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边缘型人格障碍患者在 COVID-19 大流行期间的特殊易感性——一项回顾性病历审查

Particular vulnerability of patients with borderline personality disorder during the COVID-19 pandemic - a retrospective chart review.

作者信息

Kippe Yann David, Gutwinski Stefan, Adam Maia, Finck Anna, Schouler-Ocak Meryam, Goldschmidt Thomas

机构信息

Psychiatrische Universitätsklinik der Charité im St. Hedwig Krankenhaus, Große Hamburger Str. 5-11, Berlin, 10115, Germany.

出版信息

BMC Psychiatry. 2024 Dec 27;24(1):950. doi: 10.1186/s12888-024-06366-y.

Abstract

BACKGROUND

Mental health consequences of the COVID-19 pandemic have been a major research focus since its beginning. A specific vulnerability of patients with borderline personality disorder (BPD) following social distancing measures has been reported, however there is a lack of adequately sized studies that provide evidence of this vulnerability. Suicide attempts may reflect mental health effects of the COVID-19 pandemic in psychiatric settings.

METHODS

Retrospective follow-up analysis of clinical documentation in a psychiatric emergency department (pED) of a major academic psychiatric hospital in Berlin, Germany. Observation periods include the first- (3/2/2020-5/24/2020) and second-wave (9/15/2020-3/1/2021) of the COVID-19 pandemic in Germany and respective periods one year earlier as control-periods. Poisson-regression was used for statistical modelling of individual counts of pED presentations after a suicide attempt.

RESULTS

N = 4110 patients attended the pED during the four observation periods. BPD patients were associated with elevated risk of pED presentation after a suicide attempt during COVID-periods (RR = 3.4; p = .014). Schizophrenia and psychotic disorders showed lower risk of pED presentation after a suicide attempt during COVID-periods (RR = 0.4; p = .048). Other diagnostic groups did not show significant interaction effects with COVID-periods. The first-wave was a risk factor for pED presentation after a suicide attempt affecting the sample across all diagnostic groups (RR = 3.1; p = .006).

CONCLUSIONS

BPD patients seem to be particularly vulnerable during the COVID-19 pandemic showing increased rates of suicide attempts during both COVID-periods. This should be addressed in future health crises by ensuring availability of psychosocial help. There is a need for further research regarding BPD patients in public health crisis situations.

摘要

背景

自新冠疫情开始以来,其对心理健康的影响一直是主要研究重点。有报告称,边缘性人格障碍(BPD)患者在社交 distancing 措施实施后存在特定的脆弱性,但缺乏足够规模的研究来证明这一脆弱性。自杀未遂可能反映了新冠疫情在精神科环境中对心理健康的影响。

方法

对德国柏林一家大型学术精神病医院的精神科急诊科(pED)临床记录进行回顾性随访分析。观察期包括德国新冠疫情的第一波(2020年3月2日至2020年5月24日)和第二波(2020年9月15日至2021年3月1日),以及一年前相应时期作为对照期。采用泊松回归对自杀未遂后到 pED 就诊的个体计数进行统计建模。

结果

在四个观察期内,共有4110名患者到 pED 就诊。BPD 患者在新冠疫情期间自杀未遂后到 pED 就诊的风险升高(相对风险率RR = 3.4;p = 0.014)。精神分裂症和精神障碍患者在新冠疫情期间自杀未遂后到 pED 就诊的风险较低(RR = 0.4;p = 0.048)。其他诊断组在新冠疫情期间未显示出显著的交互作用。第一波疫情是所有诊断组样本自杀未遂后到 pED 就诊的一个风险因素(RR = 3.1;p = 0.006)。

结论

BPD 患者在新冠疫情期间似乎特别脆弱,在两个新冠疫情期间自杀未遂率均有所上升。在未来的健康危机中,应通过确保提供心理社会帮助来解决这一问题。有必要对公共卫生危机情况下的 BPD 患者进行进一步研究。

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