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新型冠状病毒肺炎(COVID-19)入院后自残住院风险:法国全国性纵向研究

Risk of admission to hospital for self-harm after admission to hospital for COVID-19: French nationwide longitudinal study.

作者信息

Pirard Philippe, Decio Valentina, Pignon Baptiste, Bouaziz Olivier, Perduca Vittorio, Kovess-Masfety Viviane, Corruble Emmanuelle, Chin Francis, Geoffroy Pierre A, Strat Yann Le, Messika Jonathan, Regnault Nolwenn, Tebeka Sarah

机构信息

Non Communicable Diseases and Trauma Division, Santé publique France, Paris, France.

Département Médico Universitaire (DMU) - Innovation en santé Mentale, Psychiatrie et AddiCTologie, Hôpitaux Universitaires « H. Mondor », Assistance Publique hôpitaux de Paris (AP-HP), Université Paris-Est-Créteil (UPEC), Mondor Biomedical Research Institute (IMRB - Inserm), Translational Neuropsychiatry, Fondation FondaMental, Créteil, France.

出版信息

BJPsych Open. 2024 Dec 5;10(6):e215. doi: 10.1192/bjo.2024.786.

Abstract

BACKGROUND

Assessing the risk of subsequent self-harm after hospitalisation for COVID-19 is critical for mental health care planning during and after the pandemic.

AIMS

This study aims to compare the risk of admission to hospital for self-harm within 12 months following a COVID-19 hospitalisation during the first half of 2020, with the risk following hospitalisations for other reasons.

METHOD

Using the French administrative healthcare database, logistic regression models were employed to analyse data from patients admitted to hospitals in metropolitan France between January and June 2020. The analysis included adjustments for sociodemographic factors, psychiatric history and the level of care received during the initial hospital stay.

RESULTS

Of the 96 313 patients hospitalised for COVID-19, 336 (0.35%) were subsequently admitted for self-harm within 12 months, compared to 20 135 (0.72%) of 2 797 775 patients admitted for other reasons. This difference remained significant after adjusting for sociodemographic factors (adjusted odds ratio (aOR) = 0.66, 95% CI: 0.59-0.73), psychiatric disorder history (aOR = 0.65, 95% CI: 0.58-0.73) and the level of care received during the initial hospital stay (aOR = 0.70, 95% CI: 0.63-0.78). History of psychiatric disorders and intensive care were strongly correlated with increased risk, while older age was inversely associated with self-harm admissions.

CONCLUSIONS

Hospitalisation for COVID-19 during the early pandemic was linked to a lower risk of subsequent self-harm than hospitalisation for other reasons. Clinicians should consider psychiatric history and intensive care factors in evaluating the risk of future suicide.

摘要

背景

评估新冠病毒疾病(COVID-19)住院治疗后后续自我伤害的风险对于大流行期间及之后的精神卫生保健规划至关重要。

目的

本研究旨在比较2020年上半年COVID-19住院治疗后12个月内因自我伤害入院的风险与因其他原因住院后的风险。

方法

使用法国行政医疗保健数据库,采用逻辑回归模型分析2020年1月至6月间法国本土医院收治患者的数据。分析对社会人口统计学因素、精神病史以及初次住院期间接受的护理水平进行了调整。

结果

在96313例因COVID-19住院的患者中,336例(0.35%)随后在12个月内因自我伤害入院,相比之下,在2797775例因其他原因住院的患者中,有20135例(0.72%)因自我伤害入院。在对社会人口统计学因素(调整后的优势比(aOR)=0.66,95%置信区间:0.59 - 0.73)、精神疾病史(aOR = 0.65,95%置信区间:0.58 - 0.73)和初次住院期间接受的护理水平(aOR = 0.70,95%置信区间:0.63 - 0.78)进行调整后,这种差异仍然显著。精神疾病史和重症监护与风险增加密切相关,而年龄较大与自我伤害入院呈负相关。

结论

在疫情早期,因COVID-19住院与后续自我伤害风险低于因其他原因住院有关。临床医生在评估未来自杀风险时应考虑精神病史和重症监护因素。

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本文引用的文献

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Eur Psychiatry. 2023 Dec 13;67(1):e1. doi: 10.1192/j.eurpsy.2023.2473.
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The risk of hospitalization for psychotic disorders following hospitalization for COVID-19: a French nationwide longitudinal study.
Mol Psychiatry. 2023 Aug;28(8):3293-3304. doi: 10.1038/s41380-023-02207-8. Epub 2023 Aug 3.
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Reactive surveillance of suicides during the COVID-19 pandemic in France, 2020 to March 2022.
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Hyper/neuroinflammation in COVID-19 and suicide etiopathogenesis: Hypothesis for a nefarious collision?
Neurosci Biobehav Rev. 2022 May;136:104606. doi: 10.1016/j.neubiorev.2022.104606. Epub 2022 Mar 12.

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