Depression and anxiety among paediatric and adult in-patients with dengue fever in Metro Manila, Philippines

Abstract

Background: Psychiatric symptoms have been reported in adult patients with dengue fever (DF); however, information on pediatric patients remains inadequate. We sought to identify the prevalence and determinants of depression and anxiety and identify other encephalopathy symptoms among pediatric and adult patients with DF.Methods: This cross-sectional study used a non-probability purposive sampling method among clinically or serologically confirmed in-patients with DF. Participants completed the Revised Child Anxiety and Depression Scale for pediatric patients and youth controls and Hospital Anxiety and Depression Scale for adult patients. Results: The prevalence of depression and anxiety were significantly higher among 225 pediatric patients than among 81 youth controls, but was lower than that among 43 adult patients. A multiple linear regression analysis of socio-demographic and clinical data found that age, family history of DF, ≤2 days of hospitalization, and myalgia and arthralgia tended to increase depression and anxiety scores of pediatric patients. Further, 26.7% of pediatric patients reported irritability, agitation, visual hallucinations and aggressiveness. Conclusion: Prevalence and determinants of depression and anxiety and the presence of encephalopathy symptoms differ between pediatric and adult patients. Longitudinal post-DF recovery studies should be conducted to examine whether these symptoms may develop to subsequent chronic psychiatric conditions in the future.

Clinical Manifestations Suggestive of Depression in Patients Served with Febrile Illness in Campo Grande (MS) and Dourados (Ms), Brazil

“…The World Health Organization (WHO) [1] considers the biomedical and social changes that justified the data shown in Table 1 and Table 2 mainly associated with the clinical signs of neuro-Dengue, Zika and Chikungunya and, generally, the development of depressive signs in the disease fever are related to immunological mechanisms activated in the excessive production of pro-inflammatory cytokines [15,21,16] , which have the function of inducing organic depression in the viral infectious process seen in this study [11,28,29] .…”

“…The positive and somatic aspects among patients in V0 and V14 can be caused by the presence, mainly, of myalgia and arthralgia, which can be considered one of the triggers for the increase in the score of the depressive symptom [14,17,18]. These characteristics are predictors of an increase in the depressive symptoms score, mainly in V14 analyzed in this study [29,21]. In this study, it was reinforced that 50% of the patients developed fatigue mainly in the initial period (V0), experienced in the somatic aspects (Table 3) that aggravate the depressive signs and symptoms.…”

“…As for education, it should be noted that in this study a correct record was made in the compulsory notification forms of Dengue cases in Mato Grosso do Sul, in which 46% had completed high school, differing from the study by Santos et al [22], with more than 50% of registered cases ignored or left blank at the time of notification [19,24,22,27,20,15,21,16].…”

“…The process of diagnosing mental illnesses such as depression does not follow the logic and objectivity that other diagnoses have, therefore it becomes difficult and confusing, and develops according to the symptoms presented during the illness period [20,21,1].…”

“…And in addition to neuropsychiatric and lethal complications, mental life conditions serve to measure the individual's health burden with dengue, chronic and acute diseases [20,15,21,16]. In the literature, the report we have is that dengue significantly worsens the mental quality of individuals [20].…”