정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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코로나19 감염과 그 이후의 정신신체증상

Psychosomatic Symptoms Following COVID-19 Infection

  • 박선영 (국민건강보험 일산병원 정신건강의학과) ;
  • 류신혜 (이화여자대학교 사범대학 교육학과(교육심리상담)) ;
  • 임우영 (건양대학교병원 정신건강의학과)
  • Sunyoung Park (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Shinhye Ryu (Department of Education, College of Education, Ewha Womans University) ;
  • Woo Young Im (Department of Psychiatry, Konyang University Hospital)
  • 투고 : 2023.12.27
  • 심사 : 2023.12.30
  • 발행 : 2023.12.31
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초록

연구목적 코로나19 감염으로 인한 다양한 정신과적 증상, 정신신체증상을 파악하고 장기적 영향을 조사하였다. 방 법 체계적 문헌고찰을 통해 국내외 데이터베이스에서 논문을 선정하고, "COVID-19", "psychosomatic" 등의 검색어를 활용하였다. 정신신체증상에 대한 구조화된 측정도구를 사용한 연구를 포함하여, 총 16편의 논문이 최종 분석 대상으로 포함되었다. 결 과 코로나19 급성 감염과 관련된 정신증상으로는 불안, 우울, 신체증상 등이 보고되고 있다. 장기간 지속되는 포스트 코로나증후군의 증상으로는 흉통, 피로 등이 보고되었고, 이와 관련된 정신신체증상의 발생 빈도는 10%-20%로 파악되었다. 감염병으로 인한 심리사회적 스트레스, 여성, 노인, 정신과적 기왕력이나 동반 정신질환 등의 요인이 관련을 미친다. 전신염증, 자가면역, 자율신경계의 이상반응 등이 관련이 있을 것으로 생각되고 있다. 결 론 코로나19 감염 이후 발생하는 정신신체증상은 삶의 질과 심리사회적 기능에 부정적인 영향을 미칠 뿐 아니라 증상에 대한 정신과적 이해와 접근은 예방과 치료에도 중요하다.

Objectives : This study aims to identify various psychiatric symptoms and psychosomatic symptoms caused by COVID-19 infection and investigate their long-term impact. Methods : A systematic literature review was conducted, selecting papers from domestic and international databases using keywords such as "COVID-19" and "psychosomatic." A total of 16 papers, including those using structured measurement tools for psychosomatic symptoms, were included in the final analysis. Results : Psychiatric symptoms such as anxiety, depression, and somatic symptoms have been reported in acute COVID-19 infection, while long-term post-COVID symptoms include chest pain and fatigue. The frequency of long-term psychosomatic symptoms has been estimated to be 10%-20%. Factors contributing to these symptoms include psychological and social stress related to infectious diseases, gender, elderly age, a history of psychiatric disorders, and comorbid mental illnesses. It is suggested that systemic inflammation, autoimmune responses, and dysregulation of the autonomic nervous system may be involved. Conclusions : Psychosomatic symptoms arising after COVID-19 infection have a negative impact on quality of life and psychosocial functioning. Understanding and addressing psychiatric aspects are crucial for symptom prevention and treatment.

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참고문헌

  1. de Sousa Neto AR, de Carvalho ARB, de Oliveira EMN, de Lima Brito Magalhaes R, Batista Moura ME, de Freitas DRJ. Symptomatic manifestations of the disease caused by coronavirus (COVID-19) in adults: systematic review. Rev Gaucha Enferm 2021;42:e20200205.
  2. Bridwell R, Long B, Gottlieb M. Neurologic complications of COVID-19. Am J Emerg Med 2020;38:1549e3-1549e7.
  3. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, Psaltopoulou T, Gerotziafas G, Dimopoulos MA. Hematological findings and complications of COVID-19. Am J Hematol 2020;95:834-847. https://doi.org/10.1002/ajh.25829
  4. Park HY. Mental health in patients with coronavirus Disease-19 and the quarantined people. Korean Neuropsychiatr Assoc 2021;60:11-18. https://doi.org/10.4306/jknpa.2021.60.1.11
  5. Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global prevalence of post-coronavirus disease 2019 (COVID-19) condition or long COVID: a meta-analysis and systematic review. J Infect Dis 2022;226:1593-1607. https://doi.org/10.1093/infdis/jiac136
  6. Menges D, Ballouz T, Anagnostopoulos A, Aschmann HE, Domenghino A, Fehr JS, Puhan MA. Burden of post-COVID-19 syndrome and implications for healthcare service planning: a population-based cohort study. PloS One 2021;16:e0254523.
  7. Winkler P, Formanek T, Mlada K, Kagstrom A, Mohrova Z, Mohr P, Csemy L. Increase in prevalence of current mental disorders in the context of COVID-19: analysis of repeated nationwide cross-sectional surveys. Epidemiol Psychiatr Sci 2020;29:e173.
  8. Xiao Y, Sharma MM, Thiruvalluru RK, Gimbrone C, Weissman MM, Olfson M, Keyes KM, Pathak J. Trends in psychiatric diagnoses by COVID-19 infection and hospitalization among patients with and without recent clinical psychiatric diagnoses in New York city from March 2020 to August 2021. Transl Psychiatry 2022;12:492.
  9. Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, Zandi MS, Lewis G, David AS. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020;7:611-627. https://doi.org/10.1016/S2215-0366(20)30203-0
  10. Callard F, Perego E. How and why patients made long Covid. Soc Sci Med 2021;268:113426.
  11. NHS England, NHS Improvement Coronavirus. Post-COVID syndrome (long COVID). London: NHS England 2021.
  12. COVID-19 rapid guideline: managing the long-term effects of COVID-19. National Institute for Health and Care Excellence (NICE) 2020.
  13. Ayoubkhani D, Pawelek P. Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK. Office National Statistics 2021;1-16.
  14. Whitaker M, Elliott J, Chadeau-Hyam M, Riley S, Darzi A, Cooke G, Ward H, Elliott P. Persistent COVID-19 symptoms in a community study of 606,434 people in England. Nat Commun 2022;13:1957.
  15. Kim TJ, Ha BM, Yang JI, Kim MJ, Seo KW. Descriptive analysis of the incidence rate of post acute COVID-19 syndrome in the Republic of Korea Army. J Korean Med Assoc 2023;66:200-208. https://doi.org/10.5124/jkma.2023.66.3.200
  16. Ballering A, Hartman TO, Rosmalen J. Long COVID-19, persistent somatic symptoms and social stigmatisation. J Epidemiol Community Health 2021;75:603-604. https://doi.org/10.1136/jech-2021-216643
  17. Krygsman A, Farrell AH, Brittain H, Vaillancourt T. Anxiety symptoms before and during the COVID-19 pandemic: a longitudinal examination of Canadian young adults. J Anxiety Disord 2023;99:102769.
  18. Horn M, Wathelet M, Amad A, Martignene N, Lathiere T, Khelfaoui K, Rousselle M, Qaoubii OE, Vuotto F, Faure K, Creupelandt C, Vaiva G, Fovet T, D'Hondt F. Persistent physical symptoms after COVID-19 infection and the risk of somatic symptom disorder. J Psychosom Res 2023;166:111172.
  19. Sathyamurthy P, Madhavan S, Pandurangan V. Prevalence, pattern and functional outcome of post COVID-19 syndrome in older adults. Cureus 2021;13:e17189.
  20. Ballering AV, van Zon SKR, Hartman TCO, Rosmalen JGM. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. Lancet 2022;400:452-461. https://doi.org/10.1016/S0140-6736(22)01214-4
  21. Kachaner A, Lemogne C, Dave J, Ranque B, de Broucker T, Meppiel E. Somatic symptom disorder in patients with post-COVID-19 neurological symptoms: a preliminary report from the somatic study (Somatic Symptom Disorder Triggered by COVID-19). J Neurol Neurosurg Psychiatry 2022;93:1-7. https://doi.org/10.1136/jnnp-2021-327899
  22. Shevlin M, Nolan E, Owczarek M, McBride O, Murphy J, Miller JG, Hartman TK, Levita L, Mason L, Martinez AP, McKay R, Stocks TVA, Bennett KM, Hyland P, Bentall RP. COVID-19 related anxiety predicts somatic symptoms in the UK population. Br J Health Psychol 2020;25:875-882. https://doi.org/10.1111/bjhp.12430
  23. El-Saber Batiha G, Al-Kuraishy HM, Al-Gareeb AI, Welson NN. Pathophysiology of Post-COVID syndromes: a new perspective. Virol J 2022;19:158.
  24. Jammoul M, Naddour J, Madi A, Reslan MA, Hatoum F, Zeineddine J, Abou-Kheir W, Lawand N. Investigating the possible mechanisms of autonomic dysfunction post-COVID-19. Auton Neurosci 2023;245:103071.
  25. Mooren FC, Bockelmann I, Waranski M, Kotewitsch M, Teschler M, Schafer H, Schmitz B. Autonomic dysregulation in long-term patients suffering from Post-COVID-19 Syndrome assessed by heart rate variability. Sci Rep 2023;13:15814.
  26. Ahmed H, Patel K, Greenwood DC, Halpin S, Lewthwaite P, Salawu A, Eyre L, Breen A, O'Connor R, Jones A, Sivan M. Long-term clinical outcomes in survivors of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS) outbreaks after hospitalisation or ICU admission: a systematic review and meta-analysis. J Rehabil Med 2020;52:1-11.
  27. Ulyukin IM, Kiseleva NV, Rassokhin VV, Orlova ES, Sechin AA. Psychosomatic disorders (distress, depression, anxiety, somatization) in young patients who have had COVID-19. Medical Academic Journal 2021;21:63-72. https://doi.org/10.17816/MAJ79127
  28. Forte G, Favieri F, Tambelli R, Casagrande M. COVID-19 pandemic in the Italian population: validation of a post-traumatic stress disorder questionnaire and prevalence of PTSD symptomatology. Int J Environ Res Public Health 2020;17:4151.
  29. Horn M, Fovet T, Vaiva G, d'Hondt F, Amad A. Somatic symptom disorders and long COVID: a critical but overlooked topic. Gen Hosp Psychiatry 2021;72:149.
  30. Hufner K, Tymoszuk P, Sahanic S, Luger A, Boehm A, Pizzini A, Schwabl C, Koppelstatter S, Kurz K, Asshoff M. Persistent somatic symptoms are key to individual illness perception at one year after COVID-19 in a cross-sectional analysis of a prospective cohort study. J Psychosom Res 2023;169:111234.
  31. Schneider A, Huber L, Lohse J, Linde K, Greissel A, Sattel H, Henningsen P, Hapfelmeier A. Association between somatic symptom disorder and symptoms with daily life impairment after SARS-CoV-2 infection-results from a population-based cross-sectional study. J Psychosom Res 2023;168:111230.
  32. Engelmann P, Lowe B, Brehm TT, Weigel A, Ullrich F, Addo MM, zur Wiesch JS, Lohse AW, Toussaint A. Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic. Front Psychol 2022;13:1022203.
  33. Kamata K, Honda H, Tokuda Y, Takamatsu A, Taniguchi K, Shibuya K, Tabuchi T. Post-COVID health-related quality of life and somatic symptoms: a national survey in Japan. Am J Med Sci 2023;366:114-123. https://doi.org/10.1016/j.amjms.2023.04.018