The sense of loneliness and meaning in life in post-COVID convalescents-a preliminary study.

Introduction: The COVID-19 epidemic has provided opportunity to study the impact of a well-defined severe illness on the development of a depressive episode and the associated sense of loneliness and lack of meaning in life. Materials and Methods: The aim of the study was to assess the occurrence of a reactive depressive episode, the severity of depression, a sense of loneliness and meaning in life in subjects who approximately a year earlier than the date of the study had suffered from a pulmonary form of SARS-CoV-2 infection with radiologically documented interstitial lesions of the lungs, requiring and not requiring hospitalization compared to people who did not develop the disease as a result of infection with that virus. The study included 63 subjects hospitalized for pulmonary lesions, 67 not hospitalized and 60 healthy controls. The severity of depressive symptoms was measured using a Polish-language standardized version of the Beck Depression Inventory, a sense of loneliness using the De Jong Gierveld Loneliness Scale, and a sense of meaning in life using the Life Attitude Profile-Revised. Results: The frequency of depression and its severity were found to be the highest in hospitalized patients compared to those treated at home and healthy people. A significant difference in the frequency of depression and its severity between outpatients and healthy people was also observed. The feeling of loneliness turned out to be greatest in the group of hospitalized people. Also, the severity of loneliness was found to be higher in the outpatient compared to the control group. The sense of meaning in life reached its lowest level among hospitalized patients, was moderately reduced in the outpatient group, and typical of the Polish population in the control group. Discussion: Both pulmonary SARS-CoV-2 infection and hospitalization have been shown to be a risk factor for depression, increased feeling of loneliness and a reduced sense of meaning in life. The effect of trauma and the presence of depression can be the explanation for the increased sense of loneliness after the illness and the partial breakdown of the lifeline manifested by a decrease in the sense of meaning in life.

Is asthma with hypersenitivity to non-steroidal anti-inflammatory drugs is a risk factor for depression?

The respiratory tract disease exacerbated by non-steroidal antiinflammatory drugs (NSAIDs) is characterized by the Widal triad, which includes the presence of bronchial asthma, hypersensitivity to NSAIDs (acetylsalicylic acid) and chronic eosinophilic rhinitis and sinusitis (frequently also coincident with nasal polyps). Idiosyncratic hypersensitivity to NSAIDs in the course of bronchial asthma affects approximately 15% of patients. AIM: The aim of the study is to assess depressiveness and severity of anxiety in the population of patients with partially and poorly controlled asthma. MATERIALS AND METHODS: A group of 48 patients with partially and poorly controlled bronchial asthma without hypersensitivity to NSAIDs was selected, as well as 42 patients with partially and poorly controlled bronchial asthma hypersensitive to NSAIDs. All the patients underwent an asthma control test. To assess depression, the Beck Depression Scale - BDI II was used. When assessing anxiety as a trait and anxiety as a state, the Spielberger's STAI - State and Trait Anxiety Inventory - was used. RESULTS: The mean age in the group with no hypersensitivity to NSAIDs was 51 +/- 15 years and did not differ with statistical significance from the group of patients hypersensitive to NSAIDs, where it was 50 +/- 14 years. The mean level of depression in the group without hypersensitivity was 15 +/- 9, and in the hypersensitivity group 23 +/- 8 and the difference reached the level of statistical significance p<0.005. Moreover, anxiety as a state was lower in the group without hypersensitivity compared to the group with hypersensitivity (the result expressed in sten scores: 6 +/- 2 versus 7 +/-2, p<0.001). Anxiety as a trait was 5 +/- 2 in both groups and there was no inter-group difference. CONCLUSIONS: Subjects with partially and poorly controlled bronchial asthma and hypersensitivity to NSAIDs have a higher severity of depression and anxiety compared to those with partially and poorly controlled asthma without hypersensitivity to NSAIDs. In that group, anxiety as a state is also greater than in the group without hypersensitivity to NSAIDs.

Astma jako choroba psychosomatyczna.

In psychosomatic diseases, the damage to organs is overlaid with symptoms induced by a mental factor. Bronchial asthma is a chronic bronchitis, often of an allergic etiology, accompanied by attacks of dyspnea, which can be induced by severe stress. The mechanism involves induction of a bronchospasm, dependent on the cholinergic system, by cold air. Another aspect is the relationship of bronchial asthma with the development of mood disorders. The mechanism of such depression is the product of the psychogenic factor and the effect of inflammatory mediators on the central nervous system. The mental factor plays an important role in the clinical picture of bronchial asthma. However, this issue requires further research, especially regarding the use of psychotherapy in the management of a patient suffering from bronchial asthma.