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新冠疫情对首发和反复发作精神病患者急性精神病入院的影响。

The impact of COVID-19 on acute psychiatric admissions for first and repeated episode psychosis.

机构信息

Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK.

Coventry University, Coventry, UK.

出版信息

Int J Soc Psychiatry. 2023 Dec;69(8):2042-2047. doi: 10.1177/00207640231188031. Epub 2023 Aug 7.

Abstract

BACKGROUND

There is limited evidence of the longer-term impact of the COVID-19 pandemic on acute admissions for psychosis in the UK.

AIMS

We examined the impact of COVID-19 on rates of admissions for first and repeated episode psychosis, and changes in patient profile and seasonal patterns, over a period of 12 months.

METHOD

We conducted a retrospective case note review of all patients admitted with a primary psychosis (F20-29 ICD 10 diagnosis) to an NHS psychiatric inpatient unit. We compared the 12 months pre-COVID-19 period between 1 March 2019 and 28 February 2020, and the 12 months post-COVID-19 period between 1 March 2020 and 28 February 2021.

RESULTS

The results showed increase rates of admissions post-COVID-19 in both first and repeated episode psychosis, the patient profile had more females and older age in the repeated episode group, with increased employment rates. Combined group data for both pre- and post-COVID-19 periods showed an increased trend in spring and summer admissions, and even though not statistically significant, more pronounced post-COVID-19.

CONCLUSIONS

Our findings highlight the effect of the COVID-19 pandemic on acute psychosis admissions over a 12-month period. The results provide evidence for the 'stress-pathogenesis' in the context of genetic vulnerability in psychosis. Preventative strategies in the context of the 'stress-pathogenesis model', improved access to and responsiveness within NHS transformation efforts needs to be adjusted to fit local need and environmental changes.

摘要

背景

目前英国关于 COVID-19 大流行对精神病急性入院的长期影响的证据有限。

目的

我们研究了 COVID-19 对首次和重复发作精神病入院率的影响,以及在 12 个月期间患者特征和季节性模式的变化。

方法

我们对一家 NHS 精神病住院病房因原发性精神病(ICD-10 诊断 F20-29)入院的所有患者进行了回顾性病历审查。我们比较了 COVID-19 前的 12 个月(2019 年 3 月 1 日至 2020 年 2 月 28 日)和 COVID-19 后的 12 个月(2020 年 3 月 1 日至 2021 年 2 月 28 日)。

结果

结果显示,COVID-19 后首次和重复发作精神病的入院率均有所增加,重复发作组的患者特征为女性和年龄较大,就业率提高。COVID-19 前后的综合组数据显示,春季和夏季入院人数呈上升趋势,尽管没有统计学意义,但 COVID-19 后更为明显。

结论

我们的研究结果强调了 COVID-19 大流行对 12 个月内急性精神病入院的影响。研究结果为精神分裂症遗传易感性背景下的“应激发病机制”提供了证据。在“应激发病机制模型”的背景下,需要调整预防策略,以适应国民保健制度转型工作中当地的需求和环境变化。

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