Nocebo-Prone Behaviour in Patients with Autoimmune Rheumatic Diseases during the COVID-19 Pandemic.

COVID-19 autoimmune rheumatic diseases nocebo

Journal

Mediterranean journal of rheumatology
ISSN: 2529-198X
Titre abrégé: Mediterr J Rheumatol
Pays: Greece
ID NLM: 101730166

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 12 06 2020
accepted: 30 06 2020
entrez: 16 11 2020
pubmed: 17 11 2020
medline: 17 11 2020
Statut: epublish

Résumé

The COVID-19 pandemic is associated with emotional distress and significant disruptions in health-care services. These are key players in the development of nocebo phenomena. We aimed to investigate nocebo-prone behaviour in patients with autoimmune rheumatic diseases (ARD) amid the COVID-19 pandemic-associated lockdown. Consecutive patients were telephone-interviewed during the COVID-19 pandemic in Greece. Clinical and socioeconomic characteristics (eg, level of education) were recorded. For nocebo behaviour, a four-item validated questionnaire (Q-No, cut-off score>15), was used. Results were compared with pre-COVID-19 Q-No scores collected from patients followed-up in our department. Nocebo behaviour was detected in 51/500 (10.2%) individuals. In patients with nocebo behaviour, use of anti-hypertensives was less common (17.6% vs 31.8%, p=0.04), but a higher level of education was more common (58.8% vs 35.9%, p=0.002), compared with patients with Q-No score ≤15; the latter retained statistical significance in multivariate regression analysis (p=0.009, OR [95%CI]: 2.29, [1.23-4.25]). Total Q-No scores were higher in the COVID-19-period compared to the pre-COVID-19 era [median (range); 12 (4-20) vs 11 (4-20), p=0.02]. Among 78 patients with available Q-No questionnaires in the pre-COVID-19 era, 11 (14.1%) displayed nocebo behaviour, which increased to 16 (20.5%) amid the COVID-19 pandemic. Interim development of nocebo behaviour was also associated with higher educational level (p=0.049, OR: 3.65, 95%CI: 1.005-13.268). A considerable proportion of ARD patients manifested nocebo-prone behaviour during the COVID-19 pandemic, which was more common among those with high educational level.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic is associated with emotional distress and significant disruptions in health-care services. These are key players in the development of nocebo phenomena. We aimed to investigate nocebo-prone behaviour in patients with autoimmune rheumatic diseases (ARD) amid the COVID-19 pandemic-associated lockdown.
METHODS METHODS
Consecutive patients were telephone-interviewed during the COVID-19 pandemic in Greece. Clinical and socioeconomic characteristics (eg, level of education) were recorded. For nocebo behaviour, a four-item validated questionnaire (Q-No, cut-off score>15), was used. Results were compared with pre-COVID-19 Q-No scores collected from patients followed-up in our department.
RESULTS RESULTS
Nocebo behaviour was detected in 51/500 (10.2%) individuals. In patients with nocebo behaviour, use of anti-hypertensives was less common (17.6% vs 31.8%, p=0.04), but a higher level of education was more common (58.8% vs 35.9%, p=0.002), compared with patients with Q-No score ≤15; the latter retained statistical significance in multivariate regression analysis (p=0.009, OR [95%CI]: 2.29, [1.23-4.25]). Total Q-No scores were higher in the COVID-19-period compared to the pre-COVID-19 era [median (range); 12 (4-20) vs 11 (4-20), p=0.02]. Among 78 patients with available Q-No questionnaires in the pre-COVID-19 era, 11 (14.1%) displayed nocebo behaviour, which increased to 16 (20.5%) amid the COVID-19 pandemic. Interim development of nocebo behaviour was also associated with higher educational level (p=0.049, OR: 3.65, 95%CI: 1.005-13.268).
CONCLUSION CONCLUSIONS
A considerable proportion of ARD patients manifested nocebo-prone behaviour during the COVID-19 pandemic, which was more common among those with high educational level.

Identifiants

DOI: 10.31138/mjr.31.3.288 PMID: 33196007 PMC: PMC7656135
pubmed: 33196007
doi: 10.31138/mjr.31.3.288
pii: MJR-31-Suppl-2-288
pmc: PMC7656135
doi:

Types de publication

Journal Article

Langues

eng

Pagination

288-294

Informations de copyright

© 2020 The Mediterranean Journal of Rheumatology (MJR).

Références

J Psychosom Res. 2005 Feb;58(2):121-7
pubmed: 15820839
Nat Rev Rheumatol. 2018 Dec;14(12):727-740
pubmed: 30361674
Cancer. 2004 Aug 15;101(4):851-7
pubmed: 15305419
Ann Rheum Dis. 2020 May 31;:
pubmed: 32475830
ACR Open Rheumatol. 2020 Jun;2(6):335-343
pubmed: 32311836
Allergol Immunopathol (Madr). 2015 Jul-Aug;43(4):339-45
pubmed: 25088674
Gen Psychiatr. 2020 Mar 6;33(2):e100213
pubmed: 32215365
Neurol Sci. 2015 Mar;36(3):379-81
pubmed: 25249398
Nat Med. 2010 Nov;16(11):1277-83
pubmed: 20948533
Semin Arthritis Rheum. 2019 Apr;48(5):927-932
pubmed: 30093238
Expert Rev Clin Immunol. 2018 Sep;14(9):739-749
pubmed: 30118338
Cancer. 2010 Feb 1;116(3):766-74
pubmed: 19918921
RMD Open. 2019 May 21;5(1):e000900
pubmed: 31245050
J Psychosom Res. 2020 Jan;128:109866
pubmed: 31760341
Int J Environ Res Public Health. 2020 Mar 06;17(5):
pubmed: 32155789
Mediterr J Rheumatol. 2019 May 31;30(Suppl 1):63-68
pubmed: 32524080

Auteurs

George E Fragoulis (GE)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Gerasimos Evangelatos (G)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Aikaterini Arida (A)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Vasiliki-Kalliopi Bournia (VK)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Kalliopi Fragiadaki (K)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Anastasios Karamanakos (A)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Evrydiki Kravvariti (E)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Katerina Laskari (K)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Stylianos Panopoulos (S)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Maria Pappa (M)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Dimos D Mitsikostas (DD)

First Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Maria G Tektonidou (MG)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Petros P Sfikakis (PP)

First Department of Propaedeutic Internal Medicine, Joint Rheumatology Program, National and Kapodistrian University of Athens Medical School, "Laiko" General Hospital, Athens, Greece.

Classifications MeSH