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[新型冠状病毒肺炎的神经精神方面——叙述性综述]

[Neuropsychiatric Aspects of COVID-19 - A Narrative Overview].

作者信息

Rittmannsberger Hans, Barth Martin, Malik Peter, Yazdi Kurosch

机构信息

Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria.

Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitatsklinikum GmbH, Linz, Austria.

出版信息

Fortschr Neurol Psychiatr. 2022 Mar;90(3):108-120. doi: 10.1055/a-1523-3850. Epub 2021 Aug 2.

Abstract

The SARS-CoV-2 virus (Severe Acute Respiratory Syndrome Coronavirus Type 2) and COVID-19 (Coronavirus Disease 2019) can affect numerous organ systems. In the present paper we offer an overview of the current state of knowledge about the psychiatric aspects of SARS-CoV-2 infection.Medline, Embase und LIVIVO were searched for relevant literature, the last query dating from March 2nd, 2021. Different stress factors in the context of the pandemic can lead to manifest mental illnesses. In addition, there is a risk of neuropsychological changes due to the biological effects of the virus itself.Our work describes the psychological symptoms of COVID-19 sufferers themselves and the psychological effects of the epidemic and the associated socio-economic and psychosocial stress factors on those who are not sick.The most common psychiatric complication among people with COVID-19 is delirium, while hospitalized patients seem to have an increased incidence of symptoms of anxiety, depression and PTSD. There are many case reports on psychotic disorders. In general, an existing psychiatric illness (especially dementia and psychotic disorders) also increases the risk of infection and of a more severe course of the disease. After recovery from COVID-19 infection, there is also a higher incidence of mental illnesses, in particular "Chronic Post-SARS Syndrome" with its manifestations such as fatigue, anxiety, depression and PTSD. In addition, the course of dementia seems to be negatively influenced by an infection with SARS-CoV-2.The second part deals with the effects of the epidemic as a stressor and the established socio-political measures on the mental health of people with and without previous mental illnesses. The literature currently available shows high symptom values for anxiety and depressive disorders as well as post-traumatic stress disorders, stress, suicidality, sleep disorders etc. Risk factors seem to include female gender, younger age and fewer resources, as well as previous psychiatric or physical illnesses. Extrinsic factors such as high infection rates, large numbers of deaths, long curfews/lockdowns, low trust in the government and ineffective measures against economic and social consequences increase the burden.

摘要

严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)和2019冠状病毒病(COVID-19)可影响多个器官系统。在本文中,我们概述了目前关于SARS-CoV-2感染精神方面的知识现状。我们在医学在线数据库(Medline)、荷兰医学文摘数据库(Embase)和德国健康科学领域文献数据库(LIVIVO)中检索了相关文献,最后一次检索日期为2021年3月2日。疫情背景下的不同压力因素可导致明显的精神疾病。此外,由于病毒本身的生物学效应,存在神经心理变化的风险。我们的研究描述了COVID-19患者自身的心理症状,以及疫情及其相关的社会经济和心理社会压力因素对未患病者的心理影响。COVID-19患者中最常见的精神并发症是谵妄,而住院患者的焦虑、抑郁和创伤后应激障碍症状的发生率似乎有所增加。有许多关于精神障碍的病例报告。一般来说,现有的精神疾病(尤其是痴呆和精神障碍)也会增加感染风险和疾病更严重病程的风险。从COVID-19感染中康复后,精神疾病的发生率也较高,尤其是“慢性非典后综合征”,其表现包括疲劳、焦虑、抑郁和创伤后应激障碍。此外,SARS-CoV-2感染似乎会对痴呆病程产生负面影响。第二部分探讨了疫情作为一种压力源以及既定的社会政治措施对有或无既往精神疾病的人群心理健康产生的影响。目前可得的文献显示,焦虑和抑郁障碍、创伤后应激障碍、压力、自杀倾向、睡眠障碍等症状的发生率较高。风险因素似乎包括女性、年轻、资源较少,以及既往的精神或身体疾病。诸如高感染率、大量死亡、长时间宵禁/封锁、对政府的低信任度以及应对经济和社会后果的无效措施等外在因素会增加负担。

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