Department of Psychiatry, Psychotherapy and Psychosomatics, University Clinic for Psychiatry II, Innsbruck Medical University, Innsbruck, Austria.
Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy.
High Alt Med Biol. 2019 Sep;20(3):207-214. doi: 10.1089/ham.2019.0020. Epub 2019 Jul 25.
Psychiatric disorders have a high lifetime prevalence affecting about 30% of the global population. Not much is known about high altitude (HA) sojourns in individuals living with a psychiatric condition. This lack of scientific evidence contrasts with the anticipated increase in numbers of individuals with preexisting psychiatric conditions seeking medical advice on HA exposure. Not only are there risks associated with a HA climb, but physical activity in general is known to improve symptoms of many psychiatric disorder and enhance measures of mental well-being like quality of life and resilience. There are additional positive effects of alpine environments on mental health beyond those of physical activity. All individuals going to HA with a preexisting psychiatric condition should be in a state of stable disease with no recent change in medication. Specific considerations and recommendations apply to individual psychiatric disorders. During the HA sojourn the challenge is to separate altitude-related symptoms such as insomnia from prodromal symptoms of the underlying disorder (e.g., depressive episode) or altitude-related hyperventilation from panic attacks. In case an individual with preexisting anxiety disorder decides to go to HA there might be a predisposition toward acute mountain sickness (AMS), but it should always be considered that many symptoms of anxiety and AMS overlap. Any medication that is anticipated to be taken during ascent or at HA should be tested for compatibility with the psychiatric condition and medication before the trip.
精神障碍的终身患病率很高，影响了约全球 30%的人口。对于生活在精神疾病中的人在高海拔（HA）逗留的情况，我们知之甚少。这种缺乏科学证据的情况与预计会增加的有预先存在的精神疾病的人数形成鲜明对比，这些人会寻求关于 HA 暴露的医疗建议。不仅高海拔攀登存在风险，而且一般的身体活动已知可以改善许多精神障碍的症状，并增强心理健康的衡量标准，如生活质量和韧性。高山环境对心理健康的积极影响超出了身体活动的影响。所有患有预先存在的精神疾病前往 HA 的人都应处于疾病稳定状态，且最近没有药物变化。具体考虑因素和建议适用于特定的精神障碍。在 HA 逗留期间，挑战是要将与海拔相关的症状（如失眠）与潜在疾病的前驱症状（例如抑郁发作）或与海拔相关的过度通气与惊恐发作区分开来。如果患有预先存在的焦虑症的个体决定前往 HA，可能会倾向于急性高山病（AMS），但应始终认为焦虑症和 AMS 的许多症状重叠。预计在上升或在 HA 期间服用的任何药物都应在旅行前测试其与精神状况和药物的兼容性。
