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新冠病毒大流行对首发精神病谱系障碍发病率的影响。

The Impact of the COVID-19 Virus Pandemic on the Incidence of First Psychotic Spectrum Disorders.

机构信息

Department of Psychiatry, Medical University of Bialystok, 15-089 Bialystok, Poland.

Department of Neurology, Medical University of Bialystok, 15-089 Bialystok, Poland.

出版信息

Int J Environ Res Public Health. 2022 Mar 22;19(7):3781. doi: 10.3390/ijerph19073781.

Abstract

The effects of COVID-19 on the human body are not yet understood enough. Medical history provides information on cases of psychiatric symptoms during viral infections in the 20th century, such as the influenza pandemic. Currently, it is observed that there is an increasing number of new psychiatric disorders in previously healthy individuals. In addition, because of the decreased amount of reporting to health care providers, including psychiatrists, many physicians suggest that the number of neuropsychiatric disorders may be underestimated. In this paper, we review available studies on the occurrence of first-time psychotic spectrum disorder (PSD) in individuals related to SARS-CoV-2 infection. The reviewed studies suggest that first-time psychotic disorder in COVID-19 patients is statistically significantly more frequent compared to influenza, as well as to other respiratory infections. The emergence of new PSDs is explained by direct neurotropism of the virus on the one hand and by immunological mechanisms on the other. The main conclusions of this review should be treated with caution, and future research on this topic is needed. The authors recognize the particular need to develop standardized laboratory panels that include inflammatory markers (IL-6, TNF-α), cerebrospinal fluid (CSF) testing, and SARS-CoV-2 antibody assays to entirely understand the etiology of neuropsychiatric complications of SARS-CoV-2 infections and the pandemic itself. In addition, public health efforts are required to promote mental health, especially during COVID-19.

摘要

目前,人们对 COVID-19 对人体的影响还没有足够的了解。医学史提供了 20 世纪病毒性感染期间出现精神病症状的案例信息,如流感大流行。目前,观察到在以前健康的个体中,新的精神障碍数量正在增加。此外,由于向包括精神科医生在内的医疗保健提供者报告的数量减少,许多医生认为神经精神障碍的数量可能被低估了。在本文中,我们回顾了与 SARS-CoV-2 感染相关的个体首次出现精神病谱障碍(PSD)的现有研究。综述研究表明,COVID-19 患者首次出现精神病障碍的频率明显高于流感和其他呼吸道感染。新的 PSD 的出现一方面是由于病毒的直接神经嗜性,另一方面是由于免疫机制。本综述的主要结论应谨慎对待,需要对这一主题进行进一步研究。作者认识到特别需要制定标准化的实验室检测方案,包括炎症标志物(IL-6、TNF-α)、脑脊液(CSF)检测和 SARS-CoV-2 抗体检测,以完全了解 SARS-CoV-2 感染和大流行本身的神经精神并发症的病因。此外,需要开展公共卫生工作来促进心理健康,特别是在 COVID-19 期间。

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