Das-Munshi Jayati, Chang Chin Kuo, Bakolis Ioannis, Broadbent Matthew, Dregan Alex, Hotopf Matthew, Morgan Craig, Stewart Robert
King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neurosciences, London, United Kingdom.
South London & Maudsley NHS Foundation Trust, London, United Kingdom.
Lancet Reg Health Eur. 2021 Dec;11:100228. doi: 10.1016/j.lanepe.2021.100228. Epub 2021 Oct 7.
People with mental disorders and intellectual disabilities experience excess mortality compared with the general population. The impact of COVID-19 on exacerbating this, and in widening ethnic inequalities, is unclear.
Prospective data (N=167,122) from a large mental healthcare provider in London, UK, with deaths from 2019 to 2020, used to assess age- and gender-standardised mortality ratios (SMRs) across nine psychiatric conditions (schizophrenia-spectrum disorders, affective disorders, somatoform/ neurotic disorders, personality disorders, learning disabilities, eating disorders, substance use disorders, pervasive developmental disorders, dementia) and by ethnicity.
Prior to the World Health Organization (WHO) declaring COVID-19 a public health emergency on 30th January 2020, all-cause SMRs across all psychiatric cohorts were more than double the general population. By the second quarter of 2020, when the UK experienced substantial peaks in COVID-19 deaths, all-cause SMRs increased further, with COVID-19 SMRs elevated across all conditions (notably: learning disabilities: SMR: 9.24 (95% CI: 5.98-13.64), pervasive developmental disorders: 5.01 (95% CI: 2.40-9.20), eating disorders: 4.81 (95% CI: 1.56-11.22), schizophrenia-spectrum disorders: 3.26 (95% CI: 2.55-4.10), dementia: 3.82 (95% CI: 3.42, 4.25) personality disorders 4.58 (95% CI: 3.09-6.53)). Deaths from other causes remained at least double the population average over the whole year. Increased SMRs were similar across ethnic groups.
People with mental disorders and intellectual disabilities were at a greater risk of deaths relative to the general population before, during and after the first peak of COVID-19 deaths, with similar risks by ethnicity. Mortality from non-COVID-19/ other causes was elevated before/ during the pandemic, with higher COVID-19 mortality during the pandemic.
ESRC (JD, CM), NIHR (JD, RS, MH), Health Foundation (JD), GSK, Janssen, Takeda (RS).
与普通人群相比，精神障碍和智力残疾患者的死亡率更高。目前尚不清楚2019冠状病毒病（COVID-19）对加剧这一情况以及扩大种族不平等的影响。
来自英国伦敦一家大型精神卫生保健机构的前瞻性数据（N=167,122），涵盖2019年至2020年的死亡病例，用于评估九种精神疾病（精神分裂症谱系障碍、情感障碍、躯体形式/神经症性障碍、人格障碍、学习障碍、饮食失调、物质使用障碍、广泛性发育障碍、痴呆症）以及不同种族的年龄和性别标准化死亡率（SMR）。
在世界卫生组织（WHO）于2020年1月30日宣布COVID-19为突发公共卫生事件之前，所有精神疾病队列的全因SMR均是普通人群的两倍多。到2020年第二季度，英国COVID-19死亡人数大幅攀升，全因SMR进一步上升，所有疾病的COVID-19 SMR均升高（尤其：学习障碍：SMR：9.24（95%CI：5.98-13.64），广泛性发育障碍：5.01（95%CI：2.40-9.20），饮食失调：4.81（95%CI：1.56-11.22），精神分裂症谱系障碍：3.26（95%CI：2.55-4.10），痴呆症：3.82（95%CI：3.42, 4.25），人格障碍4.58（95%CI：3.09-6.53））。全年其他原因导致的死亡人数至少是人口平均水平的两倍。不同种族的SMR升高情况相似。
在COVID-19死亡病例的首个高峰之前、期间和之后，精神障碍和智力残疾患者相对于普通人群的死亡风险更高，不同种族的风险相似。在大流行之前/期间，非COVID-19/其他原因导致的死亡率升高，在大流行期间COVID-19死亡率更高。
经济和社会研究委员会（JD、CM）、国家卫生研究院（JD、RS、MH）、健康基金会（JD）以及葛兰素史克公司、杨森公司、武田公司（RS）。
Zotero 插件
