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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

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



Publication History

Received: 30 June 2023
Received: 30 June 2023

Accepted: 05 September 2023

Article published online:
09 November 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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