The change in disease severity and medication adherence of patients registered in community mental health center in the Covid-19 pandemic

Yıl 2023, Cilt: 13 Sayı: 2, 251 - 257, 22.03.2023

Seda Yılmaz , Nülüfer Kılıç

https://doi.org/10.16899/jcm.1244826

Öz

Aim:
In this study, we aimed to investigate the changes in disease severity and medication adherence of patients who stayed away from Community Mental Health Center (CMHC) activities during the Covid-19 pandemic period although they participated more regularly in CMHC activities before the Covid-19 pandemic.
Materials and Methods:
54 patients who regularly attended CMHC were included in the study retrospectively. The first interview in this study was held in January 2020, and the second interview was held in June 2021.
Results:
The increase in the PANSS total 2 score compared to the PANSS total 1 score, the increase in the PANSS positive 2 score compared to the PANSS positive 1 score, the increase in the YMRS 2 score compared to the YMRS 1 score, and the decrease in the MMAS 2 score compared to the MMAS 1 score were found to be significant (p<0.001, p<0.001, p=0.002, p<0.001, respectively). Those who were registered in CMHC for a longer period of time and who participated in CMHC activities for more active days in a week had higher PANSS total 2 scores, PANSS positive 2 scores, YMRS 2 scores, and lower MMAS 2 scores.
Conclusion:
In our study, patients who could not participate actively in CMHC due to social isolation had an increase in the severity of their disease and a decrease in their medication adherence. These results show both the negative effects of the covid-19 pandemic on patients and the importance of CMHC services for patients.

Anahtar Kelimeler

Covid-19, disease severity, medication adherence, community mental health center

Covid-19 Pandemisinde Toplum Ruh Sağlığı Merkezine Kayıtlı Hastaların Hastalık Şiddeti ve İlaç Uyumlarında ki Değişim

Öz

Amaç:
Bu çalışmada covid-19 pandemisinden önce Toplum Ruh Sağlığı Merkezi (TRSM) faaliyetlerine daha düzenli katılım gösteren hastaların, pandemi sürecinde TRSM’den uzak kalmaları ile hastalık şiddetlerinde ki ve ilaç uyumlarında ki değişimi araştırmayı amaçladık.
Gereç ve Yöntem:
Elazığ TRSM’ye düzenli katılım gösteren 54 hasta retrospektif olarak çalışmaya dahil edildi. Bu çalışmada ki birinci görüşme 2020’nin ocak ayında, ikinci görüşme ise 2021’in haziran ayında yapıldı.
Bulgular:
PANSS toplam1 puanına göre PANSS toplam 2 puanında ki artış anlamlı bulunmuştur (p=0,000<0,05). PANSS pozitif 1 puanına göre PANSS pozitif 2 puanında ki artış anlamlı bulunmuştur (p=0,000<0,05). YMDÖ 1 puanına göre YMDÖ 2 puanında ki artış anlamlı bulunmuştur (p=0,002<0,05). MTUÖ 1 puanına göre MTUÖ 2 puanında ki düşüş anlamlı bulunmuştur (p=0,000<0,05). Daha uzun süredir TRSM’ye kayıtlı olan ve 1 haftada aktif gelinen gün sayısı daha fazla olanlarda PANSS toplam 2, PANSS pozitif 2, YMDÖ 2 puanları daha yüksek; MTUÖ 2 puanları daha düşüktü.
Sonuç:
Çalışmamızda sosyal izolasyon nedeniyle TRSM’ye aktif katılım gösteremeyen hastaların hem hastalık şiddetlerinde artış, hem de ilaç tedavisine uyumlarında azalma olmuştur. Bu sonuçlarımız, hem covid-19 pandemisinin hastalar üzerinde ki olumsuz etkilerini, hem de TRSM hizmetlerinin hastalar için önemini göstermektedir.

Anahtar Kelimeler

Covid-19, hastalık şiddeti, ilaç uyumu, toplum ruh sağlığı merkezi

Kaynakça

• 1. Alataş G, Karaoğlan A, Arslan M, Yanık M. Toplum Temelli Ruh Sağlığı Modeli ve Türkiye'de Toplum Ruh Sağlığı Merkezleri Projesi. Noro Psikiyatr Ars 2009;46:25-29.
• 2. İçel S, Aydoğan A, Özkan B. Toplum Ruh Sağlığı Merkezlerinde Hemşirenin Rolü. Ankara Med J 2016;16(2):208-214.
• 3. Zeybek Z, Bozkurt Y, Aşkın R. Covid-19 Pandemisi: Psikolojik Etkileri Ve Terapötik Müdahaleler. İstanbul Ticaret Üniversitesi Sosyal Bilimler Dergisi 2020;19(37):304-318.
• 4. Halder S, Mahato AK, Manot S. COVID-19: Psychological Impact and Psychotherapeutic Intervention. EC Psychology and Psychiatry 2020;9(6):32-35.
• 5. Urizar AC, Maldonado JG, Castillo CM. Quality of life in caregivers of patients with schizophrenia: a literature review. Health Qual Life Outcomes 2009;7:1-5.
• 6. Fagiolini A , Coluccia A, Maina G, et al. Diagnosis, Epidemiology and Management of Mixed States in Bipolar Disorder. CNS Drugs 2015;29(9):725-740.
• 7. Sukut O, Balık CHA. The impact of COVID-19 pandemic on people with severe mental illness. Perspect Psychiatr Care 2021;57(2):953-956.
• 8. Mukhtar S. Psychological health during the coronavirus disease 2019 pandemic outbreak. Int J Soc Psychiatry 2020;66(5):512-516.
• 9. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13(2):261-276.
• 10. Kostakoğlu E, Batur S, Tiryaki A, Göğüş A. Pozitif ve Negatif Sendrom Ölçeğinin (PANSS) Türkçe Uygulamasının Geçerlik ve Güvenilirliği. Türk Psikoloji Dergisi 1999;14(44):23-32.
• 11. Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978;133:429-435.
• 12. Karadağ F, Oral ET, Yalçın FA, Erten E. Young Mani Derecelendirme Ölçeğinin Türkiye’de Geçerlik ve Güvenilirliği. Turk Psikiyatri Derg 2001;13(2):107-114.
• 13. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986;24(1):67-74.
• 14. Aşılar RH, Gözüm S, Çapık C, Morisky DE. Reliability and validity of the Turkish form of the eight-item Morisky medication adherence scale in hypertensive patients. Anadolu Kardiyol Derg 2014;14:692-700.
• 15. Mamun FA, Hosen I, Misti JM, et al. Mental Disorders of Bangladeshi Students During the COVID-19 Pandemic: A Systematic Review. Psychol Res Behav Manag 2021;14:645–654.
• 16. Nussbaumer-Streit B, Mayr V, Dobrescu AI, et al. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database Syst Rev 2020;4(4):CD013574.
• 17. Xiong J, Lipsitz O, Nasri F, et al. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord 2020;277:55-64.
• 18. Severance EG, Dickerson FB, Viscidi RP, et al. . Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophr Bull 2011;37(1):101-107.
• 19. Cheng SK, Tsang JS, Ku KH, et al. Psychiatric complications in patients with severe acute respiratory syndrome (SARS) during the acute treatment phase: a series of 10 cases. Br J Psychiatry 2004;184:359–360.
• 20. Degnan A, Berry K, Sweet D, et al. Social networks and symptomatic and functional outcomes in schizophrenia: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol 2018;53(9):873–888.
• 21. Corrigan PW, Phelan SM. Social support and recovery in people with serious mental illnesses. Community Ment Health J 2004;40(6):513–523.
• 22. Lex C, Bazner E, Meyer TD. Does stress play a significant role in bipolar disorder? A meta-analysis. J Affect Disord 2017;208:298–308.
• 23. Carta MG, Ouali U, Perra A, et al. Living with bipolar disorder in the time of covid-19: Biorhythms during the severe lockdown in Cagliari, Italy, and the moderate Lockdown in Tunis, Tunisia. Front Psychiatry 2021;12:634765.
• 24. Van Rheenen TE, Meyer D, Neill E, et al. Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project. J Affect Disord 2020;275:69–77.
• 25. Hernández-Gómez A, Andrade-González N, Lahera G, Vietaf E. Recommendations for the care of patients with bipolar disorder during the COVID-19 pandemic. J Affect Disord 2021;279:117–121.
• 26. Rajkumar RP. Bipolar disorder, COVID‐19, and the risk of relapse. Bipolar Disord 2020;22(6):640.
• 27. Yocum AK, Zhai Y, Mclnnis MG, Han P. Covid-19 pandemic and lockdown impacts: A description in a longitudinal study of bipolar disorder. J Affect Disord 2021;282:1226-1233.
• 28. Koenders M, Mesbah R, Spijker A, et al. Effects of the COVID-19 pandemic in a preexisting longitudinal study of patients with recently diagnosed bipolar disorder: Indications for increases in manic symptoms. Brain Behav 2021;11(11):e2326.
• 29. Sukut O, Balık CHA. The impact of COVID‐19 pandemic on people with severe mental illness. Perspect Psychiatr Care 2020;57(2):953-956.
• 30. Demir B, Güneysu E, Sancaktar M, et al. Effect of the COVID-19 pandemic on medication adherence in psychiatric disorders. Medicine Science 2021;10(3):720-724.
• 31. Ifteni P, Dima L, Teodorescu A. Long-acting injectable antipsychotics treatment during COVID-19 pandemic – a new challenge. Schizophr Res 2020;220:265–266.
• 32. Muruganandam P, Neelamegam S, Menon V, et al. COVID-19 and Severe Mental Illness: Impact on patients and its relation with their awareness about COVID-19. Psychiatry Res 2020;291:113265.
• 33. Iasevoli F, Fornaro M, D’Urso G, et al. Psychological distress in patients with serious mental illness during the COVID-19 outbreak and one-month mass quarantine in Italy. Psychol Med 2021;51(6):1054-1056.
• 34. Şahin Ş, Elboğa G. Toplum ruh sağlığı merkezinden yararlanan hastaların yaşam kalitesi, tıbbi tedaviye uyumu, içgörü ve işlevsellikleri. Cukurova Med J 2019;44(2):431-438.
• 35. Özdemir İ, Şafak Y, Örsel S, et al. Bir toplum ruh sağlığı merkezinde şizofreni hastalarına uygulanan ruhsal-toplumsal uyumlandırma etkinliğinin araştırılması: Kontrollü çalışma. Anadolu Psikiyatri Derg 2017;18(5):419-427.