Daaboul J, Tamouza R, Leboyer M
Université de Lille, CHU de Lille, Lille, France; DMU IMPACT, département médico-universitaire de psychiatrie et d'addictologie du groupe hospitalier universitaire Henri-Mondor, AP-HP, Créteil, France.
DMU IMPACT, département médico-universitaire de psychiatrie et d'addictologie du groupe hospitalier universitaire Henri-Mondor, AP-HP, Créteil, France; Fondation FondaMental, Créteil, France; Université Paris Est Créteil, UPEC, Inserm, U955, équipe 15 neuro-psychiatrie translationnelle, Institut Mondor de Recherche Biomédicale, IMRB, Créteil, France.
Encephale. 2021 Apr;47(2):151-156. doi: 10.1016/j.encep.2020.07.002. Epub 2020 Jul 21.
The SARS-CoV-2 (or COVID-19) pandemic has been propagating since December 2019, inducing a drastic increase in the prevalence of anxious and depressive disorders in the general population. Psychological trauma can partly explain these disorders. However, since psychiatric disorders also have an immuno-inflammatory component, the direct effects of the virus on the host's immune system, with a marked inflammatory response, but also the secondary inflammation to these psychosocial stressors, may cause the apparition or the worsening of psychiatric disorders. We describe here the probable immunopsychiatric consequences of the SARS-CoV-2 pandemic, to delineate possible screening actions and care that could be planned.
Data from previous pandemics, and existing data on the psychopathological consequences of the SARS-CoV-2 pandemic, allowed us to review the possible immunopsychiatric consequences of the SARS-CoV-2 pandemic, on the gestational environment, with the risk of consecutive neurodevelopmental disorders for the fetus on one hand, on the children and adults directly infected being at increased risks of psychiatric disorders on the other hand.
As in previous pandemics, the activation of the immune system due to psychological stress and/or to infection during pregnancy, might lead to an increased risk of neurodevelopmental disorders for the fetus (schizophrenia and autism spectrum disorders). Furthermore, in individuals exposed to psychological trauma and/or infected by the virus, the risk of psychiatric disorders, especially mood disorders, is probably increased.
In this context, preventive measures and specialized care are necessary. Thus, it is important to propose a close follow-up to the individuals who have been infected by the virus, in order to set up the earliest care possible. Likewise, in pregnant women, screening of mood disorders during the pregnancy or the postpartum period must be facilitated. The follow-up of the babies born during the pandemic must be strengthened to screen and care for possible neurodevelopmental disorders.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新型冠状病毒肺炎）大流行自2019年12月以来一直在蔓延，导致普通人群中焦虑症和抑郁症的患病率急剧上升。心理创伤可以部分解释这些疾病。然而，由于精神疾病也有免疫炎症成分，病毒对宿主免疫系统的直接影响，伴随着明显的炎症反应，以及这些心理社会应激源引发的继发性炎症，可能导致精神疾病的出现或恶化。我们在此描述SARS-CoV-2大流行可能产生的免疫精神后果，以勾勒出可能计划的筛查行动和护理措施。
以往大流行的数据，以及关于SARS-CoV-2大流行心理病理后果的现有数据，使我们能够回顾SARS-CoV-2大流行对妊娠环境可能产生的免疫精神后果，一方面胎儿有连续发生神经发育障碍的风险，另一方面直接感染的儿童和成人患精神疾病的风险增加。
与以往大流行一样，孕期因心理压力和/或感染导致的免疫系统激活，可能会增加胎儿患神经发育障碍（精神分裂症和自闭症谱系障碍）的风险。此外，在遭受心理创伤和/或感染病毒的个体中，患精神疾病尤其是情绪障碍的风险可能会增加。
在这种情况下，预防措施和专业护理是必要的。因此，对感染病毒的个体进行密切随访很重要，以便尽早提供护理。同样，对于孕妇，必须在孕期或产后促进情绪障碍的筛查。必须加强对疫情期间出生婴儿的随访，以筛查和护理可能出现的神经发育障碍。
