有 COVID-19 感染史的美国退伍军人的心理健康和自杀意念。
Mental health and suicidal ideation in US military veterans with histories of COVID-19 infection.
机构信息
Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, Tampa, Florida, USA.
出版信息
BMJ Mil Health. 2022 Feb;168(1):15-19. doi: 10.1136/bmjmilitary-2021-001846. Epub 2021 May 25.
INTRODUCTION
There have been reports of increased prevalence in psychiatric conditions in non-veteran survivors of COVID-19. To date, however, no known study has examined the prevalence, risk and protective factors of psychiatric conditions among US military veterans who survived COVID-19.
METHODS
Data were analysed from the 2019 to 2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative, prospective cohort of 3078 US veterans. Prepandemic and 1-year peripandemic risk and protective factors associated with positive screens for peripandemic internalising (major depressive, generalised anxiety and/or posttraumatic stress disorders) and externalising psychiatric disorders (alcohol and/or drug use disorders) and suicidal ideation were examined using bivariate and multivariate logistic regression analyses.
RESULTS
A total of 233 veterans (8.6%) reported having been infected with COVID-19. Relative to veterans who were not infected, veterans who were infected were more likely to screen positive for internalising disorders (20.5% vs 13.9%, p=0.005), externalising disorders (23.2% vs 14.8%, p=0.001) and current suicidal ideation (12.0% vs 7.6%, p=0.015) at peripandemic. Multivariable analyses revealed that greater prepandemic psychiatric symptom severity and COVID-related stressors were the strongest independent predictors of peripandemic internalising disorders, while prepandemic trauma burden was protective. Prepandemic suicidal ideation, greater loneliness and lower household income were the strongest independent predictors of peripandemic suicidal ideation, whereas prepandemic community integration was protective.
CONCLUSION
Psychiatric symptoms and suicidal ideation are prevalent in veterans who have survived COVID-19. Veterans with greater prepandemic psychiatric and substance use problems, COVID-related stressors and fewer psychosocial resources may be at increased risk of these outcomes.
引言
有报道称，COVID-19 非退伍军人幸存者的精神疾病患病率有所增加。然而，迄今为止，尚无已知研究调查过 COVID-19 幸存的美国退伍军人中精神疾病的患病率、风险和保护因素。
方法
本研究分析了 2019 年至 2020 年全国健康与退伍军人研究的数据，该研究调查了 3078 名美国退伍军人的全国代表性前瞻性队列。使用双变量和多变量逻辑回归分析，分析了与大流行前和大流行期间内部（重度抑郁、广泛性焦虑和/或创伤后应激障碍）和外部（酒精和/或药物使用障碍）精神障碍以及自杀意念阳性筛查相关的大流行前和大流行期间的风险和保护因素。
结果
共有 233 名退伍军人（8.6%）报告感染了 COVID-19。与未感染的退伍军人相比，感染 COVID-19 的退伍军人更有可能在大流行期间出现内部障碍（20.5%比 13.9%，p=0.005）、外部障碍（23.2%比 14.8%，p=0.001）和当前自杀意念（12.0%比 7.6%，p=0.015）。多变量分析显示，大流行前精神症状严重程度和与 COVID-19 相关的压力源是大流行期间出现内部障碍的最强独立预测因素，而大流行前创伤负担具有保护作用。大流行前自杀意念、更大的孤独感和较低的家庭收入是大流行期间自杀意念的最强独立预测因素，而大流行前社区融合具有保护作用。
结论
COVID-19 幸存的退伍军人中普遍存在精神症状和自杀意念。具有更大的大流行前精神和物质使用问题、与 COVID-19 相关的压力源和较少的社会心理资源的退伍军人可能面临这些结果的风险增加。
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