Orygen, Parkville, VIC, Australia.
Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
Aust N Z J Psychiatry. 2022 Jul;56(7):811-817. doi: 10.1177/00048674211053578. Epub 2021 Oct 15.
The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission).
Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared.
Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]).
There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.
新冠疫情对全球心理健康产生了深远影响，三分之一的感染者在感染后 6 个月内出现精神或神经疾病。感染风险以及为减少病毒传播而引入的相关限制也影响了寻求帮助的行为。因此，本研究旨在确定在新冠疫情期间，年轻人首发精神病的治疗发病率是否存在差异，以及精神病住院率（包括非自愿住院）是否存在差异。
比较墨尔本一家早期干预服务机构在疫情前 8 个月内年轻人（15 至 24 岁）首发精神病的病例数，与疫情期间的发病率。还比较了这两个时期的住院率。
在疫情之前，每 10 万高危人群的首发精神病年发病率为 104.5 例，而在疫情期间为 121.9 例（发病率比=1.14，95%置信区间=0.92 至 1.42，=0.24）。限制措施实施后，治疗发病率立即出现非显著下降（发病率比=0.80，95%置信区间=0.58 至 1.09），随后在随后的几个月中治疗发病率显著上升（发病率比=1.94，95%置信区间=1.52 至 2.49；发病率比=1.64，95%置信区间=1.25 至 2.16）。在疫情之前，37.3%的首发精神病患者住院，而在疫情期间这一比例为 61.7%（优势比=2.71，95%置信区间=1.73 至 4.24）。关于住院的法律地位，在疫情之前，27.3%的患者住院，而在疫情期间这一比例为 42.5%（优势比=1.97，95%置信区间=1.23 至 3.14）。
首发精神病的总体发病率略有上升，但未达到统计学意义；然而，表现形式发生了显著变化，限制措施实施后几个月的病例数几乎翻了一番。自愿和非自愿住院人数均显著增加，对这些发现的可能解释进行了讨论。
