Bari Sumra, Vike Nicole L, Stetsiv Khrystyna, Woodward Sean, Lalvani Shamal, Stefanopoulos Leandros, Kim Byoung Woo, Maglaveras Nicos, Breiter Hans C, Katsaggelos Aggelos K
Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, United States.
Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States.
JMIR Form Res. 2022 Aug 16;6(8):e36444. doi: 10.2196/36444.
The COVID-19 disease results from infection by the SARS-CoV-2 virus to produce a range of mild to severe physical, neurological, and mental health symptoms. The COVID-19 pandemic has indirectly caused significant emotional distress, triggering the emergence of mental health symptoms in individuals who were not previously affected or exacerbating symptoms in those with existing mental health conditions. Emotional distress and certain mental health conditions can lead to violent ideation and disruptive behavior, including aggression, threatening acts, deliberate harm toward other people or animals, and inattention to or noncompliance with education or workplace rules. Of the many mental health conditions that can be associated with violent ideation and disruptive behavior, psychosis can evidence greater vulnerability to unpredictable changes and being at a greater risk for them. Individuals with psychosis can also be more susceptible to contracting COVID-19 disease.
This study aimed to investigate whether violent ideation, disruptive behavior, or psychotic symptoms were more prevalent in a population with COVID-19 and did not precede the pandemic.
In this preliminary study, we analyzed questionnaire responses from a population sample (N=366), received between the end of February 2021 and the start of March 2021 (1 year into the COVID-19 pandemic), regarding COVID-19 illness, violent ideation, disruptive behavior, and psychotic symptoms. Using the Wilcoxon rank sum test followed by multiple comparisons correction, we compared the self-reported frequency of these variables for 3 time windows related to the past 1 month, past 1 month to 1 year, and >1 year ago among the distributions of people who answered whether they tested positive or were diagnosed with COVID-19 by a clinician. We also used multivariable logistic regression with iterative resampling to investigate the relationship between these variables occurring >1 year ago (ie, before the pandemic) and the likelihood of contracting COVID-19.
We observed a significantly higher frequency of self-reported violent ideation, disruptive behavior, and psychotic symptoms, for all 3 time windows of people who tested positive or were diagnosed with COVID-19 by a clinician. Using multivariable logistic regression, we observed 72% to 94% model accuracy for an increased incidence of COVID-19 in participants who reported violent ideation, disruptive behavior, or psychotic symptoms >1 year ago.
This preliminary study found that people who reported a test or clinician diagnosis of COVID-19 also reported higher frequencies of violent ideation, disruptive behavior, or psychotic symptoms across multiple time windows, indicating that they were not likely to be the result of COVID-19. In parallel, participants who reported these behaviors >1 year ago (ie, before the pandemic) were more likely to be diagnosed with COVID-19, suggesting that violent ideation, disruptive behavior, in addition to psychotic symptoms, were associated with COVID-19 with an approximately 70% to 90% likelihood.
2019冠状病毒病（COVID-19）由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染所致，可产生一系列从轻度到重度的身体、神经和心理健康症状。COVID-19大流行间接导致了严重的情绪困扰，使以前未受影响的个体出现心理健康症状，或使现有心理健康问题的个体症状加重。情绪困扰和某些心理健康问题可导致暴力意念和破坏性行为，包括攻击行为、威胁行为、对他人或动物的故意伤害，以及对教育或工作场所规则的忽视或不遵守。在许多可能与暴力意念和破坏性行为相关的心理健康问题中，精神病可能更容易受到不可预测变化的影响，且面临的风险更大。患有精神病的个体也更容易感染COVID-19疾病。
本研究旨在调查暴力意念、破坏性行为或精神病症状在COVID-19患者中是否更普遍，以及这些情况是否在大流行之前就已存在。
在这项初步研究中，我们分析了2021年2月底至20日1年）期间收到的关于COVID-19疾病、暴力意念、破坏性行为和精神病症状的问卷回复。我们使用威尔科克森秩和检验，随后进行多重比较校正，在回答是否检测呈阳性或被临床医生诊断为COVID-19的人群分布中，比较了这些变量在与过去1个月、过去1个月至过去1年以及超过1年之前这3个时间窗口相关的自我报告频率。我们还使用带有迭代重采样的多变量逻辑回归来研究1年多以前（即大流行之前）出现的这些变量与感染COVID-19可能性之间的关系。
我们观察到，对于所有3个时间窗口，检测呈阳性或被临床医生诊断为COVID-19的人群自我报告的暴力意念、破坏性行为和精神病症状频率显著更高。使用多变量逻辑回归，我们观察到，在报告1年多以前有暴力意念、破坏性行为或精神病症状的参与者中，COVID-19发病率增加的模型准确率为72%至94%。
这项初步研究发现，报告检测呈阳性或经临床医生诊断为COVID-19的人在多个时间窗口中也报告了更高频率的暴力意念、破坏性行为或精神病症状，这表明这些情况不太可能是由COVID-19导致的。同时，报告这些行为发生在1年多以前（即大流行之前）的参与者更有可能被诊断为COVID-19，这表明暴力意念、破坏性行为以及精神病症状与COVID-19相关，可能性约为70%至90%。
