Screening for Depressive Mood During Acute Chikungunya Infection in Primary Healthcare Settings

Abstract

Background: We aimed to screen for depressive mood experienced during acute chikungunya (CHIKV) infection, and to evaluate the association of several exposures with the risk of depressive symptoms. Methods: A cross-sectional analysis of a multicenter cohort study took place and data from 354 adult individuals with confirmed CHIKV infection were analyzed. Participants were recruited in primary health care settings and the Patient Health Questionnaire-2 (PHQ-2) was used. Prevalence odds ratios (OR) and 95% confidence intervals (CIs) estimated by means of logistic models were used. Results: Depressive mood (PHQ-2 score 3 or higher) was reported by 44.1% of individuals. Subjects with articular effusion (OR = 3.37, 95% CI 1.77–8.11), gastrointestinal manifestations (diarrhea, vomiting or abdominal pain, OR = 1.97, 95 CI 1.21–3.19), and higher length of severe arthralgia (reference ≤ 14 days: 15–30 days, OR = 3.38, 95% CI 1.78–6.41; ≥ 30 days, OR = 1.69, 95% CI 0.95–3.01) were more likely to self-report depressive mood. Increasing age (≥ 40 years old, OR = 0.55, 95% CI 0.31–0.95) and rash (OR = 0.54, 95% CI 0.30–0.98) were associated with a decreased risk of depressive mood. Conclusions: Depressive mood seemed to be a frequent event among analyzed individuals, and markers associated with its risk were identified.

Symptomatic perception of patients affected by chronic chikungunya: a qualitative perspective

“…Although the psychic complaints brought by this study have multifactorial characteristics, research increases their association with the chronicity of CHIK. According to the authors, persistent pain in these cases is one of the most important risk factors for depression, and mood disorders, in addition to gastrointestinal manifestations 31 . Thus, this study draws the attention of health professionals to the need to consider the elements of physical and psychic nature when preparing their therapeutic plans.…”

Extra-articular Manifestations of Chikungunya

“…In some patients with neurological involvement, there may be psychiatric symptoms such as confusion, delirium, disorientation, and even psychosis 57 . However, few studies have reported specific psychiatric manifestations of acute CHIK, including mania and depression [58][59][60] . Mania has been reported in a patient with acute CHIK who was previously diagnosed with bipolar disorder, although the patient was stabilized with valproic acid 58 .…”

“…Depression in acute CHIK affects up to half of the patients. Younger patients and those with severe arthritis and gastrointestinal symptoms are more likely to self-report depression 60,61 .…”

“…Manic episodes are treated with antipsychotics such as olanzapine 58,59 . The treatment of depression is similar to that used in other settings 60,63 . As psychiatric manifestations correlate with pain, analgesics may help treat chronic CHIK infections.…”

Qualidade de vida dos usuários crônicos de Chikungunya: revista em quadrinhos para convivência com as sequelas

“…Sendo assim, a ausência ou mesmo a inadequação do tratamento, em alguns casos, podem causar disfunção de sistemas orgânicos, em particular o osteoarticular, dificultando desde o caminhar até cuidados pessoais como vestir roupas, pentear os cabelos, tomar banho, entre outros, gerando uma piora da qualidade de vida, principalmente em pacientes idosos e portadores de doenças osteodegenerativas (COUTURIER et al, 2012;HUA;COMBE, 2017). Além do comprometimento orgânico, a saúde mental mostra-se abalada nesse grupo de usuários, em especial com o desencadeamento de insônia, depressão e ansiedade (MURILLO-ZAMORA et al, 2018).…”