感染引发的免疫系统紊乱可导致精神病理,在之前的冠状病毒疫情暴发后观察到精神后遗症。严重急性呼吸综合征冠状病毒(COVID-19)大流行的传播可能与精神方面的影响有关。我们调查了COVID-19对幸存者的精神病理影响,还考虑了临床和炎症预测因素的影响。在医院治疗后的一个月随访中,我们筛查了402名COVID-19幸存的成人(265名男性,平均58岁)的精神症状。采用临床访谈和一系列自我报告问卷调查创伤后应激障碍(PTSD)、抑郁、焦虑、失眠和强迫症(OC)症状学。我们收集了社会人口学信息、临床数据、基线炎症标志物和随访的氧饱和度。相当一部分患者在精神病理学范围内自评:28%为创伤后应激障碍,31%为抑郁,42%为焦虑,20%为OC症状,40%为失眠。总体而言,56%的患者至少在一个临床维度上达到了病理范围。尽管基线炎症标志物水平明显较低,但女性焦虑和抑郁的情况更严重。有精神病学阳性诊断的患者在大多数精神病理指标上得分增加,基线炎症情况相似。 Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present obervation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.
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参考文献

PubMed