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Pharmacopsychiatry 2023; 56(06): 227-238
DOI: 10.1055/a-2177-3056
Original Paper

Prevalence of COVID-19 and Psychotropic Drug Treatment in Psychiatric In-patients in Germany in 2020: Results from a Nationwide Pilot Survey

Authors

  • Juliane K. Mueller

    1   Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt/M, Germany

  • Kira F. Ahrens

    1   Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt/M, Germany

  • Michael Bauer

    8   Department of Psychiatry and Psychotherapy, Medical Faculty, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany

  • Bernhard T. Baune

    17   Department of Psychiatry, University Hospital Münster, University of Münster, Münster, Germany

  • Stefan Borgwardt

    19   Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany

  • Jürgen Deckert

    13   Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany

  • Katharina Domschke

    16   Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany

  • Regina Ellwanger

    25   Health Protection Authority, City of Frankfurt am Main, Germany

  • Andreas Fallgatter

    21   Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG)

  • Thomas Frodl

    23   Department of Psychiatry, Otto-von-Guericke University, Magdeburg, Germany
    26   Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH, University Aachen, Aachen, Germany

  • Jürgen Gallinat

    4   Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  • René Gottschalk

    25   Health Protection Authority, City of Frankfurt am Main, Germany

  • Hans J Grabe

    12   Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany

  • Alkomiet Hasan

    10   Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany

  • Sabine C Herpertz

    18   Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany

  • Rene Hurlemann

    22   Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Oldenburg, Germany

  • Frank Jessen

    9   Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

  • Joseph Kambeitz

    9   Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany

  • Tilo Kircher

    14   Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany

  • Johannes Kornhuber

    6   Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany

  • Klaus Lieb

    2   Department of Psychiatry and Psychotherapy, University Medical Center Mainz

  • Andreas Meyer-Lindenberg

    11   Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

  • Rainer Rupprecht

    5   Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany

  • Norbert Scherbaum

    7   Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Medical Faculty, University of Duisburg Essen, Essen, Germany

  • Christiane Schlang

    25   Health Protection Authority, City of Frankfurt am Main, Germany

  • Anja Schneider

    20   Department of Neurodegeneration and Geriatric Psychiatry, University of Bonn, Bonn, Germany

  • Georg Schomerus

    15   Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany

  • Andreas Thoma

    10   Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Bezirkskrankenhaus Augsburg, Augsburg, Germany

  • Stefan Unterecker

    13   Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg, Germany

  • Martin Walter

    24   Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany

  • Henrik Walter

    3   Charité University Clinic Berlin, Freie Universität Berlin, Humboldt- Universität zu Berlin

  • Andreas Reif

    1   Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt/M, Germany

  • Christine Reif-Leonhard

    1   Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt/M, Germany
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Abstract

Introduction In patients with a pre-existing mental disorder, an increased risk for a first manifestation of a psychiatric disorder in COVID-19 patients, a more severe course of COVID-19 and an increased mortality have been described. Conversely, observations of lower COVID-19 incidences in psychiatric in-patients suggested protective effects of psychiatric treatment and/or psychotropic drugs against COVID-19.

Methods A retrospective multi-center study was conducted in 24 German psychiatric university hospitals. Between April and December 2020 (the first and partly second wave of COVID-19), the effects of COVID-19 were assessed on psychiatric in-patient care, the incidence and course of a SARS-CoV-2 infection, and treatment with psychotropic drugs.

Results Patients (n=36,322) were admitted to the hospitals. Mandatory SARS-CoV-2 tests before/during admission were reported by 23 hospitals (95.8%), while 18 (75%) conducted regular testing during the hospital stay. Two hundred thirty-two (0.6%) patients were tested SARS-CoV-2-positive. Thirty-seven (16%) patients were receiving medical treatment for COVID-19 at the psychiatric hospital, ten (4.3%) were transferred to an intermediate/intensive care unit, and three (1.3%) died. The most common prescription for SARS-CoV-2-positive patients was for second-generation antipsychotics (n=79, 28.2%) and antidepressants (SSRIs (n=38, 13.5%), mirtazapine (n=36, 12.9%) and SNRIs (n=29, 10.4%)).

Discussion Contrary to previous studies, our results showed a low number of infections and mortality in SARS-CoV-2-positive psychiatric patients. Several preventive measures seem effective to protect this vulnerable group. Our observations are compatible with the hypothesis of a protective effect of psychotropic drugs against COVID-19 as the overall mortality and need for specific medical treatment was low.

Key words

COVID-19 - psychiatry - psychotropic drugs - SARS-CoV-2

Supplementary Material



Publikationsverlauf

Eingereicht: 30. Juni 2023
Eingereicht: 30. Juni 2023

Angenommen: 05. September 2023

Artikel online veröffentlicht:
09. November 2023

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