Side-effect expectations are associated with disability, physical fitness, and somatic symptoms 3 months after post-COVID neurological inpatient rehabilitation.

Autor: Salzmann S; Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany; Medical Psychology, Health and Medical University Erfurt, Erfurt, Germany. Electronic address: stefan.salzmann@staff.uni-marburg.de., Herrmann M; Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany., Henning M; Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany., Schwertner L; Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany., Euteneuer F; Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Berlin, Berlin, Germany., Goldau L; Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany., Bahr C; Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany., Berwanger C; Hardtwaldklinik I Werner Wicker GmbH & Co. KG, Hospital for Neurology - Psychiatry/Psychotherapy With Psychosomatic and Trauma Therapy, Bad Zwesten, Germany., Rief W; Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany.
Jazyk: angličtina
Zdroj: Journal of psychosomatic research [J Psychosom Res] 2024 Nov; Vol. 186, pp. 111902. Date of Electronic Publication: 2024 Aug 24.
DOI: 10.1016/j.jpsychores.2024.111902
Abstrakt: Introduction: The COVID-19 pandemic, caused by SARS-CoV-2, has led to long-term health issues known as post-COVID-19 condition, including fatigue and cognitive disruptions. Despite its recognition as a public health concern, the efficacy of therapeutic interventions, especially in neurological rehabilitation, remains unclear. This study examines how treatment expectations are associated with psychological and physical outcomes in post-COVID-19 condition neurological rehabilitation.
Methods: In an observational cohort study 61 patients with confirmed post-COVID-19 condition were included. Baseline (T0) data on treatment and side effect expectations were collected, before participants underwent a 4-6 week multidisciplinary rehabilitation program. Primary outcome was illness-related disability (Pain Disability Index). Secondary outcomes included depressive symptoms (PHQ-9), anxiety levels (GAD-7), functional status (PCFS), fatigue (CFS), and physical fitness (6MWT). Regression models analyzed the associations of baseline expectations with outcomes at the end of rehabilitation (T1) and three months post-rehabilitation (T2).
Results: After adjusting for multiple testing, higher baseline side-effect expectations were associated with greater illness-related disability (β = 0.42, p = 0.007), reduced physical fitness (β = - 0.24, p = 0.04), and more somatic symptoms (β = 0.33, p = 0.006) at follow-up (T2). Positive treatment expectations were associated with poorer functional status (β = 0.35, p = 0.011) at T2.
Conclusion: This study highlights the associations of side-effect expectations with post-COVID-19 condition rehabilitation outcomes. Higher side-effect expectations were associated to poorer outcomes, indicating a nocebo effect. Surprisingly, positive expectations were linked to worse outcomes, possibly due to unrealistic optimism. Managing patient expectations realistically and addressing side-effect concerns seems crucial for optimizing rehabilitation outcomes.
Competing Interests: Declaration of competing interest SS reports research funding (no personal honoraria) from the German Research Foundation and the German Heart Foundation/German Foundation of Heart Research. WR declares to have received honoraria from Boehringer Ingelheim for workshops on Post Covid, and royalties from book publishers. All other authors report to have no conflicts of interest to declare.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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