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Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos
Cherica A Tee1, Evelyn O Salido2, Patrick Wincy C Reyes3
1Department of Pediatrics, College of Medicine, University of the Philippines, Manila, Philippines.
Insights
Filipino patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) experienced significant psychological distress during the COVID-19 pandemic. Mental health support is crucial, considering factors like comorbidities and access to health information.
Area of Science:
- Rheumatology
- Infectious Diseases
- Psychiatry
- Public Health
Background:
- Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are considered at higher risk for severe COVID-19 outcomes.
- The COVID-19 pandemic exacerbated existing healthcare challenges, including shortages of essential medications like hydroxychloroquine.
Purpose of the Study:
- To assess the psychological responses of Filipino patients with SLE and RA to the COVID-19 pandemic and hydroxychloroquine shortage.
- To identify risk and protective factors influencing mental health in this patient population during the pandemic.
Main Methods:
- An online survey was administered to 512 Filipino patients with SLE and RA between May 19-26, 2020.
- Data collected included socio-demographics, health status, COVID-19 concerns, and validated scales for psychological impact (IES-R, DASS-21).
Main Results:
- Approximately 20% of patients reported moderate to severe psychological impact from the COVID-19 outbreak.
- High rates of moderate to severe anxiety (38.7%) and depression (27.7%) were observed.
- Comorbidities (hypertension, asthma), healthcare worker status, and specific symptoms were risk factors for adverse mental health, while satisfaction with health information and mask-wearing were protective.
Conclusions:
- In the early months of the pandemic, a significant portion of Filipino SLE and RA patients experienced moderate to severe psychological distress.
- Understanding the factors influencing mental health is vital for developing targeted psychological support strategies for these vulnerable patient groups.
Background:
Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are perceived to be more vulnerable to worse COVID-19 infection outcome. Furthermore, severe shortage in hydroxychloroquine supply was experienced.
Objective:
We presented the psychological responses of Filipino SLE and RA patients to the COVID-19 pandemic and shortage of hydroxychloroquine supply.
Methods:
A total of 512 completed online surveys from SLE and RA patients were gathered from May 19 to 26, 2020. The online survey collected data on socio-demographics, health status, contact history, health service utilization, use of hydroxychloroquine, COVID-19 knowledge and concerns, precautionary measures, information needs, the validated Impact of Events Scale-Revised (IES-R) and Depression, Anxiety and Stress Scales (DASS-21) ratings.
Results:
The psychological impact of COVID-19 outbreak was at least moderate in 20%. The mean IES-R score was higher among SLE (22.34, SD=14.39) than RA (18.85, SD=13.24) patients. Stress, anxiety and depression were moderate to severe in 12.3%, 38.7%, and 27.7% of respondents. The mean stress subscale score was 10.11 (SD=7.95), mean anxiety subscale score was 6.79 (SD=6.57) and mean depression subscale score was 9.03 (SD=8.77). The risk factors for adverse mental health during the COVID-19 pandemic include the presence of comorbidity of hypertension and asthma; being a healthcare worker; and presence of specific symptoms of myalgia, cough, breathing difficulty, dizziness and sore throat. The protective factors for mental health during the pandemic include satisfaction with available health information and wearing of face masks.
Conclusion:
In the third month of the pandemic in the Philippines, 20% of the respondents with lupus and RA experienced moderate to severe psychological impact. There was moderate to severe anxiety in 38.7% and moderate to severe depression in 27%. Identification of factors that affect mental health in lupus and RA is useful in implementation of effective psychological support strategies.
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