COVID-19 Pandemisi Sürecinde Depresyon, Anksiyete ve Stres
Özet
COVID-19 pandemisinin küresel çaptaki yıkıcı etkileri sürerken, enfeksiyonu atlatan bireylerde depresyon, anksiyete ve travma sonrası stres bozukluğu (TSSB) gibi uzun vadeli nöropsikiyatrik sekeller post-COVID sendromunun ana belirtileri haline gelmiştir. Yapılan klinik ve kesitsel çalışmalar, COVID-19 hastalarının sağlıklı popülasyona kıyasla çok daha yüksek oranlarda psikiyatrik semptomlar ve uykusuzluk bildirdiğini, hatta bu durumun akut enfeksiyon döneminden başlayarak takip eden bir yıla kadar saptanabilir düzeyde korunduğunu ortaya koymaktadır. Pandemi sürecinde psikolojik sıkıntıların gelişimini kolaylaştıran risk faktörleri arasında kadın cinsiyet, genç yaş, düşük sosyo-ekonomik durum, sosyal destek eksikliği, karantina koşulları ile sosyal medyada olumsuz haberlere uzun süre maruz kalma öne çıkmaktadır. Ayrıca, geçmiş SARS ve MERS salgınlarında olduğu gibi, hastalığın klinik şiddeti arttıkça depresif semptomların yoğunluğu da belirgin şekilde artış göstermektedir. Önceden psikiyatrik bozukluğu olan bireyler ise pandeminin getirdiği kısıtlamalardan daha fazla olumsuz etkilenmekle birlikte, COVID-19 kaynaklı hastaneye yatış ve mortalite açısından çok daha yüksek bir risk taşımaktadırlar. Bu psikiyatrik tabloların altında yatan nörobiyolojik mekanizmaların, viral enfeksiyonun tetiklediği immün-inflamatuar yanıtlar, nöroinflamasyon ve proinflamatuar biyobelirteçlerin (CRP, NLR, IL-6) anormal başlangıç seviyeleri ile doğrudan ilişkili olduğu ve bu parametrelerin kalıcı yorgunluk ile seçici dikkat, işlem hızı ve bellek gibi bilişsel işlev bozukluklarını öngördüğü belirlenmiştir.
The devastating global impacts of the COVID-19 pandemic persist, and long-term neuropsychiatric sequelae such as depression, anxiety, and post-traumatic stress disorder (PTSD) among survivors have become core symptoms of post-COVID syndrome. Clinical and cross-sectional studies reveal that COVID-19 patients report significantly higher rates of psychiatric symptoms and insomnia compared to the healthy population, with these conditions lasting from the acute infection period up to a one-year follow-up. Risk factors facilitating the development of psychological distress during the pandemic include female sex, younger age, low socio-economic status, lack of social support, quarantine conditions, and prolonged exposure to negative news on social media. Furthermore, as observed in past SARS and MERS outbreaks, the frequency of depressive symptoms increases significantly with the clinical severity of the disease. Individuals with pre-existing psychiatric disorders are more adversely affected by pandemic-related restrictions and carry a substantially higher risk for COVID-19-related hospitalization and mortality. The neurobiological mechanisms underlying these psychiatric outcomes are directly related to the immune-inflammatory responses and neuroinflammation triggered by the viral infection, along with abnormal baseline levels of proinflammatory biomarkers (CRP, NLR, IL-6), which predict persistent fatigue and cognitive impairments such as deficits in selective attention, processing speed, and memory.
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World Health Organisationhttps://covid19.who.int/ 2022
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