Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada.
Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, MP 9-325,Toronto, ON M5T 2S8, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
J Affect Disord. 2022 May 1;304:66-77. doi: 10.1016/j.jad.2022.02.025. Epub 2022 Feb 12.
Mental disorders are associated with immune dysregulation as measured by serum levels of biological markers of immunity. Adults with mental disorders have also been reported to have attenuated post vaccine immune response. The COVID-19 pandemic has invited the need to determine whether individuals with mental disorders exhibit differential immune response following the administration of vaccines for other infections.
A systematic search of MEDLINE, Embase, Cochrane, and PsycInfo was conducted from inception to May 2021 investigating vaccine response in persons with mental disorders, as measured by biological markers of immunity (i.e., antibodies, cytokines).
Thirteen articles were identified which evaluated vaccine efficacy in persons with mental disorders. Individuals with major depressive disorder (MDD) or schizophrenia revealed attenuated immune response to vaccination, or no statistical difference compared to control subjects. Individuals with anorexia nervosa or post-traumatic stress disorder (PTSD) displayed no attenuated post-vaccination antibody level. Individuals with insomnia displayed lower levels of antibodies after vaccination, whereas individuals with obstructive sleep apnea (OSA) displayed no difference in vaccine response compared to control subjects.
The limitations of this review include the relatively few articles included (n = 13) and small sample sizes (less than thirty subjects) in the majority of articles.
Vaccine response in adults with a mental disorder remains inconclusive. Notwithstanding the heterogeneity and relatively small number of studies, available evidence does suggest attenuated immune response across disparate vaccinations. Future research is required to confirm vaccine efficacy in persons with mental disorders, especially regarding immune responses to COVID-19 vaccination.
精神障碍与免疫失调有关，可通过血清免疫生物标志物水平来衡量。有精神障碍的成年人也被报道疫苗接种后的免疫反应减弱。COVID-19 大流行使得有必要确定患有精神障碍的个体在接种其他感染疫苗后是否表现出不同的免疫反应。
系统检索了 MEDLINE、Embase、Cochrane 和 PsycInfo 数据库，从建库到 2021 年 5 月，调查了精神障碍患者（通过免疫生物标志物（即抗体、细胞因子）衡量）疫苗反应。
确定了 13 篇评估精神障碍患者疫苗疗效的文章。患有重度抑郁症（MDD）或精神分裂症的个体疫苗接种后的免疫反应减弱，或与对照组相比无统计学差异。患有神经性厌食症或创伤后应激障碍（PTSD）的个体接种后抗体水平无减弱。患有失眠症的个体接种后抗体水平较低，而阻塞性睡眠呼吸暂停（OSA）患者与对照组相比疫苗反应无差异。
本综述的局限性包括纳入的文章相对较少（n=13），且大多数文章的样本量较小（少于 30 名受试者）。
成年精神障碍患者的疫苗反应仍不确定。尽管存在异质性和相对较少的研究，但现有证据确实表明，不同疫苗的免疫反应减弱。需要进一步的研究来确认精神障碍患者的疫苗疗效，特别是关于 COVID-19 疫苗接种的免疫反应。
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