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COVID-19 大流行期间的精神卫生保健原则。

Principles of mental health care during the COVID-19 pandemic.

机构信息

Department of Psychiatry, Zagreb University Hospital Centre, Zagreb, Croatia.

University of Zagreb, School of Medicine, Zagreb, Croatia.

出版信息

Eur Psychiatry. 2020 May 20;63(1):e45. doi: 10.1192/j.eurpsy.2020.54.

Abstract

We describe the basic principles of mental health care during the COVID-19 pandemic that should be endorsed by the mental health professional associations and incorporated in the health strategies for the management of the COVID-19 pandemic. The main principle is that there should be no substantial differences in the provision of health care for COVID-19 between persons with pre-existing mental health disorders and the ones without previous disorders. Subsequently, the organization of the health care should reflect that as well. These principles should (a) prevent the possible effects of stigmatizing attitudes toward mental health issues, possibly leading to potentially deleterious situations, such as psychiatric patients being treated (even temporarily) separately from other patients, in psychiatric facilities, where the staff is not equipped and trained adequately for the management of COVID-19; (b) highlight the fact that patients with mental health disorders are at greater risk for developing serious complications of COVID-19 infection due to other factors-they often smoke and have comorbidities such as hypertension, diabetes, all associated with higher morbidity and mortality from COVID-19 infection; (c) highlight that measures should be taken to minimize the risk of the spread of infection in psychiatric wards/institutions; (d) provide a general framework for the reorganization of mental health services toward the provision of services for persons in need, including frontline medical workers and patients with COVID-19 without previous mental health problems as well as for persons with pre-existing mental health problems under new circumstances of pandemic.

摘要

我们描述了在 COVID-19 大流行期间进行精神卫生保健的基本原则,这些原则应得到精神卫生专业协会的认可,并纳入 COVID-19 大流行管理的卫生战略中。主要原则是,患有先前存在的精神健康障碍的人和没有先前障碍的人在 COVID-19 保健方面不应有实质性差异。随后,医疗保健的组织也应反映这一点。这些原则应(a)防止对精神健康问题产生污名化态度的可能影响,这些态度可能导致潜在的有害情况,例如将精神科患者(甚至暂时)与其他患者分开治疗,在没有为管理 COVID-19 配备和培训足够人员的精神科设施中;(b)强调由于其他因素,精神健康障碍患者患 COVID-19 感染严重并发症的风险更高-他们经常吸烟,并且患有高血压、糖尿病等合并症,所有这些都与 COVID-19 感染的发病率和死亡率更高有关;(c)强调应采取措施尽量减少感染在精神科病房/机构中的传播风险;(d)为重新组织精神卫生服务提供一个总体框架,以向有需要的人提供服务,包括一线医务人员和患有 COVID-19 且没有先前精神健康问题的患者,以及在大流行的新情况下患有先前存在的精神健康问题的人。

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