Factors Associated With Posttraumatic Stress Symptoms 3 and 6 Months After Hospitalization for COVID-19: A Longitudinal Multicenter Study

Victor Pitron, MD, PhD^a,b,‡ ; Willys Cantenys, MD^c,‡ ; Anne Herbelin, MSc^c ; Hugo Bottemanne, MD^c,d ; Nathalie Dzierzynski, MD^e ; Eric Caumes, MD, PhD^f ; Alexis Mathian, MD, PhD^g ; Zahir Amoura, MD, PhD^g ; Yves Allenbach, MD, PhD^h,i,j ; Patrice Cacoub, MD, PhD^h,i,j ; Antoine Parrot, MD^k ; Jean-Yves Rotgé, MD, PhD^c,d ; Philippe Fossati, MD, PhD^c,d

J Clin Psychiatry. 2023;84(1):21m14277

ABSTRACT

Objective: To identify factors associated with posttraumatic stress symptoms (PTSS) 3 and 6 months after the discharge of patients hospitalized for COVID-19.

Methods: Patients hospitalized for COVID-19 between March 1 and July 31, 2020, were included in a longitudinal study. Clinical assessments were conducted with online auto-questionnaires. PTSS were assessed with the Posttraumatic Stress Disorder Checklist Scale (PCLS). We screened for several putative factors associated with PTSS, including socio-demographic status, hospitalization in an intensive care unit, history of psychiatric disorder, the Hospital Anxiety and Depression Scale, the Peritraumatic Dissociative Experiences Questionnaire, and the home-to-hospital distance. Bivariate and multilinear regression analyses were performed to evaluate their association with PTSS.

Results: 119 patients were evaluated 3 months after hospital discharge, and a subset of 94 were evaluated 6 months after discharge. The prevalence of PTSS was 31.9% after 3 months and 30.9% after 6 months. Symptoms of anxiety and depression and history of psychiatric disorder were independently associated with PTSS. Additionally, dissociative experiences during hospitalization (β = 0.35; P < .001) and a longer home-to-hospital distance (β = 0.07; P = .017) were specifically associated with PTSS 3 and 6 months after discharge, respectively.

Conclusions: Patients with COVID-19 showed persistent high scores of PTSS up to 6 months after discharge from the hospital. In this specific pandemic setting, PTSS were associated with high rates of dissociative experiences during hospitalization and a longer home-to-hospital distance due to the saturation of health care facilities. These results can foster early identification and better prevention of PTSS after hospitalization for COVID-19.

Trial Registration: ClinicalTrials.gov identifier: NCT04362930

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