Depression in adults with idiopathic inflammatory myopathy during the COVID-19 pandemic: A prospective cohort study

Purpose The COVID-19 outbreak has profoundly changed daily life and how patients access medical care. Idiopathic inflammatory myopathy (IIM) patients, who frequently develop chronic interstitial lung disease (ILD), are at high risk for respiratory infection and are also susceptible to psychological disorders. This study explored depression, anxiety, and compliance among IIM-ILD patients and the association of these factors with disease status during the COVID-19 outbreak in China. Methods A total of 94 IIM-ILD patients were included in the analysis. Baseline demographic and disease-related information was collected using the medical records system. The following questionnaires were used: Beck Depression Inventory-II (BDI-II), Compliance-Questionnaire- Rheumatology (CQR), Multidimensional Scale of Perceived Social Support (MSPSS), and the State-Trait Anxiety Inventory (STAI). The questionnaires were administered before, during, and after the COVID-19 outbreak in China by a rheumatology nurse through We-Chat. Results: During the COVID-19 outbreak, a significantly deteriorated depression status and reduced treatment compliance were found among these patients. Female gender and a dosage of greater than 15 mg of glucocorticoid per day were independently associated with depression, while social support was found to be negatively correlated with depression. Clinical follow-up revealed an overall disease flare rate of 17% (16/94). Patients with depression during the COVID-19 outbreak had a significantly higher disease flare rate than those without depression. Conclusion: Because depression negatively impacts patient quality of life and recovery from primary disease, patients with rheumatic disease should receive an early evaluation, appropriate treatment, and long-term monitoring for depression.