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由 COVID-19 大流行引发的短暂精神病性障碍的临床特征:一项多中心观察性研究。

Clinical characterization of brief psychotic disorders triggered by the COVID-19 pandemic: a multicenter observational study.

机构信息

Virgen Macarena University Hospital, Seville, Spain.

Institute of Biomedicine of Seville (IBiS), Seville, Spain.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2022 Feb;272(1):5-15. doi: 10.1007/s00406-021-01256-w. Epub 2021 Apr 3.

Abstract

This study aimed to characterize the clinical profile of patients with brief psychotic disorders (BPD) triggered by the psychosocial distress derived from the COVID-19 crisis. A multicenter study was conducted from March 14 to May 14, 2020 (the peak weeks of the pandemic in Europe). All consecutive patients presenting non-affective psychotic episodes with a duration of untreated psychosis of less than 1 month and whose onset was related to the COVID-19 crisis were recruited, but only those patients meeting Diagnostic Statistical Manual 5th edition (DSM-5) criteria for "BPD with marked stressors" (DSM-5 code: 298.8) during follow-up were finally included. Patients' sociodemographic and clinical characteristics were collected at baseline and summarized with descriptive statistics. During the study period, 57 individuals with short-lived psychotic episodes related to the emotional stress of the COVID-19 pandemic were identified, of whom 33 met DSM-5 criteria for "BPD with marked stressors". The mean age was 42.33 ± 14.04 years, the gender distribution was almost the same, and the majority were rated as having good premorbid adjustment. About a quarter of the patients exhibited suicidal symptoms and almost half presented first-rank schizophrenia symptoms. None of them were COVID-19 positive, but in more than half of the cases, the topic of their psychotic features was COVID-19-related. The coronavirus pandemic is triggering a significant number of BPD cases. Their risk of suicidal behavior, their high relapse rate, and their low temporal stability make it necessary to closely monitor these patients over time.

摘要

这项研究旨在描述由 COVID-19 危机引发的心理社会困扰导致的短暂精神病性障碍(BPD)患者的临床特征。一项多中心研究于 2020 年 3 月 14 日至 5 月 14 日进行(欧洲大流行的高峰期)。所有连续出现非情感性精神病发作且未治疗的精神病持续时间少于 1 个月且发病与 COVID-19 危机有关的患者均被招募,但仅在随访期间符合“伴有明显应激源的 BPD”(DSM-5 代码:298.8)的 DSM-5 标准的患者最终被纳入研究。在基线时收集了患者的社会人口统计学和临床特征,并进行了描述性统计分析。在研究期间,共发现 57 例与 COVID-19 大流行情绪压力相关的短暂性精神病发作患者,其中 33 例符合 DSM-5“伴有明显应激源的 BPD”标准。患者的平均年龄为 42.33±14.04 岁,性别分布几乎相同,大多数患者被评为有良好的病前适应能力。约四分之一的患者出现自杀症状,近一半的患者出现一级精神分裂症症状。他们均未感染 COVID-19,但在一半以上的病例中,他们的精神病特征的主题与 COVID-19 相关。冠状病毒大流行正在引发大量的 BPD 病例。他们有自杀行为的风险、高复发率以及低时间稳定性,这使得有必要对这些患者进行长期密切监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b545/8019303/8a2073b9117f/406_2021_1256_Fig1_HTML.jpg

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