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在中国武汉,因首发精神障碍而在精神科住院治疗的 COVID-19 患者:临床特征、治疗、结局和我们的经验。

COVID-19 patients managed in psychiatric inpatient settings due to first-episode mental disorders in Wuhan, China: clinical characteristics, treatments, outcomes, and our experiences.

机构信息

Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China.

Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, Hubei, China.

出版信息

Transl Psychiatry. 2020 Oct 2;10(1):337. doi: 10.1038/s41398-020-01022-x.

Abstract

Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder (n = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress (n = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms (n = 18, 72.0%), followed by aggressive behaviors (n = 16, 64.0%), delusion (n = 10, 40.0%), and severe anxiety (n = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.

摘要

关于 COVID-19 患者合并精神障碍及其治疗的数据很少。本研究描述了在中国武汉,因合并首发精神障碍而在精神科住院治疗的 COVID-19 患者的临床特征和治疗情况。这项基于电子病历的研究包括 25 名 COVID-19 合并首发精神障碍患者和 55 名首发精神障碍但无 COVID-19 的患者(对照组)。收集的数据包括精神障碍的 ICD-10 诊断、精神和呼吸症状、治疗和结局。调整障碍(n=11,44.0%)和急性和短暂的精神病性障碍,伴有相关的急性应激(n=6,24.0%)是 COVID-19 组的主要临床诊断,而严重精神疾病(即精神分裂症,24.5%)和酒精使用障碍(10.9%)在对照组中更为常见。入院时,COVID-19 患者最常见的精神症状是失眠症状(n=18,72.0%),其次是攻击性行为(n=16,64.0%)、妄想(n=10,40.0%)和严重焦虑(n=9,36.0%)。除了呼吸治疗外,76.0%的 COVID-19 患者还接受了抗精神病药物治疗,40.0%接受了镇静催眠药物治疗,24.0%接受了心境稳定剂治疗。在住院治疗结束时,4 名(16.0%)COVID-19 患者在控制精神症状后转至其他医院继续呼吸治疗,其余 21 名(84.0%)患者全部康复。与对照组相比,COVID-19 组的住院时间明显缩短(21.2 天 vs. 37.4 天,P<0.001)。调整障碍和急性和短暂的精神病性障碍是在精神科住院治疗的 COVID-19 患者的主要临床诊断。这些患者在接受常规精神药物治疗后,短期预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74f9/7532181/ef5ade39c948/41398_2020_1022_Fig1_HTML.jpg

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