Mental disorders during the pandemic of a new coronavirus infection: clinical features

V. Vysokova, N. A. Tyuvina, T. N. Maksimova, S. V. Prokhorova
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Abstract

Objective: to study the clinical features of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness.Material and methods. We examined 100 patients who turned to psychiatrist due to deterioration of their mental state on the background of a pandemic. Of these, 50 were new cases (1st group; 23 women and 27 men, mean age 34 years) and 50 were cases with previously diagnosed mental disorders (2nd group; 25 women and 25 men, mean age 37 years). 80% of patients of the 1st group, 54% of patients of the 2nd group had coronavirus infection. Anxiety and depressive disorders prevailed in the 1st group, endogenous diseases prevailed in the 2nd group: bipolar affective disorder, recurrent depressive disorder, schizophrenia. The study was conducted by the clinical method using a specially designed map; the severity of depression was assessed using the Montgomery-Asberg Depression Rating Scale, and the severity of anxiety was assessed using the Hamilton Anxiety Rating Scale.Results. The clinical picture of primary and recurrent depressive episodes after infection was characterized by the presence of motor and associative retardation, severe apathy, hypersomnia and lack of sleep, fatigue, increased appetite, and complaints of impaired attention and memory. Depression in SARS-CoV-2 survivors was characterized by anxiety, anhedonia, irritability, somatic complaints, and hypochondriacal inclusions. Anxiety symptoms in those who were not ill included severe anxiety, reaching agitation, disturbed sleep with frequent awakenings, irritability, somatic complaints, and hypochondriacal fixation on one’s condition. In recovering patients, anxiety was accompanied by control of somatic functions, cognitive impairments, and fear of retention or even intensification.Conclusion. The results obtained indicate the existing differences between the mental disorders that first appeared and worsened during the pandemic, as well as the differences in the structure of the depressive and anxiety syndrome depending on the presence or absence of coronavirus infection.
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新型冠状病毒大流行期间的精神障碍:临床特征
目的:研究新冠肺炎疫情期间首次就诊精神科患者及已确诊精神疾病患者的精神障碍临床特征。材料和方法。我们调查了100名在大流行背景下因精神状态恶化而求助于精神科医生的患者。其中50例为新发病例(第一组;23名女性和27名男性,平均年龄34岁)和50名既往诊断为精神障碍的病例(第二组;25名女性和25名男性,平均年龄37岁)。第一组患者有80%、第二组患者有54%的冠状病毒感染。第一组以焦虑和抑郁为主,第二组以内源性疾病为主:双相情感障碍、复发性抑郁症、精神分裂症。本研究采用临床方法,采用特别设计的地图;抑郁程度采用Montgomery-Asberg抑郁评定量表,焦虑程度采用Hamilton焦虑评定量表。感染后原发性和复发性抑郁发作的临床表现以运动和联想障碍、严重冷漠、嗜睡和睡眠不足、疲劳、食欲增加以及注意力和记忆力受损为特征。SARS-CoV-2幸存者的抑郁特征为焦虑、快感缺乏、易怒、躯体主诉和疑病症。未患病者的焦虑症状包括严重焦虑、达到躁动、睡眠紊乱伴频繁醒来、易怒、躯体抱怨和疑病症固定。在康复患者中,焦虑伴随着躯体功能的控制、认知障碍和对保留甚至加重的恐惧。获得的结果表明,在大流行期间首次出现和恶化的精神障碍之间存在差异,以及抑郁和焦虑综合征结构的差异取决于是否存在冠状病毒感染。
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