Univ Paris-Est-Créteil (UPEC), AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, INSERM, IMRB, translational Neuropsychiatry, Fondation FondaMental, F-94010, Creteil, France.
Santé publique France, French National Public Health Agency, Non Communicable Diseases and Trauma Division, F-94415, Saint-Maurice, France.
Mol Psychiatry. 2023 Aug;28(8):3293-3304. doi: 10.1038/s41380-023-02207-8. Epub 2023 Aug 3.
COVID-19, like other infectious diseases, may be a risk factor for psychotic disorders. We aimed to compare the proportions of hospitalizations for psychotic disorders in the 12 months following discharge from hospital for either COVID-19 or for another reason in the adult general population in France during the first wave of the pandemic. We conducted a retrospective longitudinal nationwide study using the national French administrative healthcare database. Psychotic disorders were first studied as a whole, and then chronic and acute disorders separately. The role of several adjustment factors, including sociodemographics, a history of psychotic disorder, the duration of the initial hospitalization, and the level of care received during that hospitalization, were also analyzed. Between 1 January 2020 and 30 June 2020, a total of 14,622 patients were hospitalized for psychotic disorders in the 12 months following discharge from hospital for either COVID-19 or another reason. Initial hospitalization for COVID-19 (vs. another reason) was associated with a lower rate of subsequent hospitalization for psychotic disorders (0.31% vs. 0.51%, odds ratio (OR) = 0.60, 95% confidence interval (CI) [0.53-0.67]). This was true for both chronic and acute disorders, even after adjusting for the various study variables. Importantly, a history of psychotic disorder was a major determinant of hospitalization for psychotic disorders (adjusted OR = 126.56, 95% CI [121.85-131.46]). Our results suggest that, in comparison to individuals initially hospitalized for another reason, individuals initially hospitalized for COVID-19 present a lower risk of hospitalization for first episodes of psychotic symptoms/disorders or for psychotic relapse in the 12 months following discharge. This finding contradicts the hypothesis that there is a higher risk of psychotic disorders after a severe COVID-19.
COVID-19 与其他传染病一样,可能是精神障碍的一个风险因素。我们的目的是比较在法国大流行的第一波期间,在因 COVID-19 或其他原因出院后的 12 个月内,成年普通人群中因精神障碍住院的比例。我们使用国家法国行政医疗保健数据库进行了回顾性纵向全国研究。首先将精神障碍作为一个整体进行研究,然后分别研究慢性和急性障碍。还分析了几个调整因素的作用,包括社会人口统计学、精神障碍史、初始住院时间和住院期间的护理水平。2020 年 1 月 1 日至 2020 年 6 月 30 日期间,共有 14622 名患者因精神障碍在因 COVID-19 或其他原因出院后的 12 个月内住院。与因其他原因住院相比,因 COVID-19 住院(vs. 其他原因)与随后因精神障碍住院的比率较低(0.31% vs. 0.51%,优势比(OR)= 0.60,95%置信区间(CI)[0.53-0.67])。这对于慢性和急性障碍都是如此,即使在调整了各种研究变量后也是如此。重要的是,精神障碍史是精神障碍住院的主要决定因素(调整 OR = 126.56,95%CI [121.85-131.46])。我们的结果表明,与最初因其他原因住院的患者相比,最初因 COVID-19 住院的患者在出院后 12 个月内首次出现精神症状/障碍或精神病复发的住院风险较低。这一发现与 COVID-19 后发生精神障碍风险较高的假设相矛盾。