study. Br J Psychiatry. 2005; 186:18-25.
• Referans 12. Nyhuis AW, Faries DE, Ascher-Svanum H, Stauffer VL, Kinon BJ. Predictors of switching antipsychotic medications in the treatment of schizophrenia. BMC psychiatry. 2010; 10:1-11.
• Referans 13. Tiryaki A, Özkorumak E, Ak İ. Şizofreni Tanısı Almış Poliklinik Hastalarında Psikiyatrik Eş Tanılar. Klinik Psikofarmakol Bulteni. 2007; 17.
• Referans 14. Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. J Psychosom Res. 2004; 57:35-43.
• Referans 15. Guilbert J. The World Health Report 2001—Mental Health: New Understanding, New Hope. Educ Health. 2002; 15:263-4.
• Referans 16. Chowdur R, Dharitri R, Kalyanasundaram S, Suryanarayana RN. Efficacy of psychosocial rehabilitation program: The RFS experience. Indian J Psychiatry. 2011; 53:45.
• Referans 17. Frey BN, Zunta-Soares GB, Caetano SC, Nicoletti MA, Hatch JP, Brambilla P, et al. Illness duration and total brain gray matter in bipolar disorder: evidence for neurodegeneration? Eur Neuropsychopharmacol. 2008; 18:717-22.
• Referans 18. Weiss DS, Marmar CR, Metzler TJ, Ronfeldt HM. Predicting symptomatic distress in emergency services personnel. J Consult Clin Psychol. 1995; 63:361.
• Referans 19. Catalan J, Burgess A, Pergami A, Hulme N, Gazzard B, Phillips R. The psychological impact on staff of caring for people with serious diseases: the case of HIV infection and oncology. J Psychosom Res. 1996; 40:425-35.
• Referans 20. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry. 2020; 7:e15-e6.
• Referans 21. Yu W, Singh SS, Calhoun S, Zhang H, Zhao X, Yang F. Generalized anxiety disorder in urban China: prevalence, awareness, and disease burden. J Affect Disord. 2018; 234:89-96.
• Referans 22. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020; 288:112954.
• Referans 23. Lee S, Tsang A, Huang Y-Q, He Y-L, Liu Z, Zhang M-Y, et al. The epidemiology of depression in metropolitan China. Psychol Med. 2009; 39:735.
• Referans 24. De Girolamo G, Cerveri G, Clerici M, Monzani E, Spinogatti F, Starace F, et al. Mental health in the coronavirus disease 2019 emergency—the Italian response. JAMA Psychiatry. 2020; 77:974-6.
• Referans 25. Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S, et al. Mental health problems and social media exposure during COVID-19 outbreak. PloS One. 2020; 15:e0231924.
• Referans 26. Neria Y, Sullivan GM. Understanding the mental health effects of indirect exposure to mass trauma through the media. Jama. 2011; 306:1374-5.
• Referans 27. Bjelland I, Krokstad S, Mykletun A, Dahl AA, Tell GS, Tambs K. Does a higher educational level protect against anxiety and depression? The HUNT study. Soc Sci Med. 2008; 66:1334-45.
• Referans 28. Chazelle E, Lemogne C, Morgan K, Kelleher CC, Chastang J-F, Niedhammer I. Explanations of educational differences in major depression and generalised anxiety disorder in the Irish population. J Affect Disord. 2011; 134:304-14.
• Referans 29. Molarius A, Granström F. Educational differences in psychological distress? Results from a population-based sample of men and women in Sweden in 2012. BMJ open. 2018; 8.
• Referans 30. Person B, Sy F, Holton K, Govert B, Liang A. Fear and stigma: the epidemic within the SARS outbreak. Emerg Infect Dis. 2004; 10:358.
• Referans 31. Leigh-Hunt N, Bagguley D, Bash K, Turner V, Turnbull S, Valtorta N, et al. An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public health. 2017; 152:157-71.
• Referans 32. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912-20.
• Referans 33. Wanchek TN, McGarvey EL, Leon-Verdin M, Bonnie RJ. The effect of community mental health services on hospitalization rates in Virginia. Psychiatr Serv. 2011; 62:194-9.
• Referans 34. Madianos MG, Economou M. The impact of a community mental health center on psychiatric hospitalizations in two Athens areas. Community Ment Health J. 1999; 35:313-23.
• Referans 35. Hyun J. Recovery-and Community-Based Mental Health Services in the Slovak Republic: A Pilot Study on the Implications for Hospitalization and Inpatient Length-of-Stay for Individuals with Severe and Persistent Mental Illness. International Journal of Psychosocial Rehabilitation. 2008; 13.
• Referans 36. Pirkola S, Sund R, Sailas E, Wahlbeck K. Community mental-health services and suicide rate in Finland: a nationwide small-area analysis. Lancet. 2009; 373:147-53.
• Referans 37. Ensari H, Gültekin BK, Karaman D, KOÇ A, BEŞKARDEŞ AF. Bolu Toplum Ruh Sağlığı Merkezi hizmetlerinin şizofreni hastalarındaki yaşam kalitesi, yeti yitimi, genel ve sosyal işlevsellik üzerine etkisi: Bir yıllık izleme sonuçları. Anadolu Psikiyatri Derg. 2013; 14.
• Referans 38. Erşan EE. Hospitalization and some sociodemographic characteristics of patients registered with a community mental health center. Community Ment Health J. 2020; 56:498-505.
• Referans 39. Arslantaş H, Adana F. Factors affecting caregivers’ burden and emotional expression of patients with schizophrenia. Anatolian J Psychiatry. 2012; 13:8-15.
• Referans 40. Yıldırım A, Buzlu S, Hacıhasanoğlu Aşılar R, Camcıoğlu TH, Erdiman S, Ekinci M. Şizofreni hastalarının ailelerine uygulanan aileden aileye destek programının hastalık hakkında bilgi, aile yükü ve öz yeterlilik üzerine etkisi. 2014.
• Referans 41. Ayhan MG, Köse A, Ercan SK, Bozdoğan ŞY, Özayhan HY, Eren İ. Toplum ruh sağlığı merkezi hizmetlerinden yararlanan şizofreni tanılı hastaların yakınlarındaki bakım yükü: karşılaştırmalı bir çalışma. Cukurova Med J. 2019; 44:92-9.
• Referans 42. Bulut M, Arslantaş H, Ferhan Dereboy İ. Effects of psychoeducation given to caregivers of people with a diagnosis of schizophrenia. Issues Ment Health Nurs. 2016; 37:800-10.
• Referans 43. Glynn SM, Randolph ET, Eth S, Paz GG, Leong GB, Shaner AL, et al. Patient psychopathology and expressed emotion in schizophrenia. Br J Psychiatry. 1990; 157:877-80.
• Referans 44. Docherty NM, St-Hilaire A, Aakre JM, Seghers JP, McCleery A, Divilbiss M. Anxiety interacts with expressed emotion criticism in the prediction of psychotic symptom exacerbation. Schizophr Bull. 2011; 37:611-8.
• Referans 45. Hausmann A, Fleischhacker W. Differential diagnosis of depressed mood in patients with schizophrenia: a diagnostic algorithm based on a review. Acta Psychiatr Scand. 2002; 106:83-96.
• Referans 46. Bleuler E. Dementia praecox or the group of schizophrenias. 1950.
• Referans 47. Cacciotti‐Saija C, Langdon R, Ward PB, Hickie IB, Guastella AJ. Clinical symptoms predict concurrent social and global functioning in an early psychosis sample. Early Interv Psychiatry. 2018; 12:177-84.
• Referans 48. Huppert JD, Weiss KA, Lim R, Pratt S, Smith TE. Quality of life in schizophrenia: contributions of anxiety and depression. Schizophr Res. 2001; 51:171-80.