Abstract：
BACKGROUND: During the COVID-19 pandemic, social-distancing and confinement measures were implemented. These may affect the mental health of patients with mental disorders such as schizophrenia. This study examined the clinical course of patients with schizophrenia at a public hospital in Morocco during the COVID-19 pandemic.
METHODS: This longitudinal observational study was conducted across three periods in 15 months: 1 April 2020 (start of strict home confinement) to 30 June 2020 (T1), 1 July 2020 to 31 January 2021 (corresponding to the Delta wave) [T2], and 1 February 2021 to 30 June 2021 (corresponding to the Omicron wave) [T3]. Patients aged 18 to 65 years with a diagnosis of schizophrenia or schizoaffective disorder (based on DSM 5) made before the pandemic who presented to the Faculty of Medicine and Pharmacy of Rabat were invited to participate. Psychotic symptomatology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Severity and improvement of mental disorder were evaluated using the Clinical Global Impression (CGI)-Severity and -Improvement subscales. Depressive symptoms were assessed using the Calgary Depression Scale (CDS). Adherence to treatments was assessed using the Medication Adherence Rating Scale (MARS). All assessments were made by psychiatrists or residents face-to-face (for T1) or via telephone (for T2 and T3).
RESULTS: Of 146 patients recruited, 83 men and 19 women (mean age, 39 years) completed all three assessments. The CGI-Severity score was higher at T2 than T1 and T3 (3.24 vs 3.04 vs 3.08, p = 0.041), and the MARS score was higher at T1 and T2 than T3 (6.80 vs 6.83 vs 6.35, p = 0.033). Patient age was negatively correlated with CDS scores for depressive symptoms at T1 (Spearman\'s rho = -0.239, p = 0.016) and at T2 (Spearman\'s rho = -0.231, p = 0.019). The MARS score for adherence was higher in female than male patients at T1 (p = 0.809), T2 (p = 0.353), and T3 (p = 0.004). Daily tobacco consumption was associated with the PANSS total score at T3 (p = 0.005), the CGI-Severity score at T3 (p = 0.021), and the MARS score at T3 (p = 0.002). Patients with a history of attempted suicide had higher CDS scores than those without such a history at T1 (p = 0.015) and T3 (p = 0.018) but not at T2 (p = 0.346).
CONCLUSIONS: Home confinement during the COVID-19 pandemic had limited negative impact on the mental health of patients with schizophrenia in Morocco.
METHODS: This longitudinal observational study was conducted across three periods in 15 months: 1 April 2020 (start of strict home confinement) to 30 June 2020 (T1), 1 July 2020 to 31 January 2021 (corresponding to the Delta wave) [T2], and 1 February 2021 to 30 June 2021 (corresponding to the Omicron wave) [T3]. Patients aged 18 to 65 years with a diagnosis of schizophrenia or schizoaffective disorder (based on DSM 5) made before the pandemic who presented to the Faculty of Medicine and Pharmacy of Rabat were invited to participate. Psychotic symptomatology was evaluated using the Positive and Negative Syndrome Scale (PANSS). Severity and improvement of mental disorder were evaluated using the Clinical Global Impression (CGI)-Severity and -Improvement subscales. Depressive symptoms were assessed using the Calgary Depression Scale (CDS). Adherence to treatments was assessed using the Medication Adherence Rating Scale (MARS). All assessments were made by psychiatrists or residents face-to-face (for T1) or via telephone (for T2 and T3).
RESULTS: Of 146 patients recruited, 83 men and 19 women (mean age, 39 years) completed all three assessments. The CGI-Severity score was higher at T2 than T1 and T3 (3.24 vs 3.04 vs 3.08, p = 0.041), and the MARS score was higher at T1 and T2 than T3 (6.80 vs 6.83 vs 6.35, p = 0.033). Patient age was negatively correlated with CDS scores for depressive symptoms at T1 (Spearman\'s rho = -0.239, p = 0.016) and at T2 (Spearman\'s rho = -0.231, p = 0.019). The MARS score for adherence was higher in female than male patients at T1 (p = 0.809), T2 (p = 0.353), and T3 (p = 0.004). Daily tobacco consumption was associated with the PANSS total score at T3 (p = 0.005), the CGI-Severity score at T3 (p = 0.021), and the MARS score at T3 (p = 0.002). Patients with a history of attempted suicide had higher CDS scores than those without such a history at T1 (p = 0.015) and T3 (p = 0.018) but not at T2 (p = 0.346).
CONCLUSIONS: Home confinement during the COVID-19 pandemic had limited negative impact on the mental health of patients with schizophrenia in Morocco.
摘要：
背景：在COVID-19大流行期间，实施了社交距离和禁闭措施。这些可能会影响精神分裂症等精神障碍患者的心理健康。这项研究调查了COVID-19大流行期间摩洛哥一家公立医院精神分裂症患者的临床病程。
方法：这项纵向观察研究在15个月的三个时期进行：2020年4月1日（严格家庭分娩开始）至2020年6月30日（T1），2020年7月1日至2021年1月31日（对应于三角洲波）[T2]，和2021年2月1日至2021年6月30日（对应于Omicronwave）[T3]。邀请在大流行前诊断为精神分裂症或分裂情感障碍（基于DSM5）的18至65岁的患者参加，这些患者被邀请参加拉巴特医学和药学学院。使用阳性和阴性综合征量表（PANSS）评估精神病症状。使用临床总体印象（CGI）-严重程度和改善分量表评估精神障碍的严重程度和改善程度。使用卡尔加里抑郁量表（CDS）评估抑郁症状。使用药物依从性评定量表(MARS)评估对治疗的依从性。所有评估均由精神科医生或居民面对面（对于T1）或通过电话（对于T2和T3）进行。
结果：在招募的146名患者中，83名男性和19名女性(平均年龄，39年）完成了所有三项评估。CGI严重程度评分在T2高于T1和T3（3.24vs3.04vs3.08，p=0.041），T1和T2时MARS评分高于T3(6.80vs6.83vs6.35,p=0.033)。患者年龄与T1时（Spearmanrho=-0.239，p=0.016）和T2时（Spearmanrho=-0.231，p=0.019）抑郁症状的CDS评分呈负相关。在T1时，女性患者的依从性MARS评分高于男性患者（p=0.809），T2（p=0.353），和T3(p=0.004)。每日烟草消费量与T3时的PANSS总分相关（p=0.005），T3时的CGI-严重性评分(p=0.021)，和T3时的MARS评分（p=0.002）。在T1（p=0.015）和T3（p=0.018），但在T2（p=0.346）时，有自杀未遂史的患者的CDS评分高于无自杀未遂史的患者。
结论：COVID-19大流行期间的家庭分娩对摩洛哥精神分裂症患者的心理健康的负面影响有限。
方法：这项纵向观察研究在15个月的三个时期进行：2020年4月1日（严格家庭分娩开始）至2020年6月30日（T1），2020年7月1日至2021年1月31日（对应于三角洲波）[T2]，和2021年2月1日至2021年6月30日（对应于Omicronwave）[T3]。邀请在大流行前诊断为精神分裂症或分裂情感障碍（基于DSM5）的18至65岁的患者参加，这些患者被邀请参加拉巴特医学和药学学院。使用阳性和阴性综合征量表（PANSS）评估精神病症状。使用临床总体印象（CGI）-严重程度和改善分量表评估精神障碍的严重程度和改善程度。使用卡尔加里抑郁量表（CDS）评估抑郁症状。使用药物依从性评定量表(MARS)评估对治疗的依从性。所有评估均由精神科医生或居民面对面（对于T1）或通过电话（对于T2和T3）进行。
结果：在招募的146名患者中，83名男性和19名女性(平均年龄，39年）完成了所有三项评估。CGI严重程度评分在T2高于T1和T3（3.24vs3.04vs3.08，p=0.041），T1和T2时MARS评分高于T3(6.80vs6.83vs6.35,p=0.033)。患者年龄与T1时（Spearmanrho=-0.239，p=0.016）和T2时（Spearmanrho=-0.231，p=0.019）抑郁症状的CDS评分呈负相关。在T1时，女性患者的依从性MARS评分高于男性患者（p=0.809），T2（p=0.353），和T3(p=0.004)。每日烟草消费量与T3时的PANSS总分相关（p=0.005），T3时的CGI-严重性评分(p=0.021)，和T3时的MARS评分（p=0.002）。在T1（p=0.015）和T3（p=0.018），但在T2（p=0.346）时，有自杀未遂史的患者的CDS评分高于无自杀未遂史的患者。
结论：COVID-19大流行期间的家庭分娩对摩洛哥精神分裂症患者的心理健康的负面影响有限。
