Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry
Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry
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DOI：
10.1016/j.bbi.2020.04.069
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发表时间：
2020-07-01
影响因子：
15.1
通讯作者：
Tam, Wilson
中科院分区：
文献类型：
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作者：
Hao, Fengyi;Tan, Wanqiu;Tam, Wilson
这项研究旨在评估和比较在2019年冠状病毒病（COVID-19）疫情高峰期实施严格封锁措施时，患有和没有精神疾病的人所经历的即时压力和心理影响。采用事件影响量表修订版（IES-R）、抑郁、焦虑和应激量表（DASS-21）和精神病严重程度指数（ISI）对76例精神病患者和109例健康对照者进行了人口学资料、过去14 d内的躯体症状和一系列精神症状的调查。IES-R测量事件后幸存者的PTSD症状。DASS-21是基于精神病理学的三方模型，包括一个具有独特特征的一般困扰结构。精神病患者的IES-R、DASS-21焦虑、抑郁和应激量表及ISI评分均高于健康对照组（P < 0.001）。精神病患者对自身健康的严重担忧、愤怒和冲动、强烈的自杀意念显著高于健康对照组（P < 0.05）。超过三分之一的精神病患者可能符合创伤后应激障碍（PTSD）的诊断标准。超过四分之一的精神病患者患有中度至重度失眠症。报告没有变化、身体健康状况差或更差以及有精神疾病的受访者更有可能具有较高的平均IES-R、DASS抑郁、焦虑和压力子量表评分以及ISI评分（p < 0.05）。这项研究证实了在COVID-19疫情期间，严格的封锁措施对精神病患者的负面心理影响的严重性。了解COVID-19大流行期间对精神病患者的心理影响，有可能为如何开发新的免疫精神病学服务提供见解。需要进一步的研究来比较大流行期间精神病患者和健康对照之间的促炎细胞因子。
This study aimed to assess and compare the immediate stress and psychological impact experienced by people with and without psychiatric illnesses during the peak of 2019 coronavirus disease (COVID-19) epidemic with strict lockdown measures. Seventy-six psychiatric patients and 109 healthy control subjects were recruited from Chongqing, China and completed a survey on demographic data, physical symptoms during the past 14 days and a range of psychiatric symptoms using the Impact of Event Scale-Revised (IES-R), Depression, Anxiety and Stress Scale (DASS-21) and Insomnia Severity Index (ISI). IES-R measures PTSD symptoms in survivorship after an event. DASS-21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. The mean IES-R, DASS-21 anxiety, depression and stress subscale and ISI scores were higher in psychiatric patients than healthy controls (p < 0.001). Serious worries about their physical health, anger and impulsivity and intense suicidal ideation were significantly higher in psychiatric patients than healthy controls (p < 0.05). More than one-third of psychiatric patients might fulfil the diagnostic criteria post-traumatic stress disorder (PTSD). More than one-quarter of psychiatric patients suffered from moderately severe to severe insomnia. Respondents who reported no change, poor or worse physical health status and had a psychiatric illness were significantly more likely to have higher mean IES-R, DASS depression, anxiety and stress subscale scores and ISI scores (p < 0.05). This study confirms the severity of negative psychological impact on psychiatric patients during the COVID-19 epidemic with strict lockdown measures. Understanding the psychological impact on psychiatric patients during the COVID-19 pandemic has the potential to provide insight into how to develop a new immunopsychiatry service. Further research is required to compare pro-inflammatory cytokines between psychiatric patients and healthy controls during the pandemic.