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Depression and anxiety screening using Zung Self-Rating Scales (SDS/SAS) among patients with post-Chikungunya chronic inflammatory rheumatism: a comparative study of a 2-year follow-up cohort in La Virginia, Risaralda, Colombia

2018; Elsevier BV; Volume: 73; Linguagem: Inglês

10.1016/j.ijid.2018.04.3861

1878-3511

Alfonso J. Rodríguez‐Morales, Sabina Ocampo-Serna, Oscar Mauricio Meneses-Quintero, Karol Liceth Hoyos-Guapacha, G. Botero-Castaño, J.C. Gutiérrez-Segura, José J. Londoño, Héctor D. Bedoya-Rendón, Javier de Jesús Cárdenas-Pérez, Jaime A. Cardona‐Ospina, C. González-Colonia, Guillermo J. Lagos-Grisales,

Autoimmune and Inflammatory Disorders Research

Background: Despite epidemics of chikungunya (CHIK) (>3 million cases in the Americas, 2014-2015), long-term psychiatric impact of CHIK infection and its chronic inflammatory rheumatism (pCHIK-CIR), has not fully addressed with validated questionnaires. Methods & Materials: In a cohort study among 62 cases serologically diagnosed in La Virginia, Colombia, followed-up by 2-years, clinical characteristics were collected at baseline. Zung Self-Rating Depression Scale (SDS) and Anxiety Scale (SAS), validated in Spanish for Colombia (Cronbach-α=0.92/0.80), were applied to patients with pCHIK-CIR(+) and without (-). Mean score comparisons (Student's t) and prevalence proportion (χ2) significances were calculated using Stata IC 14.0® licensed, p < 0.05. Results: We compared 43 patients with pCHIK-CIR + and 19 without it (pCHIK-CIR-), followed-up for 2 years. Mean age 44.1 y-old, 69% female. SDS and SAS scores were significantly higher in those with pCHIK-CIR + , 49.6 ± 15.9 versus 40.1 ± 12.4 (p = 0.025) and 49.6 ± 15.4 versus 40.1 ± 10.9 (p = 0.019), respectively. When using cut-off scores, depression and anxiety symptoms were significantly higher among those with pCHIK-CIR + , 48.8% vs 21.1% (p = 0.04) and 97.7% vs 84.2% (p = 0.047). Moderate-to-severe scores at SDS and SAS showed more marked difference in those with pCHIK-CIR + , 27.9% vs 5.3% in both scales (p = 0.039). At subscales for SDS and SAS, significant differences (p < 0.05) were found for the cognitive (9.2 vs 6.4) and somatic factors (5.6 vs 4.4) of SDS and motor (8.8 vs 6.5) and central (CNS) (9.5 vs 7.1) factors of the SAS, between pCHIK-CIR + and pCHIK-CIR- patients. At SDS, items 1,6,9,10 and 12, as well, at SAS, 3,6,7,8,10,14,15 and 18, were significantly different among groups (p < 0.05). Conclusion: Depression and anxiety symptoms, at multiple levels, were significantly higher among pCHIK-CIR + patients. This is the first study in screen these psychiatric long-term consequences with validated questionnaires, raising the relevance of mental health assessment in patients with acute but also chronic chikungunya consequences. Findings have significant implications in areas affected by chikungunya epidemics, as well later endemic areas with chronic disease.