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