Mental Health Division, Flintshire Community Mental Health Teams, Betsi Cadwaladr University Health Board, Flintshire, UK.
Centre for Mental Health and Society, Wrexham Academic Unit, Bangor University, Wrexham, UK.
Int J Soc Psychiatry. 2023 Mar;69(2):412-419. doi: 10.1177/00207640221106681. Epub 2022 Sep 1.
Reports of increasing presentations of new cases of acute psychosis both locally, nationally and internationally during the COVID-19 pandemic, warranted further investigation. International case reports almost exclusively reported only clinical outcome (e.g. remission of psychotic symptoms), and fail to report on social precipitants or social outcomes. This is a common omission when investigating new psychosis cases such as acute and transient psychotic disorder (ATPD). In order to assess social impacts and outcomes, we conducted a rapid review of recent evidence.
To conduct a rapid review of the recent evidence of social outcomes on new cases of psychosis emerging during the COVID-19 pandemic.
Four databases (Medline, Embase, Psychinfo and Cochrane COVID-19) were searched for ATPD, psychosis and social outcomes in adults aged 18+. Duplicates were removed. There were no language limitations. Results: There were 24 papers consisting of 18 original data research papers and 6 reviews. Additionally, 33 papers/letters, reporting on 60 individual cases of psychosis emerging during the COVID-19 pandemic. These two sets of papers were reviewed separately. Many original data research papers and reviews were sub optimal in their quality, with 44% online surveys, with the remainder being routinely collected data.
There is a consensus that clinical outcomes of ATPD and other brief psychotic disorders (BPD) are good in the short term. The focus only on symptomatic clinical presentation and outcomes, leaves a gap in our understanding regarding social stressors and longer term social outcomes. ATPD and BPD often may not come to the attention of Early Intervention in Psychosis services, and if they do, are discharged following symptomatic remission. Without an understanding of the social stress factors and social outcomes, opportunities may be missed to prevent increased social disability and future relapse with these presentations.
在 COVID-19 大流行期间，本地、全国和国际上都有越来越多的急性精神病新病例报告，这需要进一步调查。国际病例报告几乎完全只报告临床结果（例如精神病症状缓解），而未能报告社会促成因素或社会结果。在调查急性和短暂性精神病障碍（ATPD）等新精神病病例时，这是一个常见的遗漏。为了评估社会影响和结果，我们对最近的证据进行了快速审查。
对 COVID-19 大流行期间出现的新精神病病例的社会结果进行快速审查。
在 Medline、Embase、Psychinfo 和 Cochrane COVID-19 四个数据库中搜索 ATPD、精神病和成年人的社会结果（年龄为 18+）。去除重复项。无语言限制。结果：共有 24 篇论文，其中包括 18 篇原始数据研究论文和 6 篇综述。此外，还有 33 篇论文/信件，报告了 COVID-19 期间出现的 60 例精神病个案。这两组论文分别进行了审查。许多原始数据研究论文和综述在质量上并不理想，其中 44%是在线调查，其余是常规收集的数据。
人们普遍认为，ATP 和其他短暂性精神病障碍（BPD）的临床结果在短期内是良好的。只关注症状性临床表现和结果，使得我们对社会压力源和长期社会结果的理解存在差距。ATP 和 BPD 通常不会引起早期精神病干预服务的注意，如果它们确实引起了注意，也会在症状缓解后出院。如果不了解社会压力因素和社会结果，就可能会错过预防这些情况下社会残疾和未来复发的机会。
