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新冠肺炎住院患者的精神状态:一种计算精神病学方法

Mental State of Inpatients With COVID-19: A Computational Psychiatry Approach.

作者信息

Sorokin Mikhail Yu, Palchikova Ekaterina I, Kibitov Andrey A, Kasyanov Evgeny D, Khobeysh Maria A, Zubova Elena Yu

机构信息

The Integrative Pharmaco-Psychotherapy of Patients With Mental Disorders Department, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Saint Petersburg, Russia.

The Geriatric Psychiatry Department, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Saint Petersburg, Russia.

出版信息

Front Psychiatry. 2022 Apr 7;13:801135. doi: 10.3389/fpsyt.2022.801135. eCollection 2022.

Abstract

BACKGROUND

The overload of healthcare systems around the world and the danger of infection have limited the ability of researchers to obtain sufficient and reliable data on psychopathology in hospitalized patients with coronavirus disease 2019 (COVID-19). The relationship between severe acute respiratory syndrome with the coronavirus 2 (SARS-CoV-2) infection and specific mental disturbances remains poorly understood.

AIM

To reveal the possibility of identifying the typology and frequency of psychiatric syndromes associated with acute COVID-19 using cluster analysis of discrete psychopathological phenomena.

MATERIALS AND METHODS

Descriptive data on the mental state of 55 inpatients with COVID-19 were obtained by young-career physicians. Classification of observed clinical phenomena was performed with k-means cluster analysis of variables coded from the main psychopathological symptoms. Dispersion analysis with p level 0.05 was used to reveal the clusters differences in demography, parameters of inflammation, and respiration function collected on the basis of the original medical records.

RESULTS

Three resulting clusters of patients were identified: (1) persons with anxiety; disorders of fluency and tempo of thinking, mood, attention, and motor-volitional sphere; reduced insight; and pessimistic plans for the future ( = 11); (2) persons without psychopathology ( = 37); and (3) persons with disorientation; disorders of memory, attention, fluency, and tempo of thinking; and reduced insight ( = 7). The development of a certain type of impaired mental state was specifically associated with the following: age, lung lesions according to computed tomography, saturation, respiratory rate, C-reactive protein level, and platelet count.

CONCLUSION

Anxiety and/or mood disturbances with psychomotor retardation as well as symptoms of impaired consciousness, memory, and insight may be considered as neuropsychiatric manifestations of COVID-19 and should be used for clinical risk assessment.

摘要

背景

全球医疗系统的超负荷运转以及感染风险限制了研究人员获取有关2019冠状病毒病(COVID-19)住院患者精神病理学充分且可靠数据的能力。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染与特定精神障碍之间的关系仍知之甚少。

目的

通过对离散精神病理现象进行聚类分析,揭示识别与急性COVID-19相关的精神综合征类型和频率的可能性。

材料与方法

年轻的执业医师获取了55例COVID-19住院患者精神状态的描述性数据。对观察到的临床现象进行分类时,对主要精神病理症状编码后的变量进行了k均值聚类分析。使用p值为0.05的方差分析来揭示根据原始病历收集的人口统计学、炎症参数和呼吸功能方面的聚类差异。

结果

确定了三类患者:(1)焦虑患者;思维流畅性和速度、情绪、注意力及运动意志领域存在障碍;洞察力下降;对未来有悲观计划(n = 11);(2)无精神病理学表现的患者(n = 37);(3)定向障碍患者;记忆、注意力、思维流畅性和速度存在障碍;洞察力下降(n = 7)。某种类型的精神状态受损的发展与以下因素具体相关:年龄、计算机断层扫描显示的肺部病变、血氧饱和度、呼吸频率、C反应蛋白水平和血小板计数。

结论

焦虑和/或伴有精神运动迟缓的情绪障碍以及意识、记忆和洞察力受损的症状可被视为COVID-19的神经精神表现,应用于临床风险评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b331/9021726/84feeebf0e29/fpsyt-13-801135-g0001.jpg

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