Covid-19 pandemisinin primer immün yetmezlikli hastalarda yaşam kalitesi, depresyon, anksiyete ve psikolojik dayanıklılık üzerindeki etkisi
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Date
2022
Authors
Muştucu, Anıl
Journal Title
Journal ISSN
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Publisher
Bursa Uludağ Üniversitesi
Abstract
Primer immün yetmezlikler (PİY), primer ya da doğumsal immün yetmezlik bozuklukları sonucunda gelişen kronik ve/veya yineleyen bakteriyel, fungal, protozoal ve viral enfeksiyonlarla seyreden hastalıklar grubudur. Bu çalışmada, COVID-19 pandemisinin primer immün yetmezlikli hastalarda yaşam kalitesi, depresyon, anksiyete düzeyleri ve psikolojik dayanıklılık üzerine etkilerinin incelenmesi ve kontrol grubuyla karşılaştırılması amaçlandı. Çalışmamıza Bursa Uludağ Üniversitesi İmmünoloji Polikliniği’nde PİY tanısıyla takip 70 hasta ve kontrol grubu olarak, hasta grubuna benzer sosyodemografik özellikler gösteren, PİY tanısı olmayan 69 kişi dahil edildi. Katılımcılar bir defa kesitsel olarak görüldü; Sosyodemografik Veri Formu, Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği – Kısa Formu (WHOQoL-BREF-TR), Hamilton Depresyon Değerlendirme Ölçeği (HAM-D), Hamilton Anksiyete Ölçeği (HAM-A), Yetişkinler İçin Psikolojik Dayanıklılık Ölçeği ve COVID-19 Değerlendirme Formu ile değerlendirildi. PİY hastalarında anksiyete ve depresyon düzeylerinin, kontrollere göre anlamlı olarak yüksek olduğu görüldü. Depresyon ve anksiyete düzeylerinde artış kadın cinsiyet, evli olmak, yaş artışı, tanı alma yaşının geç olması, ek hastalık sayısı, geçmişte psikiyatrik başvuru, düşük psikolojik dayanıklılık ve düşük yaşam kalitesi düzeyleri ile ilişkiliydi. Pandemi süreciyle ilgili kaygı düzeyinin PİY hastalarında, kontrollere göre anlamlı olarak yüksek olduğu; uyku, iştah ve dikkat ile ilgili bozuklukların hastalarda, kontrollere göre anlamlı olarak daha fazla görüldüğü tespit edildi. PİY tanısıyla takip edilen hastaların yaşam kalitesi düzeylerinin, WHOQoL-BREF-TR’nin fiziksel sağlık, psikolojik ve sosyal ilişkiler alt ölçek değerlerinde, kontrollere göre anlamlı olarak düşük iv olduğu görüldü. Düşük yaşam kalitesi düzeyleri kadın cinsiyet, evli olmak, yaş artışı, ek hastalık sayısı, tanı alma yaşı ile ilişkili bulundu. Hastaların psikolojik dayanıklılık düzeylerinin, kontrollere göre anlamlı olarak düşük olduğu görüldü. Psikolojik dayanıklılığın düşük olması ile ek hastalık sayısının ilişkili olduğu görüldü. COVID-19 pandemisinin, PİY hastalarının ruhsal durumları, yaşam kaliteleri ve psikolojik dayanıklılıkları üzerindeki olumsuz etkileri göz önüne alınarak, hastaların rutin takiplerinde psikiyatrik şikayetler açısından sorgulanması önerilmektedir.
Primary immunodeficiencies (PID) are a group of diseases that develop as a result of primary or congenital malfunction of the immune system and progress with chronic and/or recurrent bacterial, fungal, protozoal and viral infections. In this study, it was aimed to examine the effects of the COVID-19 pandemic on quality of life, depression, anxiety levels and psychological resilience in patients with PID and to compare them with the controls. 70 patients, aged between 18-65 years, who were being followed up with the diagnosis of PID in Bursa Uludağ University Immunology Outpatient Clinic, and 69 people who had sociodemographic characteristics similar to the patient group and were not diagnosed with PID as the control group, voluntarily participated in our study. Participants were evaluated cross-sectionally once; Sociodemographic Data Form, World Health Organization Quality of Life Scale – Short Form (WHOQoL-BREF-TR), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Resilience Scale For Adults (YPDÖ), and COVID-19 Evaluation form were administered to the participants. Levels of anxiety and depression were found to be significantly higher in PID patients compared to controls. Increases in depression and anxiety scores were associated with female gender, being married, increasing age, diagnosis of PID at older age, number of comorbidities, personal psychiatric history, low psychological resilience and low quality of life. Anxiety level about the pandemic process was significantly higher in PID patients compared to controls. Sleep, appetite and attention related disorders were found to be significantly more common in PID patients than controls. It was observed that health related quality of life scores of the PID patients were significantly lower vi than the controls in the physical health, psychological and social relations subscales of the WHOQoL-BREF-TR. Lower scores of WHOQoL-BREF-TR were found to be associated with female gender, being married, increasing age, number of comorbidities and diagnosis of PID at older age. It was observed that the psychological resilience levels of the patients were significantly lower than the controls. Number of comorbidites was found to be associated with lower psychological resilience. Considering the negative effects of the COVID-19 pandemic on the mental status, quality of life and psychological resilience of PID patients, we recommend that patients should routinely be questioned in terms of psychiatric complaints in their follow-up.
Primary immunodeficiencies (PID) are a group of diseases that develop as a result of primary or congenital malfunction of the immune system and progress with chronic and/or recurrent bacterial, fungal, protozoal and viral infections. In this study, it was aimed to examine the effects of the COVID-19 pandemic on quality of life, depression, anxiety levels and psychological resilience in patients with PID and to compare them with the controls. 70 patients, aged between 18-65 years, who were being followed up with the diagnosis of PID in Bursa Uludağ University Immunology Outpatient Clinic, and 69 people who had sociodemographic characteristics similar to the patient group and were not diagnosed with PID as the control group, voluntarily participated in our study. Participants were evaluated cross-sectionally once; Sociodemographic Data Form, World Health Organization Quality of Life Scale – Short Form (WHOQoL-BREF-TR), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Resilience Scale For Adults (YPDÖ), and COVID-19 Evaluation form were administered to the participants. Levels of anxiety and depression were found to be significantly higher in PID patients compared to controls. Increases in depression and anxiety scores were associated with female gender, being married, increasing age, diagnosis of PID at older age, number of comorbidities, personal psychiatric history, low psychological resilience and low quality of life. Anxiety level about the pandemic process was significantly higher in PID patients compared to controls. Sleep, appetite and attention related disorders were found to be significantly more common in PID patients than controls. It was observed that health related quality of life scores of the PID patients were significantly lower vi than the controls in the physical health, psychological and social relations subscales of the WHOQoL-BREF-TR. Lower scores of WHOQoL-BREF-TR were found to be associated with female gender, being married, increasing age, number of comorbidities and diagnosis of PID at older age. It was observed that the psychological resilience levels of the patients were significantly lower than the controls. Number of comorbidites was found to be associated with lower psychological resilience. Considering the negative effects of the COVID-19 pandemic on the mental status, quality of life and psychological resilience of PID patients, we recommend that patients should routinely be questioned in terms of psychiatric complaints in their follow-up.
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Keywords
Primer immün yetmezlik, COVID-19, Anksiyete, Depresyon, Yaşam kalitesi, Psikolojik dayanıklılık, Primary immunodeficiency, Anxiety, Psychological resilience, Depression, Quality of life
Citation
Muştucu, A. (2022). Covid-19 pandemisinin primer immün yetmezlikli hastalarda yaşam kalitesi, depresyon, anksiyete ve psikolojik dayanıklılık üzerindeki etkisi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.