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在 COVID-19 大流行之前存在任何心理健康状况是大流行第一年 COVID-19 传播的风险因素:一项西班牙成年人队列研究。

Having any mental health condition before the COVID-19 pandemic as a risk factor of COVID-19 contagion during the first year of pandemic: A Spanish adult cohort.

机构信息

Benito Menni CASM, Sant Boi de Llobregat, Spain.

Department of Clinical and Health Psychology, Universitat Autonoma de Barcelona (UAB), Bellaterra, Spain.

出版信息

Stress Health. 2024 Oct;40(5):e3446. doi: 10.1002/smi.3446. Epub 2024 Jul 17.

DOI:10.1002/smi.3446
PMID:39019647
Abstract

Numerous studies suggest that subjects suffering from a mental health condition before the COVID-19 pandemic were at higher risk of contagion, but mostly are cross-sectional or retrospective. The BIOVAL-D-COVID-19 is a longitudinal cohort study design with 922 subjects who full filled two evaluations from an online survey of Spanish residents before and during the pandemic. Mental health conditions assessed were: Major Depressive Episode (MDE), Generalised Anxiety Disorder (GAD), Suicidal Thoughts and Behaviours (STB) and subthreshold of panic and bipolar disorder (BD). Mental health screening instruments used were: the Spanish version of the Composite International Diagnostic Interview (CIDI) version 3.0 for the evaluation of MDE, the GAD-7 scale to evaluate GAD; STB was evaluated with four items from the CIDI questionnaire. Panic Disorder and BD were screened from a modified and self-reported version of the CIDI. A bivariate plus five logistic regression models were developed for each mental health condition adjusted by socio-demographic variables; employment status; general and physical health; comorbidity; and including all previous variables and the other mental health conditions. We found in bivariate model that MDE; GAD and STB were statistically significant risk factors of contagion of COVID-19. The logistic regression models developed reveal that having a previous GAD (aOR 3.30 1.31-8.31) or STB (aOR 2.16 CI 95% 1.01-4.62) was statistically significant associated with COVID-19 contagion, independently of all variables included. MDE was not a risk factor of contagion when it was adjusted by comorbidity (aOR 0.99 CI 95% 0.47-2.09). It is recommended to detect those subjects with previous GAD or STB as vulnerable groups of infection to reduce contagion rates.

摘要

大量研究表明,在 COVID-19 大流行之前患有心理健康问题的患者更容易感染,但这些研究大多是横断面或回顾性研究。BIOVAL-D-COVID-19 是一项纵向队列研究设计,共有 922 名参与者完成了两次在线调查评估,调查对象是西班牙居民在大流行前和大流行期间的情况。评估的心理健康状况包括:重度抑郁发作(MDE)、广泛性焦虑症(GAD)、自杀意念和行为(STB)以及恐慌和双相障碍(BD)的亚阈值。使用的心理健康筛查工具包括:用于评估 MDE 的西班牙版复合国际诊断访谈(CIDI)第 3.0 版、用于评估 GAD 的 GAD-7 量表;STB 是通过 CIDI 问卷中的四个项目进行评估的。恐慌症和 BD 是通过 CIDI 的修改和自我报告版本进行筛查的。对于每种心理健康状况,我们都开发了一个双变量加五个逻辑回归模型,这些模型根据社会人口统计学变量、就业状况、一般和身体健康、合并症以及包括所有先前变量和其他心理健康状况进行了调整。在双变量模型中,我们发现 MDE、GAD 和 STB 是 COVID-19 感染的统计学显著危险因素。开发的逻辑回归模型表明,患有先前的 GAD(优势比 3.30,1.31-8.31)或 STB(优势比 2.16,95%CI 1.01-4.62)与 COVID-19 感染显著相关,与包括所有在内的所有变量无关。当考虑到合并症时,MDE 不是感染的危险因素(优势比 0.99,95%CI 0.47-2.09)。建议将那些有先前 GAD 或 STB 的患者作为感染的弱势群体进行检测,以降低感染率。

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