精神病理学、韧性以及 SARS-CoV-2 大流行期间的加重和保护因素。
Psychomorbidity, Resilience, and Exacerbating and Protective Factors During the SARS-CoV-2 Pandemic.
机构信息
Leibniz Institute for Resilience Research, Mainz, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Germany; Department of mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; University of Mannheim & University of Maryland; Institute of media and communication sciences, University of Erfurt, Germany; Faculty of Psychology, University of Basel, Switzerland; Human Neuroimaging Center, Focus Program Translational Neurosciences (FTN) of the Johannes; Gutenberg University Mainz, University Medical Center Mainz, Germany.
出版信息
Dtsch Arztebl Int. 2020 Sep 18;117(38):625-630. doi: 10.3238/arztebl.2020.0625.
BACKGROUND
The SARS-CoV-2 pandemic has caused mental stress in a number of ways: overstrain of the health care system, lockdown of the economy, restricted opportunities for interpersonal contact and excursions outside the home and workplace, and quarantine measures where necessary. In this article, we provide an overview of psychological distress in the current pandemic, identifying protective factors and risk factors.
METHODS
The PubMed, PsycINFO, and Web of Science databases were systematically searched for relevant publications (1 January 2019 - 16 April 2020). This study was registered in OSF Registries (osf.io/34j8g). Data on mental stress and resilience in Germany were obtained from three surveys carried out on more than 1000 participants each in the framework of the COSMO study (24 March, 31 March, and 21 April 2020).
RESULTS
18 studies from China and India, with a total of 79 664 participants, revealed increased stress in the general population, with manifestations of depression and anxiety, post-traumatic stress, and sleep disturbances. Stress was more marked among persons working in the health care sector. Risk factors for stress included patient contact, female sex, impaired health status, worry about family members and significant others, and poor sleep quality. Protective factors included being informed about the increasing number of persons who have recovered from COVID, social support, and a lower perceived infectious risk. The COSMO study, though based on an insufficiently representative population sample because of a low questionnaire return rate (<20%), revealed increased rates of despondency, loneliness, and hopelessness in the German population as compared to norm data, with no change in estimated resilience.
CONCLUSION
Stress factors associated with the current pandemic probably increase stress by causing anxiety and depression. Once the protective factors and risk factors have been identified, these can be used to develop psychosocial interventions. The informativeness of the results reported here is limited by the wide variety of instruments used to acquire data and by the insufficiently representative nature of the population samples.
背景
SARS-CoV-2 大流行以多种方式造成精神压力：医疗系统过劳、经济封锁、人际接触和家庭及工作场所外出机会受限、必要时的隔离措施。本文综述了当前大流行中的心理困扰，确定了保护因素和风险因素。
方法
系统检索了 PubMed、PsycINFO 和 Web of Science 数据库中 2019 年 1 月 1 日至 2020 年 4 月 16 日的相关文献。本研究在 OSF 注册处（osf.io/34j8g）进行了注册。通过 COSMO 研究框架下进行的三项调查（2020 年 3 月 24 日、3 月 31 日和 4 月 21 日）获得了德国精神压力和适应力方面的数据，这三项调查各有超过 1000 名参与者参与。
结果
来自中国和印度的 18 项研究共纳入 79664 名参与者，显示出普通人群压力增加，表现为抑郁和焦虑、创伤后应激、睡眠障碍。从事医疗保健工作的人压力更大。压力的危险因素包括与患者接触、女性、健康状况受损、担心家人和亲人、睡眠质量差。保护因素包括了解到越来越多的 COVID 患者已经康复、社会支持以及较低的传染性风险感知。COSMO 研究基于因问卷回复率低（<20%）而代表性不足的人群样本，显示与常态数据相比，德国人群中沮丧、孤独和绝望的发生率增加，而估计的适应力没有变化。
结论
与当前大流行相关的压力因素可能会通过引起焦虑和抑郁来增加压力。一旦确定了保护因素和风险因素，就可以利用这些因素来制定社会心理干预措施。由于用于获取数据的工具种类繁多，以及人群样本代表性不足，报告的结果的信息性受到限制。
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