COVID-19 mortality among veterans with serious mental illness in the veterans health administration.
COVID-19 mortality among veterans with serious mental illness in the veterans health administration.
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DOI：
10.1016/j.jpsychires.2023.05.024
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发表时间：
2023-07
影响因子：
4.8
通讯作者：
Washington, Donna L.
中科院分区：
文献类型：
--
作者：
Bowersox, Nicholas W.;Browne, Julia;Grau, Peter P.;Merrill, Stephanie L.;Haderlein, Taona P.;Llorente, Maria D.;Washington, Donna L.
根据几项国际评估的结果，患有严重精神疾病（SMI：精神分裂症谱系障碍，双相情感障碍）的人在感染COVID-19后死亡风险增加。然而，退伍军人健康管理局（VHA）关于SMI患者中COVID-19死亡风险的信息有限，排除了保护因素的识别。目前的评估旨在评估VHA伴SMI患者的COVID-19死亡风险，并评估在COVID-19阳性诊断后降低死亡风险的潜在保护因素。国家VHA管理数据用于识别2020年3月1日至2020年9月30日期间收到阳性COVID-19检测结果的所有患者（N = 52，916）。通过双变量比较和多变量回归分析，根据SMI状态评估死亡风险。在未校正的分析中，总体上伴有SMI的VHA患者，特别是双相情感障碍患者，在COVID检测阳性后的30天内，死亡风险没有增加，尽管精神分裂症患者的风险增加。在调整后的分析中，精神分裂症患者的死亡风险仍然增加（OR = 1.38），但相对于其他医疗机构的既往评估，死亡风险降低。在VHA中，精神分裂症患者（而非双相情感障碍患者）在COVID-19检测阳性后30天内的死亡风险增加。VHA等大型综合医疗机构可能会为SMI患者等弱势群体提供预防COVID-19死亡的服务。需要开展更多工作，以确定可能降低重度精神障碍患者COVID-19死亡风险的做法。
Persons with serious mental illness (SMI: schizophrenia-spectrum disorders, bipolar disorder) experience increased risk of mortality after contracting COVID-19 based on the results of several international evaluations. However, information about COVID-19 mortality risk among patients with SMI in the Veterans Health Administration (VHA) has been limited, precluding identification of protective factors. The current evaluation was conducted to assess COVID-19 mortality risk among VHA patients with SMI and to evaluate potential protective factors in mitigating mortality risk following a positive COVID-19 diagnosis. National VHA administrative data was used to identify all patients (N = 52,916) who received a positive COVID-19 test result between March 1, 2020, and September 30, 2020. Mortality risk was assessed by SMI status via bivariate comparisons and multivariate regression analyses. In unadjusted analyses, VHA patients with SMI overall and patients with bipolar disorder in particular did not experience increased mortality risk in the 30 days following a positive COVID test, although patients with schizophrenia had increased risk. Within adjusted analyses, patients with schizophrenia remained at increased mortality risk (OR = 1.38), but at reduced levels relative to previous evaluations in other healthcare settings. Within VHA, patients with schizophrenia, but not those with bipolar disorder, experience increased mortality risk in the 30 days following a positive COVID-19 test. Large integrated healthcare settings such as VHA may offer services which may protect against COVID-19 mortality for vulnerable groups such as persons with SMI. Additional work is needed to identify practices which may reduce the risk of COVID-19 mortality among persons with SMI.
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影响因子：
6.6
作者：
Fond G;Pauly V;Leone M;Llorca PM;Orleans V;Loundou A;Lancon C;Auquier P;Baumstarck K;Boyer L
通讯作者：
Boyer L
DOI：
10.1146/annurev-clinpsy-032813-153657
发表时间：
2014-01-01
期刊：
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 10
影响因子：
--
作者：
Laursen, Thomas Munk;Nordentoft, Merete;Mortensen, Preben Bo
通讯作者：
Mortensen, Preben Bo
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
3.6
作者：
Gin, June L.;Balut, Michelle D.;Alenkin, Nikola R.;Dobalian, Aram
通讯作者：
Dobalian, Aram
影响因子：
4.9
作者：
Kuritzky, A;Mazeh, D;Levi, A
通讯作者：
Levi, A