Sheppard Pratt (Dickerson, Katsafanas, Newman, Origoni, Rowe, Squire, Ziemann, Khushalani) and Johns Hopkins University School of Medicine (Yolken), Baltimore.
Psychiatr Serv. 2022 Feb 1;73(2):133-140. doi: 10.1176/appi.ps.202100130. Epub 2021 Jun 30.
This study aimed to characterize the experiences of persons with serious mental illness during the COVID-19 pandemic.
Adults with schizophrenia, bipolar disorder, major depression, or no psychiatric disorder (N=195) were interviewed between July 2020 and January 2021. All were previously enrolled in a cohort study. The interviews focused on mental distress and suicidal thoughts, the impact of the pandemic and pandemic-related worries, tobacco and alcohol use, and access to care. Responses of persons with serious mental illness were compared with responses of those without a psychiatric disorder by using multivariate ordered logistic regression analyses. For a subset of participants, responses about suicidal ideation were compared with their responses prior to the pandemic.
Compared with participants with no psychiatric disorder, individuals with schizophrenia were more likely to endorse that they felt overwhelmed or anxious, had difficulty concentrating, or were concerned about medical bills and having enough food; they also reported significantly increased tobacco smoking. Individuals with bipolar disorder also reported more COVID-19-related worries than did participants without a psychiatric disorder. Overall, those with a psychiatric disorder reported more frequent mental distress and more recent missed medical visits and medications than did those with no psychiatric disorder. However, participants with serious mental illness did not report a higher rate of suicidal thoughts compared with their prepandemic responses.
The pandemic poses significant challenges to individuals with serious mental illness in terms of COVID-19-related distress. Psychiatric services should proactively address the emotional distress and worries associated with the pandemic.
本研究旨在描述严重精神疾病患者在 COVID-19 大流行期间的经历。
2020 年 7 月至 2021 年 1 月期间，对 195 名患有精神分裂症、双相情感障碍、重度抑郁症或无精神疾病的成年人进行了访谈。所有参与者均曾参与过一项队列研究。访谈重点关注精神困扰和自杀意念、大流行的影响和与大流行相关的担忧、烟草和酒精使用以及获得医疗服务的情况。使用多变量有序逻辑回归分析比较严重精神疾病患者和无精神疾病患者的反应。对于一部分参与者，将关于自杀意念的反应与其大流行前的反应进行了比较。
与无精神疾病的参与者相比，精神分裂症患者更有可能表示感到不知所措或焦虑、难以集中注意力、或担心医疗费用和食物充足；他们还报告说吸烟量明显增加。与无精神疾病的参与者相比，双相情感障碍患者也报告了更多与 COVID-19 相关的担忧。总体而言，患有精神疾病的个体比无精神疾病的个体报告更频繁的精神困扰、最近错过的医疗就诊和药物治疗。然而，与大流行前相比，患有严重精神疾病的个体报告自杀意念的比率并没有更高。
对于患有严重精神疾病的个体而言，大流行给他们带来了与 COVID-19 相关的困扰。精神卫生服务机构应积极解决与大流行相关的情绪困扰和担忧。
