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Jack Ellrodt

Pronouns

He/Him/His

Job Title

Research Assistant II, BWH Rheumatology Department

Academic Rank

Department

Medicine

Authors

Jack Ellrodt*, Emily G Oakes*, Laura D Kubzansky, Karestan C Koenen, Hongshu Guan, Karen H Costenbader, *co-first authors

Principal Investigator

Karen H Costenbader

Research Category: Psychiatry/Mental Health

Tags

Posttraumatic Stress Disorder Symptoms in Systemic Autoimmune Rheumatic Disease Patients During the Early COVID-19 Pandemic

Scientific Abstract

Background: We aimed to assess prevalence of post-traumatic stress disorder (PTSD) symptoms at onset of COVID-19 pandemic in individuals with/without systemic autoimmune rheumatic disease (SARD).

Methods: May 2020, we invited 6,681 patients (378 with ≥ 2 ICD 9/10 prior PTSD codes) to complete validated PSTD symptom screenings, the Brief Trauma Questionnaire and the Posttraumatic Stress Disorder Checklist (PCL-5). We used univariable t-tests to identify differences between SARDs and non-SARDs and multivariable logistic regression to identify predictors of PCL-5 positivity.

Results: We received 1,411 responses (21% response rate) from 5/2020 to 9/2021(60 respondents had hx. of PTSD prior to the pandemic, 131 had SARD hx). SARDs population was significantly more female (p<0.0001), had higher baseline prevalence of stress disorders (p=0.0008) than those without SARDs. Adjusting for pre-pandemic PTSD dx., younger age and hx, of stress disorder found to be the most significant predictors of PCL-5 positivity There were no significant differences in PCL-5 score, positivity or traumatic events.

Conclusion:  While SARDs was not a significant predictor of new PTSD symptoms, younger individuals and those with a hx. of baseline stress disorders (more common pre-pandemic among those with SARDs) were more likely to screen positive on PCL-5 in early pandemic.

Lay Abstract

Background: Posttraumatic Stress Disorder (PTSD), a complex psychiatric disorder that can result from experiencing or witnessing a traumatic event, such as an accident, assault, or death. We aimed to assess the prevalence of PTSD symptoms at the onset of the COVID-19 pandemic among individuals with or without systemic autoimmune rheumatic disease (SARD) diagnoses, given the increased stress those with SARDs may have experienced given their immunosuppression.

Methods: In May 2020 we invited 6,681 patients to complete the Brief Trauma Questionnaire and the Posttraumatic Stress Disorder Checklist (PCL-5). The Brief Trauma Questionnaire and the PCL-5 are previously validated questionnaires that can identify individuals with probable PTSD.

Results/Conclusion: While SARDs was not a significant predictor of new onset PTSD symptoms, we found that younger individuals and those with a history of baseline anxiety, depression, or adjustment disorders, which were more common pre-pandemic among those with SARDs, were more likely to screen positive on the PCL-5 during early COVID-19 pandemic. The lack of increased PTSD symptoms in SARDs vs. non-SARDs populations suggests that during the early months of the pandemic, SARDs patients may not have been at higher risk for new PTSD symptoms.

Clinical Implications

While SARDs was not a significant predictor of new PTSD symptoms, younger individuals and those with a hx. of baseline stress disorders (more common pre-pandemic among those with SARDs) were more likely to screen positive on PCL-5 in early pandemic.