POS1493-HPR FACTORS ASSOCIATED WITH THE OCCURRENCE OF MENTAL DISORDERS IN PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASES DURING THE COVID-19 PANDEMIC.

Abstract

BackgroundMental disorders constitute a serious and underestimated problem in Latin America and they could have worse features in comparison with Europe or North America (1); that was the case even before the COVID-19 epidemic ensued in 2020.ObjectivesThe objective of this study was to determine the factors associated with the occurrence of mental health disorders (MHD) in patients with autoimmune rheumatic disease (ARD) from Perú, a high COVID-19 incidence country.MethodsPatients with ARD from a single center (Hospital Guillermo Almenara -EsSalud, Lima-Perú) were included during the first and second waves of the COVID-19 pandemic (March to November 2020). Interviews, medical records reviews, and an electronic survey were performed. MHD explored were depression (assessed with the Patient Health Questionnaire 9: PHQ-9), anxiety (ascertained with the Generalized Anxiety Disorder-7: GAD-7) and post-traumatic stress disorder: PTSD (evaluated with the Event Scale-Revised: IES-R). Variables examined were sociodemographic (age, gender, educational level, marital status, living alone, job status, religiosity), previous diagnosis and treatment for mental disorders, living with a COVID-19 patient, COVID-19 diagnosis (current or past), fear of COVID-19 (assessed with the COVID-19 Scale: FCV-19S) and the ARD type. Multivariable logistic regression models using backward elimination procedure were performed to determine the variables associated with depression, anxiety, and PTSD. (See Table 1).Table 1.Variables associated with depression, anxiety an PSTD on ARD patients: Multivariable analysis.DepressionAnxietyPTSDvariablesOR (CI=95%)p valueOR (CI95%)p valueOR (CI95%)p valuePrevious treatment for mental disorders2.35 (1.37-4.0)30.0022.42 (1.37-4.26)0.0022.42 1.39-4.210.002Fear for COVID-191.07 (1.05-1.10)<0.0011.09 (1.06-1.12)<0.0011.41 1.11-1.17<0.001COVID-19 diagnosisNSNS1.75 1.06-2.890.028Educational level University/postgraduate High SchoolNS0.43 (0.82-0.21)0.009NS ElementaryNS0.52 (0.28-0,95) Ref.0.032NSMarital status SingleNSNS0.57 (0.34-0.96)0.033 Divorced/separateNSNS1.02 (0.73-1.41)0.919ResultsNine hundred and thirteen ARD patients were evaluated. The most frequent diagnosis was rheumatoid arthritis in 446(48.8%) patients followed by systemic lupus erythematosus in 279 (30.6%). Depression, anxiety, and PTSD were observed in 128 (14.0%), 112 (12.30%) and 485 (53.1%) patients, respectively. In the multivariable analyses, previous treatment for mental disorders and fear of COVID-19 were associated with depression: OR=2.35 (95% CI 1.37-4.03; p=0.002) and OR=1.07 (95% CI 1.05-1.10; p<0.001) respectively; also with anxiety: OR= 2.42 (95% CI 1.37-4.26; p=0.002) and OR=1.09 (95% CI 1.06-1.12; p <0.01) and with PSTD: OR=2.42 (95% CI 1.39-4.21;p=0.002) and OR=1.41 (95% CI=1.11-1.17; p<0.001). A diagnosis of COVID-19 was associated with PTSD: OR=1.75 (95% CI 1.06-2.89, p=0.028), while being single was associated with a decreased probability of PTSD occurrence: OR=0.57 (95% CI=0.35-0.96; p=0.03). Finally, having a high educational level was associated with less anxiety: OR=0.43 (95% CI=0.82-0.21; p=0.009), for university /postgraduate studies and OR=0.52 (CI 95%=0.28-0.95; p=0.032) for secondary studies.ConclusionFear of COVID-19 and previous treatment for mental disorder were associated with all MHD explored on our ARD patients during the COVID-19 pandemic.