Center for Innovation to Implementation, VA Palo Alto Healthcare System, 795 Willow Road (152-MPD), Menlo Park, CA 94025, United States of America.
Department of Psychology, University of Kansas, 1415 Jayhawk Blvd., Fraser Hall, Rm. 426, Lawrence, KS 66045-7556, United States of America.
Gen Hosp Psychiatry. 2021 May-Jun;70:124-133. doi: 10.1016/j.genhosppsych.2021.03.006. Epub 2021 Mar 12.
Through a systematic review and meta-analysis of research on COVID-19, severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS) pandemics, we investigated whether mental disorder prevalence: (a) was elevated among populations impacted by coronavirus pandemics (relative to unselected populations reported in the literature), and (b) varied by disorder (undifferentiated psychiatric morbidity, anxiety, depressive, posttraumatic stress disorders [PTSD]) and impacted population (community, infected/recovered, healthcare provider, quarantined).
From 68 publications (N = 87,586 participants), 808 estimates were included in a series of multilevel meta-analyses/regressions including random effects to account for estimates nested within studies.
Median summary point prevalence estimates varied by disorder and population. Psychiatric morbidity (20-56%), PTSD (10-26%) and depression (9-27%) were most prevalent in most populations. The highest prevalence of each disorder was found among infected/recovered adults (18-56%), followed by healthcare providers (11-28%) and community adults (11-20%). Prevalence estimates were often notably higher than reported for unselected samples. Sensitivity analyses demonstrated that overall prevalence estimates moderately varied by pandemic, study location, and mental disorder measure type.
Coronavirus pandemics are associated with multiple mental disorders in several impacted populations. Needed are investigations of causal links between specific pandemic-related stressors, threats, and traumas and mental disorders.
通过对 COVID-19、严重急性呼吸综合征(SARS)和中东呼吸综合征(MERS)大流行相关研究的系统回顾和荟萃分析,我们调查了精神障碍的患病率是否存在以下情况:(a)在受冠状病毒大流行影响的人群中升高(与文献中报告的未选择人群相比),以及(b)是否因障碍(未分化的精神发病率、焦虑症、抑郁症、创伤后应激障碍[PTSD])和受影响人群(社区、感染/康复、医护人员、隔离)而异。
从 68 篇文献(N=87586 名参与者)中,我们纳入了一系列多水平荟萃分析/回归的 808 个估计值,其中包括随机效应,以解释嵌套在研究中的估计值。
按障碍和人群划分的中位数汇总点患病率估计值存在差异。在大多数人群中,精神发病率(20-56%)、PTSD(10-26%)和抑郁症(9-27%)最为常见。每种障碍的最高患病率均见于感染/康复的成年人(18-56%),其次是医护人员(11-28%)和社区成年人(11-20%)。这些患病率估计值通常明显高于对未选择样本的报告值。敏感性分析表明,总体患病率估计值在大流行、研究地点和精神障碍测量类型方面存在中度差异。
冠状病毒大流行与多个受影响人群中的多种精神障碍相关。需要调查特定大流行相关应激源、威胁和创伤与精神障碍之间的因果关系。