Factors of hedonistic balance in the post-infection period of COVID-19 in psychiatric inpatients

SARS-CoV-2 infection is associated with the development of motivational-hedonistic disorders in post-COVID syndrome. It is known that anhedonia is associated with a high risk of suicidal ideation, which emphasizes the importance of its study. The aim of the study was to determine probable clinical, therapeutic and socio-demographic predictors of severe anhedonia, as well as to establish the ratio of its physical and social aspects in psychiatric inpatients who had COVID-19. Materials and methods. Secondary analysis of retrospective data from 48 people treated in a psychiatric hospital. Sociodemographic status, neuropsychiatric symptoms, information on the diagnosis and nature of the course of COVID-19 were recorded. To assess the structure of hedonistic disorders, the Russian-language versions of the Revised Physical Anhedonia Scale (RPAS) and the Social Anhedonia Assessment Questionnaire (RSAS) were used. Information on drug therapy administered during the 2 weeks prior to hospitalization and during current inpatient treatment was collected from primary medical records. Erythrocyte sedimentation rate (ESR) as an indicator of systemic inflammation and body mass index (BMI) as a marker of metabolic syndrome were also extracted. An objective assessment of physiological functions was performed based on blood pressure variability. Results. The hypothesis that anhedonia is a component of post-COVID syndrome was partially confirmed. Among therapeutic strategies for relieving delayed neuropsychiatric symptoms, an increase in the doses of antidepressants prescribed in the hospital was observed after a longer period of time. Significant associations with the severity of social anhedonia, gender, use of antipsychotic drugs, type and dose of antidepressants, and blood pressure variability were established as predictors of the development of physical anhedonia. Conclusion. The potential for correcting anhedonia in the post-infection period of COVID-19 was demonstrated by choosing a rational therapeutic strategy, in particular modern antidepressants, as well as reducing the phenomena of vascular dysregulation.

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