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意大利新冠疫情社交隔离措施期间100例双相情感障碍患者创伤后应激症状的远程精神病学评估

Tele-Psychiatry Assessment of Post-traumatic Stress Symptoms in 100 Patients With Bipolar Disorder During the COVID-19 Pandemic Social-Distancing Measures in Italy.

作者信息

Carmassi Claudia, Bertelloni Carlo Antonio, Dell'Oste Valerio, Barberi Filippo Maria, Maglio Alessandra, Buccianelli Beatrice, Cordone Annalisa, Dell'Osso Liliana

机构信息

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

出版信息

Front Psychiatry. 2020 Dec 3;11:580736. doi: 10.3389/fpsyt.2020.580736. eCollection 2020.

DOI:10.3389/fpsyt.2020.580736
PMID:33343419
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7744453/
Abstract

The acute phase of the COrona VIrus Disease-19 (COVID-19) emergency determined relevant stressful burdens in psychiatric patients, particularly those with chronic mental disorders such as bipolar disorder (BD), not only for the threat of being infected but also for the strict lock-down and social-distancing measures adopted, the economic uncertainty, and the limited possibilities to access psychiatric services. In this regard, telepsychiatry services represented a new important instrument that clinicians could adopt to monitor and support their patients. The aim of the present study was to investigate acute post-traumatic stress symptoms (PTSS) reported by patients with BD followed in the framework of a telepsychiatry service, set up in the acute phase of the COVID-19 outbreak at the psychiatric clinic of the University of Pisa (Italy). A sample of 100 patients were consecutively enrolled and assessed by the IES-r, GAD-7, HAM-D, and YMRS. Patients reported a mean (±SD) IES-r total score of 18.15 ± 13.67. Further, 17% of the sample reported PTSS (IES-r > 32), 17% depressive symptoms (HAM-D > 17), and 26% anxiety symptoms (GAD-7 > 10). Work and financial difficulties related to the COVID-19 pandemic and anxiety symptoms appeared to be positively associated with the development of acute PTSS. Acute manic symptoms appeared to be protective. The data of the present study suggest the relevance of monitoring patients with BD exposed to the burden related to the COVID-19 outbreak for prompt assessment and treatment of PTSS.

摘要

2019冠状病毒病(COVID-19)疫情的急性期给精神病患者带来了巨大的压力负担,尤其是那些患有慢性精神障碍(如双相情感障碍,BD)的患者,这不仅是因为存在感染风险,还因为采取了严格的封锁和社交距离措施、经济不确定性以及获得精神科服务的可能性有限。在这方面,远程精神病学服务成为临床医生可用于监测和支持患者的一项重要新工具。本研究旨在调查在意大利比萨大学精神病诊所COVID-19疫情急性期建立的远程精神病学服务框架下接受随访的BD患者报告的急性创伤后应激症状(PTSS)。连续纳入100例患者,并采用IES-r、GAD-7、HAM-D和YMRS进行评估。患者报告的IES-r总分平均(±标准差)为18.15±13.67。此外,17%的样本报告有PTSS(IES-r>32),17%有抑郁症状(HAM-D>17),26%有焦虑症状(GAD-7>10)。与COVID-19大流行相关的工作和经济困难以及焦虑症状似乎与急性PTSS的发生呈正相关。急性躁狂症状似乎具有保护作用。本研究数据表明,监测暴露于COVID-19疫情相关负担下的BD患者对于及时评估和治疗PTSS具有重要意义。

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