Department of Psychiatry and Behavioral Sciences, McGovern Medical, The University of Texas Health Science Center at Houston, Houston, TX, United States of America.
School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States of America.
PLoS One. 2022 Sep 22;17(9):e0274330. doi: 10.1371/journal.pone.0274330. eCollection 2022.
The Coronavirus Disease (COVID-19) pandemic has significantly impacted mental health outcomes. While the frequency of anxiety and depressive symptoms has increased in the whole population, the relationship between COVID-19 and new psychiatric diagnoses remains unclear.
To compare the population incidence rate of emergence of de novo psychiatric disorders in 2020 compared to the previous years, and to compare the incidence rate of new psychiatric disorder diagnoses between people with vs without COVID-19.
DESIGN, SETTING, AND PARTICIPANTS: This study utilized administrative claims data from the Clinformatics® Data Mart database, licensed from Optum®. The study is a cross-sectional analysis that compared the incidence rate of new psychiatric disorders in 2020 vs. 2018 and 2019 in the entire insured population database. Subsequently, the incidence of new psychiatric disorders in people with vs. without COVID-19 during 2020 was analyzed.
The exposures included diagnosis and severity of COVID-19 infection.
The dependent variables of interest were the incidence rates of new psychiatric disorders, specifically schizophrenia spectrum disorders, mood disorders, anxiety disorders, and obsessive-compulsive disorder.
The population studied included 10,463,672 US adults (mean age 52.83, 52% female) who were unique people for the year of 2020. Incidence of newly diagnosed psychiatric disorders per 1,000 individuals in the 2020 whole population were 28.81 (CI: 28.71, 28.92) for anxiety disorders, 1.04 (CI: 1.02, 1.06) for schizophrenia disorders, 0.42 (CI: 0.41, 0.43) for OCD and 28.85 (CI: 28.75, 28.95) for mood disorders. These rates were not significantly higher than 2018 or 2019. When comparing incidence rates between COVID-19 vs. non-COVID-19 populations in 2020, the rates were significantly higher in the COVID-19 population: 46.89 (CI: 46.24, 47.53) for anxiety, 49.31 (CI: 48.66, 49.97) for mood disorders, 0.57 (CI: 0.50, 0.65) for OCD, and 3.52 (CI: 3.34, 3.70) for schizophrenia. COVID-19 severity was significantly associated with new diagnoses of schizophrenia, anxiety and mood disorders in multivariate analyses.
Compared to 2018 and 2019, in 2020 there was no increased incidence of new psychiatric disorders in the general population based on insurance claims data. Importantly, people with COVID-19 were more likely to be diagnosed with a new psychiatric disorder, most notably disorders with psychosis, indicating a potential association between COVID-19 and mental/brain health.
冠状病毒病（COVID-19）大流行对心理健康结果产生了重大影响。虽然整个人群的焦虑和抑郁症状的频率有所增加，但 COVID-19 与新的精神科诊断之间的关系仍不清楚。
比较 2020 年新发精神障碍的人群发病率与前几年相比的变化，比较 COVID-19 患者与非 COVID-19 患者中新发精神障碍诊断的发病率。
设计、设置和参与者：本研究利用了来自 Optum®授权的 Clinformatics®Data Mart 数据库的行政索赔数据。该研究是一项横断面分析，比较了整个参保人群数据库中 2020 年与 2018 年和 2019 年新发精神障碍的发病率。随后，分析了 2020 年 COVID-19 患者与非 COVID-19 患者中新发精神障碍的发病率。
暴露因素包括 COVID-19 感染的诊断和严重程度。
感兴趣的因变量是新发精神障碍的发病率，特别是精神分裂症谱系障碍、心境障碍、焦虑障碍和强迫症。
本研究纳入了 10463672 名美国成年人（平均年龄 52.83 岁，52%为女性），他们是 2020 年唯一的人群。2020 年整个人群中每 1000 人新发精神障碍的发病率为：焦虑障碍 28.81（CI：28.71，28.92）、精神分裂症障碍 1.04（CI：1.02，1.06）、强迫症 0.42（CI：0.41，0.43）和心境障碍 28.85（CI：28.75，28.95）。这些比率与 2018 年或 2019 年相比没有显著升高。当比较 2020 年 COVID-19 与非 COVID-19 人群的发病率时，COVID-19 人群的发病率显著升高：焦虑症 46.89（CI：46.24，47.53）、心境障碍 49.31（CI：48.66，49.97）、强迫症 0.57（CI：0.50，0.65）和精神分裂症 3.52（CI：3.34，3.70）。多变量分析显示，COVID-19 的严重程度与新发精神分裂症、焦虑和心境障碍的诊断显著相关。
根据保险索赔数据，与 2018 年和 2019 年相比，2020 年一般人群中新发精神障碍的发病率没有增加。重要的是，COVID-19 患者更有可能被诊断为新发精神障碍，尤其是精神病性障碍，这表明 COVID-19 与精神/大脑健康之间可能存在关联。
