Mental health outcomes of encephalitis: an international web-based study
Mental health outcomes of encephalitis: an international web-based study
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脑炎的心理健康结果：一项国际网络研究
DOI：
10.1101/2023.02.03.23285344
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Abdat Y
中科院分区：
文献类型：
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作者：
Abdat Y
脑炎在急性期和急性期后与精神症状有关，许多幸存者会出现长期后遗症。尽管如此，脑炎幸存者心理健康症状的广度和严重程度尚未得到系统报道。我们招募了被诊断患有任何病因的脑炎的成年人，以完成一份基于网络的问卷，评估各种心理健康症状和障碍。共有来自31个国家的445名受访者（55.1%英国，23.1%美国，2.2%低收入和中等收入国家）完成了调查，自脑炎诊断以来的中位时间为7年; 84.7%由神经科医生或传染病医生诊断。感染性脑炎占65.4%，自身免疫性脑炎占29.7%。平均年龄为50.1岁（SD 15.6）; 65.8%为女性。最常见的自我报告的精神症状是焦虑（75.2%），睡眠问题（64.4%），情绪问题（62.2%），意外哭泣（35.2%）和攻击（29.9%）。脑炎后自我报告的精神病诊断率很高：焦虑（44.0%），抑郁（38.6%），惊恐障碍（15.7%）和创伤后应激障碍（PTSD，21.3%）;这些比率与经验证的自我报告测量结果大致一致，精神病诊断筛查问卷（PDSQ）。还报告了严重的精神疾病，如精神病（3.3%）和双相情感障碍（3.1%）。许多受访者还认为他们有焦虑症（37.5%），抑郁症（28.1%），创伤后应激障碍（26.8%）或恐慌症（20.9%）的症状，这些症状没有被专业人士诊断出来。总体而言，自我报告的主要精神病诊断和症状的发生率在自身免疫性脑炎和感染性脑炎之间没有显著差异。总体而言，37.5%的受访者曾想过自杀，4.4%的人自脑炎诊断以来曾试图自杀。超过一半（53.5%）的人报告说，他们没有获得或无法获得适当的心理健康护理。感觉超敏反应的高发生率（>75%）表明脑炎与这一令人痛苦的症状群之间存在以前未报道的联系。这项大型国际调查表明，脑炎后的精神症状是常见的，精神卫生保健提供给这一人群可能是不够的，强调需要增加提供积极的精神病护理，这些患者。
Encephalitis is associated with psychiatric symptoms in the acute and post-acute stages, and many survivors experience long-term sequelae. Despite this, the breadth and severity of mental health symptoms in survivors of encephalitis has not been systematically reported. We recruited adults who had been diagnosed with encephalitis of any aetiology to complete a web-based questionnaire assessing a wide range of mental health symptoms and disorders. In total, 445 respondents from 31 countries (55.1% UK, 23.1% USA, 2.2% low-and middle-income countries) completed the survey, with a median seven years since encephalitis diagnosis; 84.7% were diagnosed by a neurologist or infectious diseases doctor. Infectious encephalitis constituted 65.4% of cases, autoimmune 29.7%. Mean age was 50.1 years (SD 15.6); 65.8% were female. The most common self-reported psychiatric symptoms were anxiety (75.2%), sleep problems (64.4%), mood problems (62.2%), unexpected crying (35.2%), and aggression (29.9%). Rates of self-reported psychiatric diagnoses following encephalitis were high: anxiety (44.0%), depression (38.6%), panic disorder (15.7%), and post-traumatic stress disorder (PTSD, 21.3%); these rates were broadly consistent with the results of a validated self-report measure, the Psychiatric Diagnostic Screening Questionnaire (PDSQ). Severe mental illnesses such as psychosis (3.3%) and bipolar affective disorder (3.1%) were also reported. Many respondents also felt they had symptoms of disorders including anxiety (37.5%), depression (28.1%), PTSD (26.8%), or panic disorder (20.9%) which had not been diagnosed by a professional. Overall, rates of major self-reported psychiatric diagnoses and symptoms did not significantly differ between autoimmune and infectious encephalitis. In total, 37.5% of respondents had thought about suicide, and 4.4% had attempted suicide since their encephalitis diagnosis. Over half (53.5%) reported that they either had no, or substandard, access to appropriate care for their mental health. High rates of sensory hypersensitivities (>75%) suggest a previously unreported association between encephalitis and this distressing symptom cluster. This large international survey indicates that psychiatric symptoms following encephalitis are common, and that mental healthcare provision to this population may be inadequate, highlighting a need for increased provision of proactive psychiatric care for these patients.