Yue Ling, Wang Jingyi, Ju Mingliang, Zhu Yi, Chen Lianghu, Shi Lin, Shi Bohai, Chen Jun, Shen Yifeng
Department of Psychiatry, Shanghai Jiao Tong University School of Medicine, Affiliated Shanghai Mental Health Center, Shanghai, China.
Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China.
Gen Psychiatr. 2020 Jul 21;33(4):e100272. doi: 10.1136/gpsych-2020-100272. eCollection 2020.
Patients with COVID-19 are at high risk of developing mental health problems; however, the prevalence and management of mental disorders and how psychiatrists coordinate the treatment are unclear.
We aimed to investigate the mental health problems of patients infected with COVID-19 and to identify the role of psychiatrists in the clinical treatment team during the pandemic. We also share the experience of psychiatric consultations of patients with COVID-19 in Shanghai, China.
We analysed data from the psychiatric medical records of 329 patients with COVID-19 in the Shanghai Public Health Clinical Center from 20 January to 8 March 2020. We collected information including sociodemographic characteristics, whether patients received psychiatric consultation, mental health symptoms, psychiatric diagnoses, psychiatric treatments and severity level of COVID-19.
Psychiatric consultations were received by 84 (25.5%) patients with COVID-19. The most common symptoms of mental health problems were sleep disorders (75%), anxiety (58.3%) and depressive symptoms (11.9%). The psychiatric consultation rate was highest in critically ill patients (69.2%), with affective symptoms or disturbed behaviour as their main mental health problems. Psychiatric diagnoses for patients who received consultation included acute stress reaction (39.3%), sleep disorders (33.3%), anxiety (15.5%), depression (7.1%) and delirium (4.8%). In terms of psychiatric treatments, 86.9% of patients who received psychiatric consultation were treated with psychotropic medications, including non-benzodiazepine sedative-hypnotic agents (54.8%), antidepressants (26.2%), benzodiazepines (22.6%) and antipsychotics (10.7%). Among the 76 patients who were discharged from the hospital, 79% had recovered from mental health problems and were not prescribed any psychotropic medications. The symptoms of the remaining 21% of patients had improved and they were prescribed medications to continue the treatment.
This is the first study to report psychiatric consultations for patients with COVID-19. Our study indicated that a considerable proportion of patients with COVID-19, especially critically ill cases, experienced mental health problems. Given the remarkable effect of psychiatric treatments, we recommend that psychiatrists be timely and actively involved in the treatment of COVID-19.
新冠病毒病（COVID-19）患者出现心理健康问题的风险很高；然而，精神障碍的患病率及管理情况，以及精神科医生如何协调治疗尚不清楚。
我们旨在调查COVID-19感染患者的心理健康问题，并确定精神科医生在疫情期间临床治疗团队中的作用。我们还分享了中国上海COVID-19患者精神科会诊的经验。
我们分析了2020年1月20日至3月8日上海公共卫生临床中心329例COVID-19患者的精神科病历数据。我们收集了社会人口学特征、患者是否接受精神科会诊、心理健康症状、精神科诊断、精神科治疗以及COVID-19严重程度等信息。
84例（25.5%）COVID-19患者接受了精神科会诊。心理健康问题最常见的症状是睡眠障碍（75%）、焦虑（58.3%）和抑郁症状（11.9%）。重症患者的精神科会诊率最高（69.2%），其主要心理健康问题为情感症状或行为紊乱。接受会诊患者的精神科诊断包括急性应激反应（39.3%）、睡眠障碍（33.3%）、焦虑（15.5%）、抑郁（7.1%）和谵妄（4.8%）。在精神科治疗方面，86.9%接受精神科会诊的患者接受了精神药物治疗，包括非苯二氮䓬类镇静催眠药（54.8%）、抗抑郁药（26.2%）、苯二氮䓬类药物（22.6%）和抗精神病药（10.7%）。在76例出院患者中，79%的患者心理健康问题已康复，未再开具任何精神药物。其余21%患者的症状有所改善，仍需继续服药治疗。
这是第一项报告COVID-19患者精神科会诊情况的研究。我们的研究表明，相当一部分COVID-19患者，尤其是重症患者，存在心理健康问题。鉴于精神科治疗效果显著，我们建议精神科医生及时、积极地参与COVID-19的治疗。
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