Araştırma Makalesi
BibTex RIS Kaynak Göster

YATARAK TEDAVİ GÖREN HASTALARDA COVID-19 'UN AKUT DÖNEM PSİKİYATRİK ETKİLERİ: GERİYE DÖNÜK BİR İNCELEME

Yıl 2022, , 372 - 383, 10.03.2022
https://doi.org/10.33715/inonusaglik.1022907

Öz

COVID-19’un ruh sağlığında ciddi etkilenme yarattığı bilinmesine rağmen, yatarak tedavi gören hastalardaki akut dönem komplikasyonlar hakkında az sayıda araştırma vardır. Bu çalışmada, konsültasyon liyezon psikiyatrisine danışılan COVID-19 enfekte hastalarda konsültasyon istenme nedeni, psikiyatrik hastalık yaygınlığı ve önerilen psikiyatrik müdahalelerin değerlendirilmesi amaçlanmıştır. Çalışma, Türkiye’de bir üniversite hastanesinde, Mart 2020- Ekim 2021 tarihleri arasında, COVID-19 nedeniyle yatarak tedavi gören 138 hastaya ait psikiyatrik konsültasyon raporlarının geriye doğru incelenmesiyle yürütülmüştür. Hastalara ait veriler elektronik tıbbi kayıtlardan elde edilmiştir. Yapılan analiz sonuçlarına göre, konsültasyon istenme nedenleri sırasıyla uykusuzluk (%26.22), kaygı/ölüm korkusu (%20.76), ajitasyon (%17.48) ve halüsinasyon/bilinçte dalgalanma (%11.47) idi. En sık konulan psikiyatrik tanılar deliryum ve uyku bozuklukları (%22.5) idi, bunları sırasıyla uyum bozukluğu (%11.6), anksiyete (%10.9) ve depresyon (%3.6) izliyordu. Hastaların % 85.5’ine medikal tedavi önerilmişti ve haloperidol en sık önerilen ajandı. Yoğun bakımda tedavi gören hastaların %44.1’i deliryum tanısı almıştı ve bunların yaşları daha yüksekti. İleri yaş, deliryum ve ölüm oranlarında artışa neden olmuştu. Bu bulgular, COVID-19 hastaları arasında psikiyatrik morbiditelerin ve deliryumun yaygın olduğuna, pandemisi sırasında konsültasyon-liyezon hizmetlerine olan ihtiyacın artabileceğine işaret etmektedir.

Kaynakça

  • American Psychiatric Association. (2006). Practice guidelines for the treatment of Psychiatric disorders compendium içinde (ss.65-100). American Psychiatric Publishing Incorporated. Arlington: Virginia
  • Arbelo, N., López-Pelayo, H., Sagué, M., Madero, S., Pinzón-Espinosa, J., Gomes-da-Costa, S., …Pintor, L. (2021). Psychiatric Clinical Profiles and Pharmacological Interactions in COVID-19 Inpatients Referred to a Consultation Liaison Psychiatry Unit: a Cross-Sectional Study. The Psychiatric quarterly, 92(3), 1021–1033.
  • Baig, A. M., Khaleeq, A., Ali, U., Syeda, H. (2020). Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS chemical neuroscience, 11(7), 995–998.
  • Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet (London, England), 395(10227), 912–920.
  • Castro, V. M., Sacks, C. A., Perlis, R. H., McCoy, T. H. (2021). Development and External Validation of a Delirium Prediction Model for Hospitalized Patients With Coronavirus Disease 2019. Journal of the Academy of Consultation-Liaison Psychiatry, 62(3), 298–308.
  • Çolak, G. V. Hocaoğlu, Ç. (2021). Kayıp ve Yas: Bir Gözden Geçirme. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 3 (1), 56-62.
  • Dönmez, M. C., Gündoğar, D., Demirci, S. (2007). Deliryum: nedenleri ve klinik yaklaşım. Turkiye Klinikleri J Med Sci, 27, 718-24.
  • Düğer, Ü., Kolutek, R. (2020). Nöroloji servisinde yatan geriatrik hastalarda hastane ortamının uyku kalitesine etkisi. (Yayımlanmamış Yüksek Lisans Tezi). Nevşehir Hacı Bektaş Veli Üniversitesi, Nevşehir.
  • Eser, B., Batmaz, S., Songur, E., Yıldız, M., Akpınar Aslan, E. (2018). Bir üniversite hastanesinde yatan hastalar için ve acil servisten istenilen ruh sağlığı ve hastalıkları konsültasyonlarının incelenmesi: Türkiye’den çalışmalarla bir karşılaştırma.
  • El Hayek, S., Kassir, G., Zalzale, H., Gonzalez-Diaz, J. M., Bizri, M. (2021). Emerging Psychiatric Themes in Post-COVID-19 Patients on a Psychiatry Consultation-liaison Service. The Psychiatric quarterly, 92(4), 1785–1796.
  • Grover, S., Sahoo, S., Chakrabarti, S. (2021). Impact of the COVID-19 Pandemic on Consultation-Liaison Psychiatry Services: An Exploratory Study From a Tertiary Care Center in North India. The primary care companion for CNS disorders, 23(5), 21m02973.
  • Gültekin, B. K. (2010). Ruhsal bozuklukların önlenmesi: Kavramsal çerçeve ve sınıflandırma. Psikiyatride Güncel Yaklaşımlar, 2(4), 583-594.
  • Iqbal, Y., Al Abdulla, M. A., Albrahim, S., Latoo, J., Kumar, R., Haddad, P. M. (2020). Psychiatric presentation of patients with acute SARS-CoV-2 infection: a retrospective review of 50 consecutive patients seen by a consultation-liaison psychiatry team. BJPsych open, 6(5).
  • Incerti, D., Rizzo, S., Li, X., Lindsay, L., Yau, V., Keebler, D., ... Tsai, L. (2020). Risk factors for mortality among hospitalized patients with COVID-19. medRxiv.
  • Lam, M. H., Wing, Y. K., Yu, M. W., Leung, C. M., Ma, R. C., Kong, A. P., … Lam, S. P. (2009). Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long- term follow-up. Archives of internal medicine, 169(22), 2142–2147.
  • Leslie, D. L., Inouye, S. K. (2011). The importance of delirium: economic and societal costs. Journal of the American Geriatrics Society, 59 Suppl 2(Suppl 2), S241–S243.
  • Marengoni, A., Zucchelli, A., Grande, G., Fratiglioni, L., Rizzuto, D. (2020). The impact of delirium on outcomes for older adults hospitalised with COVID-19. Age and ageing, 49(6), 923–926.
  • Nalleballe, K., Reddy Onteddu, S., Sharma, R., Dandu, V., Brown, A., Jasti, M., … Kovvuru, S. (2020). Spectrum of neuropsychiatric manifestations in COVID-19. Brain, behavior, and immunity, 88, 71–74.
  • O'Hanlon, S., Inouye, S. K. (2020). Delirium: a missing piece in the COVID-19 pandemic puzzle. Age and ageing, 49(4), 497–498.
  • Oh, E. S., Needham, D. M., Nikooie, R., Wilson, L. M., Zhang, A., Robinson, K. A., Neufeld, K. J. (2019). Antipsychotics for Preventing Delirium in Hospitalized Adults: A Systematic Review. Annals of internal medicine, 171(7), 474–484.
  • Prajapati, N. K., Parikh, N. C., Shah, N. D., Darji, V. M., Jariwala, H. B., Miroliya, M. T. (2021). Evaluation of Psychiatric Morbidity in COVID-19-Positive Inpatients Referred to Consultation Liaison Psychiatry in a Tertiary Care Hospital. Indian journal of psychological medicine, 43(4), 330–335.
  • Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., …David, A. S. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. The lancet. Psychiatry, 7(7), 611–627.
  • Salluh, J. I., Wang, H., Schneider, E. B., Nagaraja, N., Yenokyan, G., Damluji, A., … Stevens, R. D. (2015). Outcome of delirium in critically ill patients: systematic review and meta-analysis. BMJ (Clinical research ed.), 350, h2538.
  • Shalev, D., Nakagawa, S., Stroeh, O. M., Arbuckle, M. R., Rendleman, R., Blinderman, C. D., Shapiro, P. A. (2020). The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis. Journal of pain and symptom management, 60(3), e12–e16.
  • Turan, Ş., Poyraz, B. Ç., Aksoy Poyraz, C., Demirel, Ö. F., Tanrıöver Aydın, E., Uçar Bostan, B., … Ali, R. K. (2021). Characteristics and outcomes of COVID-19 inpatients who underwent psychiatric consultations. Asian journal of psychiatry, 57, 102563.
  • Uzun, K., Yavşan, D. M. (2014). Yoğun bakımda uyku. Güncel Göğüs Hastalıkları Serisi, 2(2), 230-236.
  • van den Ende, E. S., van Veldhuizen, K., Toussaint, B., Merten, H., van de Ven, P. M., Kok, N. A., Nanayakkara, P. (2021). Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study. Frontiers in neuroscience, 15, 680932.
  • Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., …Yang, C. (2020). Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, behavior, and immunity, 87,18–22.
  • Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., Ng, C. H. (2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The lancet. Psychiatry, 7(3), 228–229.
  • Xie, Q., Fan, F., Fan, X. P., Wang, X. J., Chen, M. J., Zhong, B. L., Chiu, H. F. (2020). COVID-19 patients managed in psychiatric inpatient settings due to first-episode mental disorders in Wuhan, China: clinical characteristics, treatments, outcomes, and our experiences. Translational psychiatry, 10(1), 337.

Acute Period Psychiatric Effects of COVID- 19 in Hospitalized Patients: A Retrospective Investigation

Yıl 2022, , 372 - 383, 10.03.2022
https://doi.org/10.33715/inonusaglik.1022907

Öz

Although it is known that COVID-19 has a serious impact on mental health, there are few studies on the acute period complications in hospitalized patients. In this study, it has been aimed to evaluate the reason for asking for consultation, prevalence of psychiatric disease and recommended psychiatric interventions, in COVID-19 infected patients who were consulted to consultation liaison psychiatry. This study has been conducted by retrospectively examining the psychiatric consultation reports of 138 patients who were hospitalized for COVID-19 in a university hospital in Turkey between March 2020 and October 2021. Patients’ data were obtained from electronic medical records. According to the results of the analysis, the reasons for requesting a consultation were insomnia (26.22%), anxiety/fear of death (20.76%), agitation (17.48%), and hallucinations/fluctuation in consciousness (11.47%), respectively. The most common psychiatric diagnoses were delirium and sleep disorders (22.5%), these were followed respectively by adjustment disorder (11.6%), anxiety (10.9%) and depression (3.6%). Medical treatment was recommended for 85.5% of the patients, and haloperidol was the most frequently recommended agent. 44.1% of the patients treated in the intensive care unit were diagnosed with delirium and their age was higher. Advanced age caused an increase in delirium and death rates. These findings indicate that psychiatric morbidities and delirium are common among COVID-19 patients, and the need for consultation-liaison services may increase during the pandemic.

Kaynakça

  • American Psychiatric Association. (2006). Practice guidelines for the treatment of Psychiatric disorders compendium içinde (ss.65-100). American Psychiatric Publishing Incorporated. Arlington: Virginia
  • Arbelo, N., López-Pelayo, H., Sagué, M., Madero, S., Pinzón-Espinosa, J., Gomes-da-Costa, S., …Pintor, L. (2021). Psychiatric Clinical Profiles and Pharmacological Interactions in COVID-19 Inpatients Referred to a Consultation Liaison Psychiatry Unit: a Cross-Sectional Study. The Psychiatric quarterly, 92(3), 1021–1033.
  • Baig, A. M., Khaleeq, A., Ali, U., Syeda, H. (2020). Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS chemical neuroscience, 11(7), 995–998.
  • Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet (London, England), 395(10227), 912–920.
  • Castro, V. M., Sacks, C. A., Perlis, R. H., McCoy, T. H. (2021). Development and External Validation of a Delirium Prediction Model for Hospitalized Patients With Coronavirus Disease 2019. Journal of the Academy of Consultation-Liaison Psychiatry, 62(3), 298–308.
  • Çolak, G. V. Hocaoğlu, Ç. (2021). Kayıp ve Yas: Bir Gözden Geçirme. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 3 (1), 56-62.
  • Dönmez, M. C., Gündoğar, D., Demirci, S. (2007). Deliryum: nedenleri ve klinik yaklaşım. Turkiye Klinikleri J Med Sci, 27, 718-24.
  • Düğer, Ü., Kolutek, R. (2020). Nöroloji servisinde yatan geriatrik hastalarda hastane ortamının uyku kalitesine etkisi. (Yayımlanmamış Yüksek Lisans Tezi). Nevşehir Hacı Bektaş Veli Üniversitesi, Nevşehir.
  • Eser, B., Batmaz, S., Songur, E., Yıldız, M., Akpınar Aslan, E. (2018). Bir üniversite hastanesinde yatan hastalar için ve acil servisten istenilen ruh sağlığı ve hastalıkları konsültasyonlarının incelenmesi: Türkiye’den çalışmalarla bir karşılaştırma.
  • El Hayek, S., Kassir, G., Zalzale, H., Gonzalez-Diaz, J. M., Bizri, M. (2021). Emerging Psychiatric Themes in Post-COVID-19 Patients on a Psychiatry Consultation-liaison Service. The Psychiatric quarterly, 92(4), 1785–1796.
  • Grover, S., Sahoo, S., Chakrabarti, S. (2021). Impact of the COVID-19 Pandemic on Consultation-Liaison Psychiatry Services: An Exploratory Study From a Tertiary Care Center in North India. The primary care companion for CNS disorders, 23(5), 21m02973.
  • Gültekin, B. K. (2010). Ruhsal bozuklukların önlenmesi: Kavramsal çerçeve ve sınıflandırma. Psikiyatride Güncel Yaklaşımlar, 2(4), 583-594.
  • Iqbal, Y., Al Abdulla, M. A., Albrahim, S., Latoo, J., Kumar, R., Haddad, P. M. (2020). Psychiatric presentation of patients with acute SARS-CoV-2 infection: a retrospective review of 50 consecutive patients seen by a consultation-liaison psychiatry team. BJPsych open, 6(5).
  • Incerti, D., Rizzo, S., Li, X., Lindsay, L., Yau, V., Keebler, D., ... Tsai, L. (2020). Risk factors for mortality among hospitalized patients with COVID-19. medRxiv.
  • Lam, M. H., Wing, Y. K., Yu, M. W., Leung, C. M., Ma, R. C., Kong, A. P., … Lam, S. P. (2009). Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long- term follow-up. Archives of internal medicine, 169(22), 2142–2147.
  • Leslie, D. L., Inouye, S. K. (2011). The importance of delirium: economic and societal costs. Journal of the American Geriatrics Society, 59 Suppl 2(Suppl 2), S241–S243.
  • Marengoni, A., Zucchelli, A., Grande, G., Fratiglioni, L., Rizzuto, D. (2020). The impact of delirium on outcomes for older adults hospitalised with COVID-19. Age and ageing, 49(6), 923–926.
  • Nalleballe, K., Reddy Onteddu, S., Sharma, R., Dandu, V., Brown, A., Jasti, M., … Kovvuru, S. (2020). Spectrum of neuropsychiatric manifestations in COVID-19. Brain, behavior, and immunity, 88, 71–74.
  • O'Hanlon, S., Inouye, S. K. (2020). Delirium: a missing piece in the COVID-19 pandemic puzzle. Age and ageing, 49(4), 497–498.
  • Oh, E. S., Needham, D. M., Nikooie, R., Wilson, L. M., Zhang, A., Robinson, K. A., Neufeld, K. J. (2019). Antipsychotics for Preventing Delirium in Hospitalized Adults: A Systematic Review. Annals of internal medicine, 171(7), 474–484.
  • Prajapati, N. K., Parikh, N. C., Shah, N. D., Darji, V. M., Jariwala, H. B., Miroliya, M. T. (2021). Evaluation of Psychiatric Morbidity in COVID-19-Positive Inpatients Referred to Consultation Liaison Psychiatry in a Tertiary Care Hospital. Indian journal of psychological medicine, 43(4), 330–335.
  • Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., …David, A. S. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. The lancet. Psychiatry, 7(7), 611–627.
  • Salluh, J. I., Wang, H., Schneider, E. B., Nagaraja, N., Yenokyan, G., Damluji, A., … Stevens, R. D. (2015). Outcome of delirium in critically ill patients: systematic review and meta-analysis. BMJ (Clinical research ed.), 350, h2538.
  • Shalev, D., Nakagawa, S., Stroeh, O. M., Arbuckle, M. R., Rendleman, R., Blinderman, C. D., Shapiro, P. A. (2020). The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis. Journal of pain and symptom management, 60(3), e12–e16.
  • Turan, Ş., Poyraz, B. Ç., Aksoy Poyraz, C., Demirel, Ö. F., Tanrıöver Aydın, E., Uçar Bostan, B., … Ali, R. K. (2021). Characteristics and outcomes of COVID-19 inpatients who underwent psychiatric consultations. Asian journal of psychiatry, 57, 102563.
  • Uzun, K., Yavşan, D. M. (2014). Yoğun bakımda uyku. Güncel Göğüs Hastalıkları Serisi, 2(2), 230-236.
  • van den Ende, E. S., van Veldhuizen, K., Toussaint, B., Merten, H., van de Ven, P. M., Kok, N. A., Nanayakkara, P. (2021). Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study. Frontiers in neuroscience, 15, 680932.
  • Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., …Yang, C. (2020). Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, behavior, and immunity, 87,18–22.
  • Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., Ng, C. H. (2020). Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The lancet. Psychiatry, 7(3), 228–229.
  • Xie, Q., Fan, F., Fan, X. P., Wang, X. J., Chen, M. J., Zhong, B. L., Chiu, H. F. (2020). COVID-19 patients managed in psychiatric inpatient settings due to first-episode mental disorders in Wuhan, China: clinical characteristics, treatments, outcomes, and our experiences. Translational psychiatry, 10(1), 337.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Neslihan Cansel 0000-0002-5519-205X

Yayımlanma Tarihi 10 Mart 2022
Gönderilme Tarihi 14 Kasım 2021
Kabul Tarihi 9 Şubat 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

APA Cansel, N. (2022). YATARAK TEDAVİ GÖREN HASTALARDA COVID-19 ’UN AKUT DÖNEM PSİKİYATRİK ETKİLERİ: GERİYE DÖNÜK BİR İNCELEME. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 10(1), 372-383. https://doi.org/10.33715/inonusaglik.1022907