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Schizophrenia and the COVID-19 pandemic: A narrative review from the biomedical perspective. 精神分裂症与COVID-19大流行:从生物医学角度的叙事回顾。
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-07-08 DOI: 10.1016/j.rpsm.2023.04.002
Krzysztof Kowalski, Błażej Misiak

The outbreak of the Coronavirus Disease 2019 (COVID-19) pandemic in 2020 caused a rapid worsening of global mental health. Patients with severe mental disorders, including schizophrenia, are at higher risk of being infected. The neuroinvasive potential of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has been confirmed. The aim of this article was to present a narrative and comprehensive review of multidimensional associations between schizophrenia and COVID-19 with special emphasis on common biological pathways. Online searches were performed in the PubMed database and covered the publication period until September 17, 2022. Search terms included "psychosis", "schizophrenia", "inflammation" and "COVID-19". Viewed as a neuroinflammatory state, schizophrenia shares several neurobiological mechanisms with the COVID-19. Environmental stress, common comorbidities of schizophrenia and adverse effects of antipsychotic treatment are associated with the higher severity and mortality of the COVID-19. Additionally, more frequent relapses of psychosis have been observed, and might be related to lower treatment adherence. In the context of clinical manifestation, higher level of negative symptoms has been identified among patients with schizophrenia during the pandemic. Improvements in mental health care policy and treatment adjustment are necessary to protect people with schizophrenia who are the population that is particularly vulnerable to the consequences of the COVID-19 pandemic. Future research will show if prenatal infection with the SARS-CoV-2 increases a risk of psychosis.

2020年爆发的2019冠状病毒病(COVID-19)大流行导致全球精神卫生状况迅速恶化。患有严重精神障碍的患者,包括精神分裂症患者,被感染的风险更高。严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)的神经侵袭潜力已得到证实。本文的目的是对精神分裂症和COVID-19之间的多维关联进行叙述和全面回顾,特别强调常见的生物学途径。在PubMed数据库中进行了在线搜索,涵盖了截止到2022年9月17日的出版期。搜索词包括“精神病”、“精神分裂症”、“炎症”和“COVID-19”。精神分裂症被视为一种神经炎症状态,与COVID-19具有几种相同的神经生物学机制。环境压力、精神分裂症的常见合并症和抗精神病药物治疗的不良反应与COVID-19的更高严重程度和死亡率相关。此外,还观察到更频繁的精神病复发,这可能与较低的治疗依从性有关。在临床表现方面,在大流行期间,在精神分裂症患者中发现了更高水平的阴性症状。有必要改进精神卫生保健政策和调整治疗,以保护精神分裂症患者,他们是特别容易受到COVID-19大流行后果影响的人群。未来的研究将显示产前感染SARS-CoV-2是否会增加患精神病的风险。
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引用次数: 0
Volume alterations of the hippocampus and amygdala in patients with schizophrenia and persistent auditory hallucinations. 精神分裂症和持续性幻听患者海马体和杏仁核的体积改变。
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-07-03 DOI: 10.1016/j.rpsm.2023.05.002
Marta Perez-Rando, Carlota Penades-Gomiz, Pablo Martinez-Marin, Gracián García-Martí, Eduardo J Aguilar, Maria J Escarti, Eva Grasa, Iluminada Corripio, Julio Sanjuan, Juan Nacher

Introduction: Auditory hallucinations (AH) are one of the most prevalent symptoms of schizophrenia. They might cause several brain alterations, especially changes in the volumes of hippocampus and amygdala, regions related to the relay and processing of auditory cues and emotional memories.

Material and methods: We have recruited 41 patients with schizophrenia and persistent AH, 35 patients without AH, and 55 healthy controls. Using their MRIs, we have performed semiautomatic segmentations of the hippocampus and amygdala using Freesurfer. We have also performed bilateral correlations between the total PSYRATS score and the volumes of affected subregions and nuclei.

Results: In the hippocampus, we found bilateral increases in the volume of its hippocampal fissure and decreases in the right fimbria in patients with and without AH. The volume of the right hippocampal tail and left head of the granule cell layer from the dentate gyrus were decreased in patients with AH. In the amygdala, we found its left total volume was shrunk, and there was a decrease of its left accessory basal nucleus in patients with AH.

Conclusions: We have detected volume alterations of different limbic structures likely due to the presence of AH. The volumes of the right hippocampal tail and left head of the granule cell layer from the dentate gyrus, and total volume of the amygdala and its accessory basal nucleus, were only affected in patients with AH. Bilateral volume alterations in the hippocampal fissure and right fimbria seem inherent of schizophrenia and due to traits not contemplated in our research.

幻听(AH)是精神分裂症最常见的症状之一。它们可能会导致大脑的一些变化,尤其是海马体和杏仁核体积的变化,这两个区域与听觉线索和情感记忆的传递和处理有关。材料和方法:我们招募了41名精神分裂症合并持续性AH患者,35名非AH患者和55名健康对照。利用他们的核磁共振成像,我们使用Freesurfer对海马体和杏仁核进行了半自动分割。我们还在PSYRATS总分与受影响的子区域和核的体积之间进行了双边相关性。结果:在海马体中,我们发现患有和不患有AH的患者的双侧海马体裂体积增加,右侧纤维体积减少。AH患者海马右尾和齿状回颗粒细胞层左头体积减小。在AH患者的杏仁核中,我们发现其左侧总体积缩小,左侧副基底核减少。结论:我们已经检测到不同边缘结构的体积改变可能是由于AH的存在。仅在AH患者中,海马右侧尾部和齿状回颗粒细胞层左侧头部的体积,以及杏仁核及其附属基底核的总体积受到影响。双侧海马体裂和右膜的体积变化似乎是精神分裂症固有的,并且由于我们的研究中没有考虑到的特征。
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引用次数: 0
Deep brain stimulation and digital monitoring for patients with treatment-resistant schizophrenia and bipolar disorder: A case series. 难治性精神分裂症和双相情感障碍患者的脑深部刺激和数字监测:一个病例系列。
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-06-24 DOI: 10.1016/j.rpsm.2023.05.001
Miquel Bioque, Jordi Rumià, Pedro Roldán, Diego Hidalgo-Mazzei, Laura Montejo, Antonio Benabarre, Joaquín Gil-Badenes, Javier Tercero, Eduard Parellada, Eduard Vieta

Aim: The use of deep brain stimulation (DBS) has been recently extended for treating resistant psychiatric disorders, but the experience in patients with schizophrenia-related disorders and bipolar disorder (BD) is scarce.

Method: We conducted an observational, one-year longitudinal study to evaluate the effects of DBS in four treatment-resistant patients with schizophrenia, schizoaffective, and BD, included in a pilot, last-resource protocol. Patients were digitally monitored for objective assessment of behavioral changes.

Results: After one year of its initiation, DBS of the nucleus accumbens (in subjects N2, N3, and N4) and subgenual anterior cingulate cortex (in N1) produced a significant clinical improvement, associated with decreases in the Clinical Global Impression (from 5.25±0.5 to 3.5±1, p=0.035) and in the Hamilton Depression Rating Scale (HADRS scores, from 14.5±6.56 to 1.5±1.29, p=0.020). We observed a notable, durable therapeutic response in two patients from this cohort (N1 and N3), a clinically relevant relief in a third (N2), and a lack of a significant response in the last one (N4). Maintenance electroconvulsive therapy sessions could be discontinued in the three patients that responded to DBS (N1-3). There were no side effects or relevant changes in cognitive functioning. There were relevant differences between physical activity and sleep time among the four participants.

Conclusions: These results suggest initial evidence that DBS may be an effective and safe alternative for treating complex and resistant forms of schizophrenia-related disorders and BD. Digital monitoring may help to capture objective measures of behavioral changes after the intervention.

目的:脑深部刺激(DBS)最近被扩展用于治疗顽固性精神障碍,但在精神分裂症相关障碍和双相情感障碍(BD)患者中的经验很少。方法:我们进行了一项为期一年的观察性纵向研究,评估DBS对四名精神分裂症、分裂情感性和BD患者的疗效,包括在一项试点的最后资源方案中。对患者进行数字监测,以客观评估行为变化。结果:在开始一年后,伏隔核(受试者N2、N3和N4)和球下前扣带皮层(N1)的DBS产生了显著的临床改善,与临床总体印象(从5.25±0.5降至3.5±1,p=0.035)和汉密尔顿抑郁评定量表(HADRS评分,从14.5±6.56降至1.5±1.29,p=0.020)的下降相关。我们在该队列的两名患者(N1和N3)中观察到显著、持久的治疗反应,第三名患者(N2)出现临床相关缓解,最后一名患者(N4)缺乏显著反应。对DBS(N1-3)有反应的三名患者可以停止维持性电休克治疗。认知功能没有副作用或相关变化。四名参与者的体力活动和睡眠时间之间存在相关差异。结论:这些结果表明,DBS可能是治疗复杂和耐药形式的精神分裂症相关疾病和BD的有效和安全的替代方案。数字监测可能有助于捕捉干预后行为变化的客观指标。
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引用次数: 0
Koro-like syndrome in Huntington's disease. 亨廷顿舞蹈症中的Koro样综合征。
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-05-25 DOI: 10.1016/j.rpsm.2023.01.006
Saul Martinez-Horta, Jesus Perez-Perez, Jaime Kulisevsky
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引用次数: 0
Digital mental health interventions for anxiety and depressive symptoms in university students during the COVID-19 pandemic: A systematic review of randomized controlled trials 2019冠状病毒病大流行期间大学生焦虑和抑郁症状的数字心理健康干预:随机对照试验的系统综述
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1016/j.rpsm.2022.04.005
Ilaria Riboldi , Daniele Cavaleri , Angela Calabrese , Chiara Alessandra Capogrosso , Susanna Piacenti , Francesco Bartoli , Cristina Crocamo , Giuseppe Carrà

University students are particularly vulnerable to mental health issues, with anxiety and depression identified as the most common conditions. During the COVID-19 pandemic, social distancing, self-isolation, and difficulties linked to online teaching and learning have increased their burden of anxiety and depressive symptoms. Thus, the urgent need to intervene in favour of these vulnerable subjects, together with the difficulties in delivering in-person interventions because of lockdowns and restrictions, has led to prioritize digital mental health strategies. This study aimed at systematically reviewing the existing literature on digital mental health interventions targeting anxiety and depressive symptoms in university students during the COVID-19 emergency. Systematic searches of Medline, Embase, and PsycInfo databases identified eight randomized controlled trials. Regarding anxiety symptoms, digitally delivered cognitive behavioural therapy, dialectical behaviour therapy, and mind-body practice techniques emerged as valid strategies, while digital positive psychology and mindfulness-based interventions showed mixed results. On the other hand, digitally delivered dialectical behaviour therapy and positive psychology interventions have shown some efficacy in reducing depressive symptoms. Overall, the available literature, albeit of low quality, seems to support the role of digital interventions in promoting the mental health of university students during the COVID-19 pandemic.

大学生特别容易受到心理健康问题的影响,焦虑和抑郁被认为是最常见的情况。在新冠肺炎大流行期间,社交距离、自我安慰以及与在线教学相关的困难增加了他们的焦虑和抑郁症状负担。因此,迫切需要对这些弱势群体进行干预,再加上封锁和限制导致的亲自干预的困难,导致数字心理健康战略成为优先事项。本研究旨在系统回顾现有关于新冠肺炎紧急情况下针对大学生焦虑和抑郁症状的数字心理健康干预的文献。对Medline、Embase和PsycInfo数据库的系统搜索确定了八项随机对照试验。关于焦虑症状,数字传递的认知行为疗法、辩证行为疗法和身心练习技术成为有效的策略,而数字积极心理学和基于正念的干预措施显示出喜忧参半的结果。另一方面,数字提供的辩证行为疗法和积极的心理干预在减少抑郁症状方面显示出一定的疗效。总体而言,现有文献尽管质量较低,但似乎支持数字干预在新冠肺炎大流行期间促进大学生心理健康方面的作用。
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引用次数: 15
Efficacy and fMRI-based response predictors to mindfulness-based cognitive therapy in obsessive-compulsive disorder: Study protocol for a randomised clinical trial. 强迫症患者基于正念的认知治疗的疗效和基于功能磁共振成像的反应预测因素:一项随机临床试验的研究方案。
IF 5.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 Epub Date: 2022-11-17 DOI: 10.1016/j.rpsm.2022.11.002
Neus Miquel-Giner, Muriel Vicent-Gil, Ignacio Martínez-Zalacaín, Daniel Porta-Casteras, Lorea Mar, Marina López-Solà, Jessica R Andrews-Hanna, Carles Soriano-Mas, José Manuel Menchón, Narcís Cardoner, Pino Alonso, Maria Serra-Blasco, Clara López-Solà

Background: Around 40-50% of patients with obsessive-compulsive disorder (OCD) suffer from obsessions and compulsions after receiving first-line treatments. Mindfulness-based cognitive therapy (MBCT) has been proposed as a reasonable augmentation strategy for OCD. MBCT trains to decentre from distressful thoughts and emotions by focusing on them voluntarily and with consciousness. This practice develops alternative ways to deal with obsessions, which could increase non-reactivity behaviours and, in turn, reduce compulsions. This study aims to investigate the efficacy of MBCT to improve OCD symptoms. Secondly, it pursues to investigate which socio-demographic, clinical, and neurobiological characteristics mediate or moderate the MBCT response; and identify potential biomarkers of positive/negative response.

Methods: This study is a randomised clinical trial (RCT) of 60 OCD patients who do not respond to first-line treatments. Participants will be randomised to either an MBCT program or treatment as usual. The MBCT group will undergo 10 weekly sessions of 120min. Principal outcome: change in OCD severity symptoms using clinician and self-reported measures. Also, participants will undergo a comprehensive evaluation assessing comorbid clinical variables, neuropsychological functioning and thought content. Finally, a comprehensive neuroimaging protocol using structural and functional magnetic resonance imaging will be acquired in a 3T scanner. All data will be obtained at baseline and post-intervention.

Discussion: This study will assess the efficacy of mindfulness in OCD patients who do not achieve clinical recovery after usual treatment. It is the first RCT in this subject examining clinical, neuropsychological and neuroimaging variables to examine the neural patterns associated with the MBCT response.

Clinical trials registration: NCT03128749.

背景:大约40-50%的强迫症患者在接受一线治疗后会出现强迫症和强迫症状。基于正念的认知疗法(MBCT)已被认为是治疗强迫症的一种合理的强化策略。MBCT训练通过自愿和有意识地专注于痛苦的思想和情绪,从而从痛苦中解脱出来。这种做法开发了处理强迫症的替代方法,可以增加非反应性行为,进而减少强迫症。本研究旨在探讨MBCT改善强迫症症状的疗效。其次,它试图调查哪些社会人口学、临床和神经生物学特征介导或调节MBCT反应;并鉴定阳性/阴性反应的潜在生物标志物。方法:本研究是一项随机临床试验(RCT),共有60名对一线治疗无反应的强迫症患者。参与者将被随机分配到MBCT项目或常规治疗。MBCT组将进行10次每周120分钟的治疗。主要结果:使用临床医生和自我报告的措施改变强迫症严重症状。此外,参与者将接受综合评估,评估共病临床变量、神经心理功能和思维内容。最后,将在3T扫描仪中获得使用结构和功能磁共振成像的综合神经成像方案。所有数据将在基线和干预后获得。讨论:这项研究将评估正念对那些在常规治疗后没有实现临床康复的强迫症患者的疗效。这是该学科中第一次通过检查临床、神经心理学和神经影像学变量来检查与MBCT反应相关的神经模式的随机对照试验。临床试验注册号:NCT03128749。
{"title":"Efficacy and fMRI-based response predictors to mindfulness-based cognitive therapy in obsessive-compulsive disorder: Study protocol for a randomised clinical trial.","authors":"Neus Miquel-Giner, Muriel Vicent-Gil, Ignacio Martínez-Zalacaín, Daniel Porta-Casteras, Lorea Mar, Marina López-Solà, Jessica R Andrews-Hanna, Carles Soriano-Mas, José Manuel Menchón, Narcís Cardoner, Pino Alonso, Maria Serra-Blasco, Clara López-Solà","doi":"10.1016/j.rpsm.2022.11.002","DOIUrl":"10.1016/j.rpsm.2022.11.002","url":null,"abstract":"<p><strong>Background: </strong>Around 40-50% of patients with obsessive-compulsive disorder (OCD) suffer from obsessions and compulsions after receiving first-line treatments. Mindfulness-based cognitive therapy (MBCT) has been proposed as a reasonable augmentation strategy for OCD. MBCT trains to decentre from distressful thoughts and emotions by focusing on them voluntarily and with consciousness. This practice develops alternative ways to deal with obsessions, which could increase non-reactivity behaviours and, in turn, reduce compulsions. This study aims to investigate the efficacy of MBCT to improve OCD symptoms. Secondly, it pursues to investigate which socio-demographic, clinical, and neurobiological characteristics mediate or moderate the MBCT response; and identify potential biomarkers of positive/negative response.</p><p><strong>Methods: </strong>This study is a randomised clinical trial (RCT) of 60 OCD patients who do not respond to first-line treatments. Participants will be randomised to either an MBCT program or treatment as usual. The MBCT group will undergo 10 weekly sessions of 120min. Principal outcome: change in OCD severity symptoms using clinician and self-reported measures. Also, participants will undergo a comprehensive evaluation assessing comorbid clinical variables, neuropsychological functioning and thought content. Finally, a comprehensive neuroimaging protocol using structural and functional magnetic resonance imaging will be acquired in a 3T scanner. All data will be obtained at baseline and post-intervention.</p><p><strong>Discussion: </strong>This study will assess the efficacy of mindfulness in OCD patients who do not achieve clinical recovery after usual treatment. It is the first RCT in this subject examining clinical, neuropsychological and neuroimaging variables to examine the neural patterns associated with the MBCT response.</p><p><strong>Clinical trials registration: </strong>NCT03128749.</p>","PeriodicalId":21391,"journal":{"name":"Revista de psiquiatria y salud mental","volume":" ","pages":"58-59"},"PeriodicalIF":5.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of COVID-19 pandemic on the quality of life of healthcare workers and the associated factors: A systematic review COVID-19大流行对医护人员生活质量的影响及其相关因素:系统综述
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1016/j.rpsm.2022.11.003
Liliana Cruz-Ausejo , David Villarreal-Zegarra , C. Mahony Reátegui-Rivera , Miguel Burgos , Ana L. Vilela-Estrada , Gabriel Castro , Héctor Collantes , Anthony Copez-Lonzoy

Introduction

The COVID-19 pandemic has exacerbated health issues in healthcare workers which in turn impacts their quality of life.

Objective

This review aimed to (i) analyze the impact of the COVID-19 pandemic on the quality of life of healthcare professionals and (ii) identify the associated factors with quality of life.

Materials and methods

We conducted a systematic review using the PRISMA guidelines previously registered in PROSPERO (CRD42021253075). The searched in Web of Science, Scopus, MEDLINE and EMBASE databases included original articles published till May 2021.

Results

We found 19 articles and 14,352 professionals in total, the median age ranged from 29 to 42.5 years and 37% of the studies used the WHOQOL-BREF instrument to assess the outcome. The report was heterogeneous, 7 studies described global scores and 9 by domains. Depression, anxiety and stress were commonly reported factors affecting professional's quality of life and this was significantly lower among professionals working with COVID-19 patients compared to their counterparts.

Conclusion

COVID-19 frontline workers perceived lower quality of life, which was mainly associated with psychological states such as the aforementioned besides to working conditions like not being previously trained in COVID-19 cases. On the other hand, social support, resilience and active coping could improved their quality of life.

简介新冠肺炎大流行加剧了医护人员的健康问题,进而影响了他们的生活质量。目的本综述旨在(i)分析新冠肺炎大流行对医护人员生活质量的影响,(ii)确定与生活质量相关的因素。材料和方法我们使用之前在PROSPERO注册的PRISMA指南(CRD42021253075)进行了系统审查。在Web of Science、Scopus、MEDLINE和EMBASE数据库中搜索到的包括截至2021年5月发表的原创文章。结果我们总共发现了19篇文章和14352名专业人员,中位年龄在29-42.5岁之间,37%的研究使用WHOQOL-BREF工具来评估结果。该报告是异质性的,7项研究描述了全球得分,9项研究按领域分类。据报道,抑郁、焦虑和压力是影响专业人员生活质量的常见因素,与同行相比,从事新冠肺炎患者工作的专业人员的生活质量明显较低。结论COVID-19一线工作人员的生活质量较低,这主要与上述心理状态有关,此外还与工作条件有关,如未接受过COVID-19]病例的培训。另一方面,社会支持、复原力和积极应对可以提高他们的生活质量。
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引用次数: 1
Mental health symptoms one year after acute COVID-19 infection: Prevalence and risk factors 急性COVID-19感染后一年的精神健康症状:患病率和危险因素
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1016/j.rpsm.2022.05.008
Marco Colizzi , Maddalena Peghin , Maria De Martino , Giulia Bontempo , Valentina Gerussi , Alvisa Palese , Miriam Isola , Carlo Tascini , Matteo Balestrieri

Introduction

Emerging evidence suggests that mental health symptoms in COVID-19 survivors are higher than expected, possibly indicating that such symptoms are more likely to develop post-infection than just persist as a residual component of the acute phase. It is thus imperative to investigate the potential development of a post-COVID mental health syndrome in the longer-term and identify its risk factors.

Material and methods

A prospective study investigated mental health symptoms associated with COVID-19 and its determinants over a 12-month period following the disease onset in all consecutive adult inpatients and outpatients with COVID-19 attending a tertiary referral hospital from March to May 2020.

Results

A total of 479 patients (female, 52.6%) were followed-up for 12 months after COVID-19 onset. Of them, 47.2% were still presenting with at least one symptom. While most symptoms subsided as compared to COVID-19 onset (all p < 0.001), a significant increase was observed only for symptoms of psychiatric disorders (10.2%) and lack of concentration and focus (20%; all p < 0.001). Patients presenting with symptoms related to multiple body systems 12 months after contracting COVID-19 (all p  0.034) were more likely to suffer from mental health domain-related symptoms at follow-up. Also, a higher risk of presenting with lack of concentration and focus 12 months post infection was found in those suffering of psychiatric symptoms at COVID-19 onset (p = 0.005).

Conclusions

Findings of this study may have important public health implications, as they underlie the increased need for mental health support in COVID-19 survivors.

引言新出现的证据表明,新冠肺炎幸存者的心理健康症状高于预期,这可能表明这些症状更有可能在感染后发展,而不仅仅是作为急性期的残余成分持续存在。因此,有必要长期研究新冠肺炎后心理健康综合征的潜在发展,并确定其风险因素。材料和方法一项前瞻性研究调查了2020年3月至5月在三级转诊医院就诊的所有连续成年新冠肺炎住院患者和门诊患者在发病后12个月内与新冠肺炎相关的心理健康症状及其决定因素开端其中,47.2%的患者仍有至少一种症状。虽然与新冠肺炎发作相比,大多数症状消退(全部p<0.001),仅在精神障碍症状(10.2%)和注意力不集中(20%;所有p<0.001)方面观察到显著增加。在感染新冠肺炎12个月后出现与多个身体系统相关症状的患者(所有p≤0.034)更有可能在随访中出现与精神健康领域相关的症状。此外,在感染后12个月,新冠肺炎发病时出现精神症状的患者出现注意力不集中和注意力不集中的风险更高(p=0.005)。结论这项研究的发现可能对公共卫生有重要影响,因为它们是新冠肺炎幸存者对心理健康支持需求增加的基础。
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引用次数: 19
Urgent care and suicidal behavior in the child and adolescent population in a psychiatric emergency department in a Spanish province during the two COVID-19 states of alarm 在两个COVID-19警报状态期间,西班牙某省精神科急诊科儿童和青少年人群的紧急护理和自杀行为
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1016/j.rpsm.2022.03.003
Vicent Llorca-Bofí, Marina Adrados-Pérez, Marta Sánchez-Cazalilla, Giovanni Torterolo, Laura Arenas-Pijoan, Esther Buil-Reiné, Eugènia Nicolau-Subires, Carla Albert-Porcar, Lucía Ibarra-Pertusa, Margarita Puigdevall-Ruestes, María Irigoyen-Otiñano

Introduction

The COVID-19 outbreak and lockdown may have an impact in mental health among youth, but reports of psychiatry emergency department encounters in young Spanish population are scarce. The aim of this study is to characterize the reasons for psychiatric urgent care of youth during COVID-19 pandemic in our hospital.

Material and methods

This cross-sectional study compare visits to the psychiatry emergency department and their characteristics in young patients in the province of Lleida before and after the pandemic with special attention to the two states of alarm and suicidal behavior. Information regarding sociodemographic status, chief complaints, diagnosis, characteristics of suicidal behavior, and other data were obtained from the electronic medical records.

Results

Within the total psychiatric emergency attendances, youth patients increased a 83.5% in the second state of alarm (p = 0.001). In this period patients were younger (p = 0.006), had less psychiatric history (p = 0.017) and their living conditions changed with an increase of those living with relatives (p = 0.004). Suicidal ideation care increased without statistical significance (p = 0.073). Multiple logistic regression identifies independent risk factors for suicidal behavior being female (OR: 2.88 [1.39–5.98]), living with relatives (OR: 3.49 [1.43–8.54]), and having a diagnosis of depression (OR: 6.34 [3.58–11.24]).

Conclusions

The number of young people seen in psychiatric emergencies during the chronic stage of the pandemic increased, and these were getting younger and without previous psychiatric contact. The trend to higher rates of suicidal ideation indicates that youth experienced elevated distress during these periods, especially women, living with relatives and presenting depression.

2019冠状病毒病的爆发和封锁可能会对年轻人的心理健康产生影响,但关于西班牙年轻人在精神科急诊就诊的报道很少。本研究的目的是分析COVID-19大流行期间我院青少年精神科急诊的原因。材料和方法本横断面研究比较了莱伊达省年轻患者在大流行前后的精神病学急诊科就诊情况及其特点,特别关注了两种状态的报警和自杀行为。从电子病历中获得有关社会人口状况、主诉、诊断、自杀行为特征和其他数据的信息。结果在精神科急诊总人数中,青年患者在第二报警状态下增加了83.5% (p = 0.001)。这一时期患者年龄较轻(p = 0.006),精神病史较少(p = 0.017),其生活条件随与亲属同住人数的增加而改变(p = 0.004)。自杀意念护理增加,但无统计学意义(p = 0.073)。多元logistic回归分析发现,自杀行为的独立危险因素为女性(OR: 2.88[1.39-5.98])、与亲属同住(OR: 3.49[1.43-8.54])、患有抑郁症(OR: 6.34[3.58-11.24])。结论在疫情慢性期接受精神科急诊的青少年人数有所增加,且呈年轻化趋势,且无精神科接触史。自杀意念率上升的趋势表明,在这些时期,年轻人,特别是妇女,与亲戚住在一起并表现出抑郁症,经历了更大的痛苦。
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引用次数: 2
Psychological impact of COVID-19 lockdown on a population with serious mental illness. A prospective cohort study COVID-19封锁对严重精神疾病人群的心理影响。一项前瞻性队列研究
IF 9.2 3区 医学 Q1 PSYCHIATRY Pub Date : 2023-01-01 DOI: 10.1016/j.rpsm.2022.04.004
Borja Pedruzo , Ana Catalan , Claudia Aymerich , Marta Bordenave , Olatz Estevez , Diego Aurofio Gómez , Jon Herrero , María Laborda , Gonzalo Mancebo , Ania Martínez , Malein Pacho , Ana Paniagua , José Luis Pérez , Miguel Ángel González-Torres

Introduction

COVID-19 has spread worldwide since its appearance at the end of 2019. In Spain, 99-day long home confinement was set from March 15th 2020. Previous studies about events requiring situations of isolation suggested that mental health problems may occur among the general population and, more specifically, vulnerable groups such as individuals with serious mental illness (SMI). This study aims to assess the psychological effect of confinement in patients with mental illness admitted to an inpatient psychiatric unit.

Method

In this longitudinal study, IDER (State-Trait Depression Inventory) and STAI (State-Trait Anxiety Inventory) questionnaires were used at two different times (at the beginning and after the lockdown) of the pandemic to evaluate the depression and anxiety symptoms, respectively, in a population of patients who had been previously admitted to the Psychiatry Unit of the Basurto University Hospital.

Results

95 participants completed the IDER questionnaire in the first measurement, with a mean score of 24.56 (SD = 8.18) for state and 23.57 (SD = 8.14) for trait. In the case of STAI, the mean score was 27.86 (SD = 15.19) for the state and 30.49 (SD = 14.71) for the trait. No differences between the first and the second time were found in anxiety and depression levels. People with personality disorders presented high levels of anxiety.

Conclusions

Individuals with a personality disorder showed the highest scores in anxiety and depression. Nevertheless, strict confinement did not affect this population, despite the literature that evidences that the pandemic has worsened people's mental health with SMI.

简介新冠肺炎自2019年底出现以来已在全球范围内传播。西班牙从2020年3月15日开始实行为期99天的家庭禁闭。先前关于需要隔离的事件的研究表明,心理健康问题可能发生在普通人群中,更具体地说,可能发生在弱势群体中,如患有严重精神疾病(SMI)的人。本研究旨在评估精神病住院患者禁闭的心理影响。方法采用IDER(State Trait Depression Inventory)和STAI(State Trait Anxiety Inventory)问卷,分别在疫情的两个不同时间(封锁初期和封锁后)评估抑郁和焦虑症状,在之前曾入住巴苏尔托大学医院精神科的患者群体中。结果95名参与者在第一次测量中完成了IDER问卷,状态平均得分为24.56(SD=8.18),特质平均得分为23.57(SD=8.14)。在STAI的情况下,状态的平均得分为27.86(SD=15.19),特质的平均得分是30.49(SD=14.71)。第一次和第二次在焦虑和抑郁水平上没有发现差异。有人格障碍的人表现出高度焦虑。结论人格障碍患者在焦虑和抑郁方面得分最高。尽管如此,尽管有文献表明,新冠疫情恶化了SMI患者的心理健康,但严格的禁闭并没有影响这一人群。
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引用次数: 4
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Revista de psiquiatria y salud mental
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