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Prodi T, Dragogna F, Benatti B, Varinelli A, Vanzetto S, Gianfelice L, Dell'Osso B. COVID-19 and psychiatric disorders among young people: a cross-sectional study. Int Clin Psychopharmacol 2024:00004850-990000000-00148. [PMID: 39120982 DOI: 10.1097/yic.0000000000000565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/11/2024]
Abstract
During the COVID-19 pandemic, a significant rise in mental health issues was observed. Particularly, children and adolescents have shown a higher risk of developing mental disorders than adults. This study aimed to describe the evolving features of the requests for psychiatric emergency interventions during the COVID-19 pandemic in young people. We conducted a cross-sectional study comparing the number, characteristics, and symptoms of people aged between 12 and 18 years old attending one Emergency Department (ED) for psychiatric issues, considering three different periods: T0 (8 March 2019-7 March 2020), T1 (8 March 2020-7 March 2021), and T2 (8 March 2021-7 March 2022). Total admissions were 220: 99 (45%) during T0, 40 (18.1%) for T1, and 81 (36.8%) for T2 (P < 0.001). A significant decrease in the mean age from T0 to T1 was found (P < 0.01). Admissions for psychomotor agitation decreased, while admission due to anxiety disorder and nonsuicidal self-injury raised significantly (P < 0.05), as for first psychiatric presentation (P < 0.01). Regarding substance use, a significant reduction was observed (P < 0.05). The rates of eating disorders (P < 0.001) and early insomnia (P < 0.01) increased from T0. These findings highlight the worsening of psychiatric symptoms in the young population during the COVID-19 pandemic.
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Affiliation(s)
- Tiziano Prodi
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Filippo Dragogna
- Department of Mental Health, Psychiatry 1 Unit, Fatebenefratelli Hospital, Milan
| | - Beatrice Benatti
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | - Alberto Varinelli
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
| | | | | | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan
- Department of Mental Health, Psychiatry 1 Unit, Fatebenefratelli Hospital, Milan
- "Aldo Ravelli" Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
- Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche, University of Milan, Milan, Italy
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Villarreal-Zegarra D, García-Serna J, Segovia-Bacilio P, Mayo-Puchoc N, Navarro-Flores A, Huarcaya-Victoria J. In-Person and Teleconsultation Services at a National Hospital in Peru: Time Series Analysis of General and Psychiatric Care Amid the COVID-19 Pandemic. JMIR Ment Health 2024; 11:e53980. [PMID: 38976320 PMCID: PMC11263901 DOI: 10.2196/53980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic led to a global reduction in health care accessibility for both infected and noninfected patients, posing a particular burden on those with chronic conditions, including mental health issues. Peru experienced significant devastation from the pandemic, resulting in a collapsed health care system and leading to the world's highest per capita mortality rate as a result of COVID-19. Understanding the trends in health care utilization, particularly in mental health care, is crucial for informing pandemic response efforts and guiding future recovery strategies. OBJECTIVE This study aims to analyze the trends of outpatient medical and psychiatric consultations during the COVID-19 pandemic in a national hospital in Peru. METHODS This observational study was conducted at a national hospital in Lima, Peru. We analyzed data on user care across all services, including psychiatric services, from May 2019 to December 2022. The data were calculated for users served per month, including the number of users seen monthly in mental health services. Sociodemographic variables such as sex (female or male), age (≥0 years), type of medical appointment (regular or additional), and modality of care (in-person or teleconsultations) were taken into account. An interrupted time series regression model was conducted to assess the number of outpatient medical and psychiatric consultations. Subgroup analyses were performed based on service modality, including overall consultations, telemonitoring/teleconsultations only, or face-to-face only, for all service users and for mental health service users. RESULTS A total of 1,515,439 participants were included, with females comprising 275,444/484,994 (56.80%) of the samples. Only 345,605/1,515,439 (22.81%) visits involved telemedicine. The total monthly outpatient visits were significantly reduced compared with the expected projection (P<.001) at the beginning of the pandemic, followed by a later monthly increment of 298.7 users. Face-to-face interventions experienced a significant reduction at the beginning of the pandemic (P<.001), gradually recovering in the following months. By contrast, telemedicine use initially increased but subsequently declined toward the end of the pandemic. A similar trend was observed in mental health units. CONCLUSIONS During the pandemic years, health care utilization in both general and psychiatric services experienced a significant decrease, particularly at the beginning of the pandemic (March 2020). However, no significant trends were observed in either case throughout the pandemic period. Telemedicine consultations witnessed a significant increase overall during this period, particularly among mental health users.
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Affiliation(s)
- David Villarreal-Zegarra
- Escuela de Medicina Humana, Universidad César Vallejo, Trujillo, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
| | | | | | | | - Alba Navarro-Flores
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Jeff Huarcaya-Victoria
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
- Unidad de Investigación de Psiquiatría, Departamento de Psiquiatría, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru
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Ryan SC, Sugg MM, Runkle JD, Wertis L, Singh D, Green S. Short-term changes in mental health help-seeking behaviors following exposure to multiple social stressors and a natural disaster. Soc Sci Med 2024; 348:116843. [PMID: 38603916 PMCID: PMC11134597 DOI: 10.1016/j.socscimed.2024.116843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
In 2020, unprecedented circumstances led to significant mental health consequences. Individuals faced mental health stressors that extended beyond the devastating impact of the COVID-19 pandemic, including widespread social unrest following the murder of George Floyd, an intense hurricane season in the Atlantic, and the politically divisive 2020 election. The objective of this analysis was to consider changes in help-seeking behavior following exposure to multiple social stressors and a natural disaster. Data from Crisis Text Line (CTL), a national text-based mental health crisis counseling service, was used to determine how help-seeking behavior changed in the wake of each event. Wilcoxon rank sum tests assessed changes in help-seeking behavior for each event in 2020 as compared to the same period in 2019. AutoRegressive Integrated Moving Average (ARIMA) models examined if changes in crisis conversation volumes following each event differed. Higher median conversation volumes noted for the COVID-19 pandemic (+1 to +5 conversations), Hurricane Laura (+1 to +7 conversations) and the 2020 Election (+1 to +26 conversations). ARIMA models show substantial increases in help-seeking behavior following the declaration of a national emergency for the COVID-19 pandemic (+4.3 to +38.2%) and following the 2020 election (+3 to +24.44%). Our analysis found that the mental health response following social stressors may be distinct from natural events, especially when natural disasters occur in the context of multiple social stressors. This analysis adds to the growing body of literature considering the mental health impact of exposure to multiple co-occurring societal stressors, like police violence and a global pandemic.
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Affiliation(s)
- Sophia C Ryan
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA.
| | - Margaret M Sugg
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Raleigh NC, 27695, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone NC, 28607, USA
| | - Devyani Singh
- Data Team, Crisis Text Line, New York City, New York, USA
| | - Shannon Green
- Data Team, Crisis Text Line, New York City, New York, USA
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Tsiachristas A, Holland J, Guo B, Chitsabesan P, Sayal K, Abdul Pari AA. The impact of the COVID-19 pandemic on children and adolescent mental health in-patient service use in England: interrupted time-series analysis of national patient records. BJPsych Open 2024; 10:e69. [PMID: 38511352 PMCID: PMC10988600 DOI: 10.1192/bjo.2024.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/31/2023] [Accepted: 01/10/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND During the initial phases of the COVID-19 pandemic, children and young people (CYP) faced significant restrictions. The virus and mitigation approaches significantly impacted how health services could function and be safely delivered. AIMS To investigate the impact of COVID-19 lockdowns on CYP psychiatric admission trends during lockdown 1 (started 23 Mar 2020) and lockdown 2 (started 5 Nov 2020) of the COVID-19 pandemic in England. METHOD Routinely collected, retrospective English administrative data regarding psychiatric hospital admissions, length of stay and patient demographic factors were analysed using an interrupted time series analysis (ITSA) to estimate the impact of COVID-19 lockdowns 1 and 2 on service use trends. We analysed data of 6250 CYP (up to 18 years of age) using ordinary least squares (OLS) regression analysis with Newey-West standard errors to handle autocorrelation and heteroscedasticity. RESULTS Psychiatric hospital admissions for CYP significantly fell during lockdown 1, and then fell even further during lockdown 2. A greater proportion of admissions during lockdown were out of area or to independent sector units. During lockdown, the average age of CYP admitted was higher, and a greater proportion were female. There was also a significant increase in the proportion of looked-after children and CYP from the most socioeconomically deprived areas admitted during lockdown 2. CONCLUSIONS During both lockdowns, fewer CYP had psychiatric admissions. The subsequent rise in admissions for more socioeconomically deprived CYP and looked-after children suggests that these CYP may have been disproportionately affected by the pandemic, or overlooked during earlier phases.
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Affiliation(s)
- Apostolos Tsiachristas
- Nuffield Department of Primary Care Health Sciences & Department of Psychiatry, University of Oxford, UK
| | - Josephine Holland
- Mental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, UK
| | - Boliang Guo
- Mental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, UK
| | | | - Kapil Sayal
- Mental Health and Clinical Neurosciences, Institute of Mental Health, University of Nottingham, UK
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Mirzayi C, Westmoreland D, Stief M, Grov C. Depression and Anxiety Symptoms Among Cisgender Gay and Bisexual Men During the Onset of the COVID-19 Pandemic: Time Series Analysis of a US National Cohort Study. JMIR Public Health Surveill 2024; 10:e47048. [PMID: 38277213 PMCID: PMC10858417 DOI: 10.2196/47048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 11/08/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The onset of the COVID-19 pandemic in the United States in March 2020 caused a dramatic change in the way many people lived. Few aspects of daily life were left undisrupted by the pandemic's onset as well as the accompanying policies to control the spread of the disease. Previous research has found that the pandemic may have significantly impacted the mental health of lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals-potentially more so than other individuals. However, the pandemic did not affect all areas of the United States at the same time, and there may be regional variation in the impact of the onset of the pandemic on depressive symptoms among LGBTQ individuals. OBJECTIVE To assess regional variation of the impact of the pandemic, we conducted a time series analysis stratified by US geographic region to examine symptoms of depression and anxiety among a sample of primarily cisgender gay and bisexual men before and after the onset of the COVID-19 pandemic in the United States. METHODS In total, 5007 participants completed assessments as part of the Together 5000 study, an ongoing prospective cohort study. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire-4. Patient Health Questionnaire-4 scores were graphed as a function of days from March 15, 2020. Locally estimated scatterplot smoothing trend lines were applied. A sieve-bootstrap Mann-Kendall test for monotonic trend was conducted to assess the presence and direction of trends in the scatterplots. We then compared the observed trends to those observed for 1 year prior (2018-2019) to the pandemic onset using data collected from the same sample. RESULTS Significant positive trends were detected for the Northeast (P=.03) and Midwest (P=.01) regions of the United States in the 2020 assessment, indicating that symptoms of anxiety and depression were increasing in the sample in these regions immediately prior to and during the onset of the pandemic. In contrast, these trends were not present in data from the 2018 to 2019 assessment window. CONCLUSIONS Symptoms of anxiety and depression increased among the study population in the Northeast and Midwest during the beginning months of the COVID-19 pandemic, but similar increase was not observed in the South and West regions. These trends were also not found for any region in the 2018 to 2019 assessment window. This may indicate region-specific trends in anxiety and depression, potentially driven by the burden of the pandemic and policies that varied from region to region. Future studies should consider geographic variation in COVID-19 spread and policies as well as explore potential mechanisms by which this could influence the mental health of LGBTQ individuals.
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Affiliation(s)
- Chloe Mirzayi
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Drew Westmoreland
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Matthew Stief
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | - Christian Grov
- CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
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Cataldo I, Novotny D, Carollo A, Esposito G. Mental Health in the Post-Lockdown Scenario: A Scientometric Investigation of the Main Thematic Trends of Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6310. [PMID: 37444157 PMCID: PMC10341738 DOI: 10.3390/ijerph20136310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/27/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
Since the outbreak of COVID-19, researchers and clinicians have published scientific articles on the SARS-CoV-2 virus and its medical, organizational, financial, and psychological implications. However, many effects have been observed in the post-lockdown scenario. In this study, we adopted a scientometric-bibliometric approach to drawing the state of the art regarding the emotional and psychological effects of the pandemic after the lockdown. In Scopus, we found 791 papers that were subsequently analyzed using CiteSpace. The document co-citation analysis (DCA) computation generated a network of eight major clusters, each representing a central area of investigation. Specifically, one major cluster-cluster no. 1-focuses on the long-term effects of the COVID-19 pandemic and individuals' ability to develop adaptive coping mechanisms and resilience. The results allow us to frame the fields covered by researchers more precisely and the areas that still need more investigation.
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Affiliation(s)
- Ilaria Cataldo
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
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Ahmed N, Barnett P, Greenburgh A, Pemovska T, Stefanidou T, Lyons N, Ikhtabi S, Talwar S, Francis ER, Harris SM, Shah P, Machin K, Jeffreys S, Mitchell L, Lynch C, Foye U, Schlief M, Appleton R, Saunders KRK, Baldwin H, Allan SM, Sheridan-Rains L, Kharboutly O, Kular A, Goldblatt P, Stewart R, Kirkbride JB, Lloyd-Evans B, Johnson S. Mental health in Europe during the COVID-19 pandemic: a systematic review. Lancet Psychiatry 2023; 10:537-556. [PMID: 37321240 PMCID: PMC10259832 DOI: 10.1016/s2215-0366(23)00113-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions.
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Affiliation(s)
- Nafiso Ahmed
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK.
| | - Phoebe Barnett
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK; Centre for Outcomes Research and Effectiveness, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | - Anna Greenburgh
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Tamara Pemovska
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Theodora Stefanidou
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Natasha Lyons
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sarah Ikhtabi
- Division of Psychiatry, University College London, London, UK
| | - Shivangi Talwar
- Division of Psychiatry, University College London, London, UK
| | - Emma R Francis
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Samantha M Harris
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Prisha Shah
- Lived Experience Working Group, University College London, London, UK
| | - Karen Machin
- Lived Experience Working Group, University College London, London, UK
| | - Stephen Jeffreys
- Lived Experience Working Group, University College London, London, UK
| | - Lizzie Mitchell
- Lived Experience Working Group, University College London, London, UK
| | - Chris Lynch
- Lived Experience Working Group, University College London, London, UK
| | - Una Foye
- National Institute of Health and Care Research Mental Health Policy Research Unit, King's College London, London, UK
| | - Merle Schlief
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Rebecca Appleton
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Katherine R K Saunders
- National Institute of Health and Care Research Mental Health Policy Research Unit, King's College London, London, UK
| | - Helen Baldwin
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sophie M Allan
- Cambridgeshire and Peterborough National Health Service Foundation Trust, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Luke Sheridan-Rains
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | | | - Ariana Kular
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Peter Goldblatt
- Institute of Health Equity, University College London, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | | | - Brynmor Lloyd-Evans
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sonia Johnson
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
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Goh ZZS, Chan LG, Lai JY, Lee J, Lee ES, Soon WSW, Toh A, Griva K. Impact of COVID-19 on mental health and social service provision in Singapore: Learnings from a descriptive mixed-methods study for future resource planning. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:239-248. [PMID: 38904521 DOI: 10.47102/annals-acadmedsg.2022332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction COVID-19 restrictions and lockdown measures have led to impact on the mental health and social service delivery, including the rapid adoption of digital solutions to mental healthcare delivery in Singapore. This study aims to rapidly document the quantitative and qualitative impact of the pandemic restrictions on mental health and social services. Method This descriptive mixed-methods study consisted of a survey arm and a qualitative arm. Providers and clients from eligible mental health organisations and social service agencies were recruited. The respondents completed a survey on changes to their service delivery and the extent of impact of the pandemic on their clients. In-depth interviews were also conducted with representatives of the organisations and clients. Results There were 31 organisation representatives to the survey, while 16 providers and 3 clients participated in the in-depth interviews. In the survey arm, all representatives reported pivoting to remote means of delivering care during the lockdown. An increase in new client referrals and more domestic violence were reported from primary and community health partners respondents who made up 55.5% of health partners respondents. Three distinct response themes were recorded in the in-depth interviews: impact on clients, impact on service provision and impact on mental health landscape. Conclusion Two key findings are distilled: (1) mental health and social services have been challenged to meet the evolving demands brought about by the pandemic; (2) more societal attention is needed on mental health and social services. The findings indicate a necessary need for extensive studies on COVID-19 that can inform policies to build a more pandemic-resilient nation.
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Affiliation(s)
| | - Lai Gwen Chan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Psychiatry, Tan Tock Seng Hospital, Singapore
| | | | - Jimmy Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Institute of Mental Health, Singapore
| | - Eng Sing Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- National Healthcare Group Polyclinics, Singapore
| | | | - Adrian Toh
- Department of Psychology, National University of Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Perozziello A, Sousa D, Aubriot B, Dauriac-Le Masson V. Use of mental health services in the aftermath of COVID-19 waves: a retrospective study conducted in a French Psychiatric and Neurosciences University Hospital. BMJ Open 2023; 13:e064305. [PMID: 36822810 PMCID: PMC9950587 DOI: 10.1136/bmjopen-2022-064305] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic and the restrictive measures taken to prevent its propagation had profound effects on mental health and well-being, especially in children and young adults (<25 years old). This study aimed to analyse the medium and long-term impact of the COVID-19 pandemic on the use of the mental health services, by age groups and gender. DESIGN We conducted a retrospective study using the medical and administrative information system databases of patients, between 2019 and 2021. SETTING This study was conducted in the Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences. OUTCOME MEASURES We reported three indicators: the number of new patients attending outpatient clinics, the number of emergency department (ED) visits and the number of hospital admissions. METHODS We considered the weekly number of each indicator, by age groups and by gender. We also collected the reasons of ED visits and hospital admissions. The 2020 and 2021 data were compared with the same period in 2019. The evolution of the indicators over the 3 years was analysed with interrupted time-series analysis. RESULTS All three indicators showed a dramatic decrease during the first lockdown period (March 2020) especially for the youngest. In 2021, the activity resumed but without reaching its prepandemic level. Moreover, mental healthcare seeking was significantly lower since the beginning of the pandemic compared with the prepandemic period for all age groups, except for young women (<25 years old). Among them, there was a higher level of mental health services use in 2021, compared with 2019: +20% of new patients at the outpatient clinics, +39% of ED visits and+17% of hospital admissions. CONCLUSIONS The COVID-19 pandemic has had severe consequences on populations' mental health, especially among young women, which seem to persist months after the end of restrictive measures.
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Affiliation(s)
- Anne Perozziello
- Cellule épidémiologie, Groupe Hospitalier Universitaire Paris psychiatrie & neurosciences, Paris, France
| | - Daniel Sousa
- Département d'Information Médicale, Groupe Hospitalier Universitaire Paris psychiatrie & neurosciences, Paris, France
| | - Béatrice Aubriot
- DOMUS MEDICA, Groupe Hospitalier Universitaire Paris psychiatrie & neurosciences, Paris, France
| | - Valérie Dauriac-Le Masson
- Département d'Information Médicale, Groupe Hospitalier Universitaire Paris psychiatrie & neurosciences, Paris, France
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Kim J, Rao N, Collins A, Eboh T, Chugh J, Sheladia S, Naguib TH. Retrospective Study of Psychiatric Hospitalizations in a West Texas Mental Health Treatment Facility during the COVID-19 Pandemic. South Med J 2023; 116:170-175. [PMID: 36724531 PMCID: PMC9897119 DOI: 10.14423/smj.0000000000001514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The association between the coronavirus disease (COVID-19) pandemic and adverse mental health outcomes has been well documented; however, little is known about its impact in rural areas of the United States. This study aims to characterize and compare inpatient psychiatric admissions in West Texas before and during the initial months of the COVID-19 pandemic. METHODS A retrospective study was conducted using the electronic health records of 1392 inpatient psychiatric admissions from period A (March 13, 2019-July 3, 2019) to period B (March 13, 2020-July 3, 2020). RESULTS During period B, there was a significant increase in the length of stay (P < 0.01) compared with period A. The pandemic was associated with an increased history of psychiatric medication use (P < 0.01), substance use (P ≤ 0.01), and suicide risk at the time of admission (P < 0.01). Significant differences were found in employment status (P < 0.01), living situation (P < 0.01), and ethnicity (P = 0.03). CONCLUSIONS Rural communities in West Texas experienced a decrease in psychiatric hospitalizations during the beginning of the COVID-19 pandemic, followed by an increase as lockdown restrictions began to lift; this warrants further investigation into healthcare service utilization during the pandemic.
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Affiliation(s)
- Jimin Kim
- From the Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Nikita Rao
- the School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Alex Collins
- the School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Tochi Eboh
- the School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Julie Chugh
- the School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Shyam Sheladia
- the School of Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Tarek H Naguib
- the Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo
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Gao CX, McDonald LP, Hamilton MP, Simons K, Menssink JM, Filia K, Rickwood D, Rice S, Hickie I, McGorry PD, Cotton SM. Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic. Psychiatr Serv 2022:appips20220345. [PMID: 36444529 DOI: 10.1176/appi.ps.20220345] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic status, and residence in particular geographical areas. METHODS Interrupted time-series analyses were conducted by using quarterly mental health MBS service data (all young people ages 12-25 years, 2015-2020) for individual Statistical Area Level 3 areas across Australia. The data captured >22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates. RESULTS Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%-7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18-25. A decreasing trend was observed for males ages 18-25 (3.5% reduction, 95% CI=2.5%-4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status. CONCLUSIONS During 2020, young people's use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds.
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Affiliation(s)
- Caroline X Gao
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Lachlan P McDonald
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Matthew P Hamilton
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Koen Simons
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Jana M Menssink
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Kate Filia
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Debra Rickwood
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Simon Rice
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Ian Hickie
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Patrick D McGorry
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
| | - Sue M Cotton
- Centre for Youth Mental Health (Gao, Menssink, Filia, Rice, McGorry, Cotton) and Melbourne School of Population and Global Health (McDonald, Simons), University of Melbourne, Parkville, Victoria, Australia; Orygen, Parkville, Victoria, Australia (Gao, Hamilton, Menssink, Filia, Rice, McGorry, Cotton); headspace National Youth Mental Health Foundation, Melbourne (Rickwood); Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia (Rickwood); Brain and Mind, University of Sydney, Camperdown, New South Wales, Australia (Hickie)
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12
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Chen S, Wang Y, She R, Qin P, Ming WK. Disparities in the unmet mental health needs between LGBTQ+ and non-LGBTQ+ populations during COVID-19 in the United States from 21 July 2021 to 9 May 2022. Front Med (Lausanne) 2022; 9:995466. [PMID: 36425114 PMCID: PMC9679212 DOI: 10.3389/fmed.2022.995466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Evidence highlighted the likelihood of unmet mental health needs (UMHNs) among LGBTQ+ than non-LGBTQ+ populations during COVID-19. However, there lacks evidence to accurately answer to what extent the gap was in UMHN between LGBTQ+ and non-LGBTQ+ populations. We aim to evaluate the difference in UMHN between LGBTQ+ and non-LGBTQ+ during COVID-19. Methods Cross-sectional data from Household Pulse Survey between 21 July 2021 and 9 May 2022 were analyzed. LGBTQ+ was defined based on self-reported sex at birth, gender, and sexual orientation identity. UMHN was assessed by a self-reported question. Multivariable logistic regressions generated adjusted odds ratios (AODs) of UMHN, both on overall and subgroups, controlling for a variety of socio-demographic and economic-affordability confounders. Findings 81267 LGBTQ+ and 722638 non-LGBTQ+ were studied. The difference in UMHN between LGBTQ+ and non-LGBTQ+ (as reference) varied from 4.9% (95% CI 1.2-8.7%) in Hawaii to 16.0% (95% CI 12.2-19.7%) in Utah. In multivariable models, compared with non-LGBTQ+ populations, LGBTQ+ had a higher likelihood to report UMHN (AOR = 2.27, 95% CI 2.18-2.39), with the highest likelihood identified in transgender (AOR = 3.63, 95% CI 2.97-4.39); compared with LGBTQ+ aged 65+, LGBTQ+ aged 18-25 had a higher likelihood to report UMHN (AOR = 1.34, 95% CI 1.03-1.75); compared with White LGBTQ+ populations, Black and Hispanic LGBTQ+ had a lower likelihood to report UMHN (AOR = 0.72, 95% CI 0.63-0.82; AOR = 0.85, 95% CI 0.75-0.97, respectively). Interpretation During the COVID-19, LGBTQ+ had a substantial additional risk of UMHN than non-LGBTQ+. Disparities among age groups, subtypes of LGBTQ+, and geographic variance were also identified.
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Affiliation(s)
- Shanquan Chen
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Yuqi Wang
- Department of Mathematics, Imperial College London, London, United Kingdom
- Department of Computer Science, University College London, London, United Kingdom
| | - Rui She
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Shatin, Hong Kong SAR, China
| | - Pei Qin
- Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
- School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Wai-Kit Ming
- Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, MA, United States
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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13
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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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14
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Zhang P, Chen S. Association between workplace and mental health and its mechanisms during COVID-19 pandemic: A cross-sectional, population-based, multi-country study. J Affect Disord 2022; 310:116-122. [PMID: 35545153 PMCID: PMC9078935 DOI: 10.1016/j.jad.2022.05.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/20/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The COVID-19 pandemic worsens populations' mental health. However, little is known about the COVID-19-related mental health among remote workers. METHODS We retrieved data from survey of Health, Ageing and Retirement in Europe, covering 27 countries. Eligible people were those employed. The main outcome is the mental disorder, covering four aspects: depression, anxiety, sleep disorder, and loneliness. Country-specific weighted mixed models were fitted to estimate the association of workplaces with mental health, controlled for age, gender, education level, living alone, making ends meets, working hours, closing to suspected or confirmed COVID-19 cases, received anti-virus protection, social contact, disability, and chronic disease. Moderate analyses were conducted to explore possible mechanisms. RESULTS 11,197 participants were included, among them 29.3% suffered at least one worse mental disorder. After controlling for covariates, compared with those who worked at the usual workplace, those who worked at home only or part of the time did not associate with worse mental disorders (p-value ≥0.1395), and those who worked at neither the usual workplace nor home had a 55% higher likelihood of suffering from worse mental disorders (OR = 1.55, 95%CI 1.03-2.36). The mediation analyses identified three indirect pathways by which workplaces influence mental health, including making ends meets, social contact, and receiving anti-virus protection. Detailed results on subtypes of mental disorders were also provided. LIMITATIONS All assessments were self-reported, resulting in a risk of method bias. CONCLUSIONS During the COVID-19 pandemic, working at other places, neither at the usual workplace nor home, worsened mental health. Evidence provided in this study will contribute to more nuanced and practical public health policy strategy making.
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Affiliation(s)
- Pan Zhang
- Institute of Hospital Management, ZhongNan Hospital of Wuhan University, Wuhan, China.
| | - Shanquan Chen
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
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15
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Prevalence, progress, and subgroup disparities in pharmacological antidepressant treatment of those who screen positive for depressive symptoms: A repetitive cross-sectional study in 19 European countries. Lancet Reg Health Eur 2022; 17:100368. [PMID: 35373171 PMCID: PMC8969158 DOI: 10.1016/j.lanepe.2022.100368] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The European Mental Health Action Plan (EMHAP) 2013–2020 promoted community-based mental health services. One potential success indicator is the provision of antidepressant medication to those needing it. Methods Public data from two surveys (Health Survey for England, UK; Survey of Health, Ageing and Retirement in Europe) covered 19 European countries across EMHAP phases one (2011–2015) and two (2015–2018). People screening positive for depressive symptoms by self-report were included. The primary outcome was antidepressant use: using country-specific weighted regression models, we estimated temporal trends and subgroup disparities in antidepressant receipt, with secondary analysis by country-level measures including healthcare expenditure. Findings Across 37,250 participants, after controlling for age, sex, wealth, and physical disability, antidepressant use (amongst those screening positive) increased significantly in 14/19 countries, with the smallest increase being in Slovenia (adjusted OR[AOR] for trend=1.68[1.20–2.36]) and the highest increase being in Germany (AOR for trend=10.07[7.54–13.46]) and Austria (AOR for trend=10.07[7.32–13.74]). The overall proportion using antidepressants was positively associated with national health expenditure (coefficient=5.43[1.62–9.25]), but not with gross national income per capita or the number of psychiatrists, general practitioners, or psychiatric hospital beds. In 15/19 countries, antidepressants were used less by ≥65-year-olds than 50–64-year-olds, with the smallest differential reported in Luxembourg (AOR=0.70[0.49, 0.98]) and the highest in Germany (AOR=0.28[0.21, 0.37]); this disparity widened in 12/15 countries. Men used antidepressants less than women in 8/19 countries, across phases. In 13/19 countries, people with physical disability were more likely to receive antidepressants, with the smallest gap in Italy (AOR=1.42[1.12–1.80]) and the largest in Israel (AOR=2.34[1.46–3.74]); this disparity narrowed in 5/13 countries. Disparity by wealth was found in 8/19 countries, but its temporal trend varied. Interpretation Usage of antidepressants by those with depressive symptoms has increased, with wide variation between countries and subgroups. Disparities across age, sex, and disability should prompt further research. Funding Medical Research Council (grants MC_PC_17213 and MR/W014386/1), UK National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England, NIHR Cambridge Biomedical Research Centre (BRC-1215-20014).
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16
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Enrico C, Caldiroli A, Di Brita C, Colmegna F, Nava R, Colzani LC, Sibilla M, Prodi T, Buoli M, Clerici M. Profile of patients attending psychiatric emergency care during the coronavirus 2019 (COVID 19) pandemic: a comparative cross-sectional study between lockdown and post-lockdown periods in Lombardy, Italy. Int J Psychiatry Clin Pract 2022; 26:132-138. [PMID: 34151680 DOI: 10.1080/13651501.2021.1939385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the long-term impact of early COVID-19 lockdown phase on emergency psychiatric consultations in two psychiatric emergency departments located in Italy. METHODS We conducted a cross-sectional study comparing the number and characteristics of emergency psychiatric consultations during post-lockdown with respect to the lockdown period. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis, information on multiple psychiatric consultations and hospitalisation were collected. RESULTS A rise of almost 60% in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed. Emergency psychiatric consultations in the post-lockdown period were associated with lower rates of cannabis (aOR = 0.42, p = 0.011) and cocaine use (aOR = 0.39, p = 0.011). Despite a lower occurrence of two or more psychiatric consultations was observed during post-lockdown phase (aOR = 0.44, p = 0.008), subjects who had anxiety disorders (aOR = 3.91, p = 0.000) and substance intoxication or withdrawal (aOR = 6.89, p = 0.000) were more likely to present to emergency psychiatric consultations during post-lockdown period compared to the lockdown one. CONCLUSIONS Substance intoxication or withdrawal and anxiety disorders increased after the COVID-19 lockdown. The findings of this study suggest to address more economic and professional sources to the mental health areas potentially more affected by the different phases of a pandemic.KEYPOINTSCOVID-19 pandemic and lockdown measures increased mental health unmet needs.According to our findings, a rise in emergency psychiatric consultations during the post-lockdown compared to the lockdown period was observed.Patients with substance intoxication or withdrawal syndrome and anxiety disorders were significantly more likely to present to emergency psychiatric consultations during post-lockdown.Lockdown was associated with higher rates of both cannabis and cocaine use disorders as well as of multiple psychiatric consultations.Alternative strategies to improve mental health such as e-health technologies should be promoted.
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Affiliation(s)
- Capuzzi Enrico
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Carmen Di Brita
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Roberto Nava
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Lia Chiara Colzani
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Matteo Sibilla
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Tiziano Prodi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy.,Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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17
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Kim S, Yoon H, Morton P, Jang Y. Longitudinal links between behavioral activation coping strategies and depressive symptoms of U.S. adults living alone during the COVID-19 pandemic. PLoS One 2022; 17:e0267948. [PMID: 35503796 PMCID: PMC9064085 DOI: 10.1371/journal.pone.0267948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
The COVID-19 pandemic and related physical distancing measures have posed a significant threat to the mental health of adults, particularly those living alone. Accordingly, the World Health Organization implemented the #HealthyAtHome program, encouraging people to keep in regular contact with loved ones, stay physically active, and keep a regular routine. The current study aims to examine a micro-longitudinal link between behavioral activation coping strategies (exercise, meditation, relaxation, and social connection) and depressive symptoms among adults who lived alone during the COVID-19 pandemic. We used 21 biweekly waves of longitudinal data from the Understanding America Study (UAS) collected between April 2020 and February 2021 (N = 1,280). The multilevel models with correlated random effects were estimated to examine lagged effects of coping strategies (t-1) on depressive symptoms (t). The results showed that exercise was predictive of lower depressive symptoms even after controlling for time-invariant and time-varying covariates. The results showed that modifiable lifestyle factors, such as taking time to exercise, may be beneficial for the mental health of Americans living in single-person households.
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Affiliation(s)
- Seoyoun Kim
- Department of Sociology, Texas State University, San Marcos, Texas, United States of America
| | - Hyunwoo Yoon
- Department of Social Welfare, Kongju National University, Gongju, South Korea
| | - Patricia Morton
- Department of Sociology, Department of Public Health, Wayne State University, Detroit, Michigan, United States of America
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, United States of America
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18
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Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, Long D, Snell G. Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review. Child Adolesc Ment Health 2022; 27:173-189. [PMID: 34455683 PMCID: PMC8653204 DOI: 10.1111/camh.12501] [Citation(s) in RCA: 354] [Impact Index Per Article: 177.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic's global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes. METHODS We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme. RESULTS Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes. CONCLUSIONS This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.
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Affiliation(s)
- Hasina Samji
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Judy Wu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Amilya Ladak
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Caralyn Vossen
- School of Population and Global Health, McGill University, Montreal, QC, Canada
| | - Evelyn Stewart
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Mental Health and Substance Use Research Institute, Vancouver, BC, Canada
| | - Naomi Dove
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - David Long
- Division of Clinical and Behavioural Neurosciences, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Gaelen Snell
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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19
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Uthayakumar S, Tadrous M, Vigod SN, Kitchen SA, Gomes T. The effects of COVID-19 on the dispensing rates of antidepressants and benzodiazepines in Canada. Depress Anxiety 2022; 39:156-162. [PMID: 34843627 PMCID: PMC9015529 DOI: 10.1002/da.23228] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Population studies have shown that rates of depressive and anxious symptoms have increased as a result of COVID-19. We analyzed trends in the dispensing rates of antidepressants and benzodiazepines in Canada to determine whether the pandemic has caused changes in rates of pharmacological treatment for depression and anxiety. METHODS We conducted a population-based, cross-sectional time-series analysis of antidepressants and benzodiazepines dispensed monthly by Canadian community pharmacies between January 2017 and December 2020. We used March 2020 as the intervention month to determine if there were any significant changes in the national rate of antidepressant and benzodiazepine tablets dispensed as the result of the COVID-19 pandemic. RESULTS There was a temporary reduction in the dispensing rate of antidepressants in April 2020 (from 489 tablets per 100 in March 2020 to 356 tablets per 100 in April 2020; p ≤ .0001); however, the rate returned to its previous level by August 2020. There were no detectable deviations in benzodiazepine dispensing after the declaration of the state of emergency in Ontario. CONCLUSIONS Despite the increased reporting of depressive and anxious symptoms during the COVID-19 pandemic, there have been no changes in the dispensing trends of medications used to treat these disorders. As the pandemic continues to evolve, future research is needed to monitor the prevalence of depression and anxiety, and associated medication use, in the Canadian population.
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Affiliation(s)
| | - Mina Tadrous
- Leslie Dan Faculty of PharmacyUniversity of TorontoTorontoOntarioCanada,WCH Institute for Health System Solutions and Virtual CareWomen's College Research InstituteTorontoOntarioCanada,ICESTorontoOntarioCanada
| | - Simone N. Vigod
- WCH Institute for Health System Solutions and Virtual CareWomen's College Research InstituteTorontoOntarioCanada,ICESTorontoOntarioCanada,Department of PsychiatryWomen's College HospitalTorontoOntarioCanada,Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada,Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada,Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada
| | - Sophie A. Kitchen
- Li Ka Shing Knowledge Institute of St. Michael's HospitalUnity Health TorontoTorontoOntarioCanada
| | - Tara Gomes
- Leslie Dan Faculty of PharmacyUniversity of TorontoTorontoOntarioCanada,ICESTorontoOntarioCanada,Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoOntarioCanada,Li Ka Shing Knowledge Institute of St. Michael's HospitalUnity Health TorontoTorontoOntarioCanada
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20
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Zielasek J, Lehmann I, Vrinssen J, Gouzoulis-Mayfrank E. Analysis of the utilization, processes, and outcomes of inpatient mental healthcare during the first three waves of the COVID-19 pandemic in the federal state of North Rhine-Westphalia, Germany. Front Psychiatry 2022; 13:957951. [PMID: 36620689 PMCID: PMC9814723 DOI: 10.3389/fpsyt.2022.957951] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND During the first phase of the Coronavirus-19 disorder (COVID-19) pandemic in the spring of 2020, utilization of inpatient mental healthcare was significantly reduced. We now report on a long-term observational study of inpatient mental healthcare in a large psychiatric hospital association in North Rhine-Westphalia, Germany, covering the second and third pandemic waves of autumn and winter 2020 followed up until June 2021. OBJECTIVES Analysis of the changes of inpatient and day patient mental healthcare utilization in an association of psychiatric hospitals during the COVID-19 pandemic from January 2020 until June 2021. MATERIALS AND METHODS We used the statistics database of the association of the nine psychiatric hospitals of the Rhineland Regional Council (Landschaftsverband Rheinland, LVR). We compared the case numbers of the pandemic period with previous years and analyzed changes in the diagnostic spectrum, rates of coercion and therapeutic outcomes. We also analyzed age, gender, diagnoses and coercive measures of patients tested positive for COVID-19 during inpatient psychiatric healthcare. RESULTS Case rates were reduced during and after the COVID-19 pandemic episodes of 2020 and the following months of spring and summer 2021. Changes varied between diagnostic groups, and there were even increases of case numbers for acute psychotic disorders. Coercive measures increased during the pandemic, but therapeutic outcomes were maintained at the pre-pandemic level. Women and patients of higher ages were overrepresented among psychiatric inpatients with COVID-19. CONCLUSION The COVID-19 pandemic led to over during reductions of inpatient psychiatric hospital admissions and changes of the diagnostic spectrum accompanied by increased rates of coercive measures. These effects may reflect an overall increased severity of mental disorders during the COVID-19 pandemic, deferrals of inpatient admissions or a lack of outpatient mental healthcare services utilization. To differentiate and quantitate these potential factors, further studies in the general population and in the different mental healthcare sectors are needed. In order to reduce the number of COVID-19 cases in psychiatric hospitals, vaccination of people of higher ages and with dementias seem to be the most needed strategy.
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Affiliation(s)
- Jürgen Zielasek
- LVR-Institute for Healthcare Research, Cologne, Germany.,Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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21
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Beghi M, Ferrari S, Biondi L, Brandolini R, Corsini C, De Paoli G, Sant’Angelo RP, Fraticelli C, Casolaro I, Zinchuk M, Pashnin E, Urh L, Castelpietra G, Cornaggia CM. Mid-term psychiatric consequences of the COVID-19 pandemic: a 4 months observational study on emergency room admissions for psychiatric evaluation after the (first) lockdown period in Italy. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1283-1289. [PMID: 35279745 PMCID: PMC8917958 DOI: 10.1007/s00127-022-02262-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/18/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The aim of our study is to evaluate the number and the features of admissions to the emergency room (ER) requiring psychiatric consultation, in the period between May 4th and August 31st 2020. METHODS We carried out a retrospective longitudinal observational study examining the 4 months following the initial lockdown imposed during the COVID-19 outbreak (May 4th and August 31st 2020). More specifically, the ER admissions leading to psychiatric referral were reviewed at all seven public hospitals of AUSL Romagna (Emilia Romagna region, Italy). Socio-demographic variables, history of medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge, and actions taken by the psychiatrist were collected. RESULTS An 11.3% (p = 0.007) increase in psychiatric assessments was observed when compared with the same period of the previous year (2019). A positive personal history of psychiatric disorders (OR:0.68, CI: 0.53-0.87) and assessments leading to no indication for follow-up (OR: 0.22, CI: 0.13-0.39) were significantly less frequent, while there was a significant increase of cases featuring organic comorbidities (OR: 1.24, CI: 1.00-1.52) and suicidal ideation/self-harm/suicide attempt (OR: 1,71, CI: 1.19-2.45) or psychomotor agitation (OR: 1.46, CI: 1.02-2.07) as reason for admission. CONCLUSIONS Our results showed an increase in ER psychiatric consultations compared to the previous year, underlying the increased psychological distress caused by the lockdown.
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Affiliation(s)
- Massimiliano Beghi
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Piazzale Giommi, 47521, Cesena, Italy.
| | - Silvia Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Biondi
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Ravenna, Italy ,Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum, Bologna, Italy
| | - Riccardo Brandolini
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Rimini, Italy
| | - Claudia Corsini
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Ravenna, Italy
| | - Giovanni De Paoli
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Piazzale Giommi, 47521 Cesena, Italy
| | - Rosa Patrizia Sant’Angelo
- Department of Mental Health and Pathological Dependencies, AUSL Romagna, Piazzale Giommi, 47521 Cesena, Italy
| | - Carlo Fraticelli
- Department of Mental Health and Addictions, ASST Lariana, Como, Italy
| | - Ilaria Casolaro
- Department of Mental Health and Addictions, ASST Lariana, Como, Italy
| | - Mikhail Zinchuk
- Moscow Research and Clinical Centre for Neuropsychiatry, Moscow, Russian Federation
| | - Evgenii Pashnin
- Moscow Research and Clinical Centre for Neuropsychiatry, Moscow, Russian Federation
| | - Lina Urh
- School of Medicine and Surgery, University of Milano Bicocca, GSD Research and Hospital, Milan, Italy
| | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy
| | - Cesare Maria Cornaggia
- School of Medicine and Surgery, University of Milano Bicocca, GSD Research and Hospital, Milan, Italy
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22
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Wiegand HF, Bröcker AL, Fehr M, Lohmann N, Maicher B, Röthke N, Rueb M, Wessels P, de Greck M, Pfennig A, Unterecker S, Tüscher O, Walter H, Falkai P, Lieb K, Hölzel LP, Adorjan K. Changes and Challenges in Inpatient Mental Health Care During the First Two High Incidence Phases of the COVID-19 Pandemic in Germany - Results From the COVID Ψ Psychiatry Survey. Front Psychiatry 2022; 13:855040. [PMID: 35573380 PMCID: PMC9091906 DOI: 10.3389/fpsyt.2022.855040] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/15/2022] [Indexed: 01/14/2023] Open
Abstract
Psychiatric inpatient treatment, an important pillar of mental health care, is often of longer duration in Germany than in other countries. The COVID-19 pandemic called for infection prevention and control measures and thereby led to shifts in demand and inpatient capacities. The Germany-wide COVID Ψ Psychiatry Survey surveyed department heads of German psychiatric inpatient institutions. It assessed changes in utilization during the first two high incidence phases of the pandemic (spring 2020 and winter 2020/21) and also consequences for care, telemedicine experiences, hygiene measures, treatment of patients with mental illness and co-occuring SARS-CoV-2, and coercive measures in such patients. A total of n = 71 psychiatric departments (of 346 contacted) participated in the survey. The results showed a median decrease of inpatient treatment to 80% of 2019 levels and of day hospital treatment to 50% (first phase) and 70% (second phase). Reductions were mainly due to decreases in elective admissions, and emergency admissions remained unchanged or increased in 87% of departments. Utilization was reduced for affective, anxiety, personality, and addiction disorders but appeared roughly unaffected for psychotic disorders. A lack of integration of patients into their living environment, disease exacerbations, loss of contact, and suicide attempts were reported as problems resulting from reduced capacities and insufficient outpatient treatment alternatives. Almost all departments (96%) treated patients with severe mental illness and co-occurring SARS-CoV-2 infection. The majority established special wards and separate areas for (potentially) infectious patients. Telephone and video consultations were found to provide benefits in affective and anxiety disorders. Involuntary admissions of persons without mental illness because of infection protection law violations were reported by 6% of the hospitals. The survey showed high adaptability of psychiatric departments, which managed large capacity shifts and introduced new services for infectious patients, which include telemedicine services. However, the pandemic exacerbated some of the shortcomings of the German mental health system: Avoidable complications resulted from the lack of cooperation and integrated care sequences between in- and outpatient sectors and limited options for psychiatric hospitals to provide outpatient services. Preventive approaches to handle comparable pandemic situations in the future should focus on addressing these shortcomings.
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Affiliation(s)
- Hauke Felix Wiegand
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Anna-Lena Bröcker
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Mandy Fehr
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Niklas Lohmann
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Birgit Maicher
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Nikolaus Röthke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mike Rueb
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Paula Wessels
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wurzburg, Wurzburg, Germany
| | - Moritz de Greck
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Frankfurt, Frankfurt, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wurzburg, Wurzburg, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Lars Peer Hölzel
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Oberberg Parkklinik Schlangenbad, Wiesbaden Schlangenbad, Wiesbaden, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University Munich, Munich, Germany
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23
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Medium-term and peri-lockdown course of psychosocial burden during the ongoing COVID-19 pandemic: a longitudinal study on patients with pre-existing mental disorders. Eur Arch Psychiatry Clin Neurosci 2022; 272:757-771. [PMID: 34825249 PMCID: PMC8614217 DOI: 10.1007/s00406-021-01351-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
While the COVID-19 pandemic continues, patients with pre-existing mental disorders are increasingly recognized as a risk group for adverse outcomes. However, data are conflicting and cover only short time spans so far. Here, we investigate the medium-term and peri-lockdown-related changes of mental health outcomes in such patients in a longitudinal study. A cohort of 159 patients comprising all major mental disorders (ICD-10 F0-F9) were interviewed twice with the Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) to evaluate psychosocial burden, psychiatric symptoms and resilience at the end of the first (April/May 2020) and the second lockdown in Germany (November/December 2020). For the primary outcome "psychosocial burden" ratings also comprised retrospective pre-pandemic (early 2020) and very early states during the pandemic (March 2020). For all diagnostic groups, psychosocial burden varied significantly over time (p < 0.001) with an increase from the pre-pandemic to the initial phase (p < 0.001), followed by a steady decrease across both lockdowns, normalizing in November/December 2020. Female gender, high adjustment disorder symptom load at baseline and psychiatric comorbidities were risk factors for higher levels and an unfavorable course of psychosocial burden. Most psychiatric symptoms changed minimally, while resilience decreased over time (p = 0.044 and p = 0.037). The longitudinal course of psychosocial burden indicates an initial stress response, followed by a return to pre-pandemic levels even under recurrent lockdown conditions, mimicking symptoms of an adjustment disorder. Strategies for proactive, specific and continuous treatment have to address resilience capacities before their depletion in the pandemic aftermath, especially for patients with additional risk factors.
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24
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Burrows AG, Ellis AK. Psychological Impacts of COVID-19 on people with Asthma, Allergic Rhinitis and Food Allergy. Ann Allergy Asthma Immunol 2021; 129:52-61. [PMID: 34971763 PMCID: PMC8714612 DOI: 10.1016/j.anai.2021.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Alyssa G Burrows
- Allergy Research Unit, Kingston Health Sciences Center - KGH Site, Kingston, ON, Canada; Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Anne K Ellis
- Allergy Research Unit, Kingston Health Sciences Center - KGH Site, Kingston, ON, Canada; Department of Medicine, Queen's University, Kingston, ON, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada.
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25
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Chow MW, Noorthoorn EO, Wierdsma AI, van der Horst M, de Boer N, Guloksuz S, Luykx JJ. Impact of the first COVID-19 outbreak on mental health service utilisation at a Dutch mental health centre: retrospective observational study. BJPsych Open 2021; 7:e213. [PMID: 34784994 PMCID: PMC8632375 DOI: 10.1192/bjo.2021.1049] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Previous studies into mental health service utilisation during the COVID-19 pandemic are limited to a few countries or specific type of service. In addition, data on changes in telepsychiatry are currently lacking. AIMS We aimed to investigate whether the COVID-19 pandemic is associated with changes in mental health service utilisation, including telepsychiatry, and how these changes were distributed among patients with mental illness during the first COVID-19 outbreak. METHOD This retrospective study obtained routinely assessed healthcare data from a large Dutch mental healthcare institute. Data from the second quarter of 2020 (the first COVID-19 outbreak period) were compared with the pre-pandemic period between January 2018 and March 2020. Time-series analyses were performed with the quasi-Poisson generalised linear model, to examine the effect of the COVID-19 lockdown and the overall trend of mental health service utilisation per communication modality and diagnostic category. RESULTS We analysed 204 808 care contacts of 28 038 patients. The overall number of care contacts in the second quarter of 2020 remained the same as in the previous 2 years, because the number of video consultations significantly increased (B = 2.17, P = 0.488 × 10-3) as the number of face-to-face out-patient contacts significantly decreased (B = -0.98, P = 0.011). This was true for all different diagnostic categories, although this change was less pronounced in patients with psychotic disorders. CONCLUSIONS Diminished face-to-face out-patient contacts were well-compensated by the substantial increase of video consultations during the first COVID-19 outbreak in The Netherlands. This increase was less pronounced for psychotic disorders. Further research should elucidate the need for disorder-specific digital mental healthcare delivery.
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Affiliation(s)
- Man Wei Chow
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands; and Department of Translational Neuroscience, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands
| | - Eric O Noorthoorn
- Department Training of Psychiatrists, GGNet Mental Health, The Netherlands
| | - André I Wierdsma
- Department of Psychiatry, Erasmus Medical Centre, The Netherlands
| | - Marte van der Horst
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands; Department of Translational Neuroscience, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands; and Department Training of Psychiatrists, GGNet Mental Health, The Netherlands
| | - Nini de Boer
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands; and Department of Translational Neuroscience, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands; and Department of Psychiatry, Yale School of Medicine, Connecticut, USA
| | - Jurjen J Luykx
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands; Department of Translational Neuroscience, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, The Netherlands; and Department Training of Psychiatrists, GGNet Mental Health, The Netherlands
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26
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Liu KY, Howard R, Banerjee S, Comas‐Herrera A, Goddard J, Knapp M, Livingston G, Manthorpe J, O'Brien JT, Paterson RW, Robinson L, Rossor M, Rowe JB, Sharp DJ, Sommerlad A, Suárez‐González A, Burns A. Dementia wellbeing and COVID-19: Review and expert consensus on current research and knowledge gaps. Int J Geriatr Psychiatry 2021; 36:1597-1639. [PMID: 34043836 PMCID: PMC8237017 DOI: 10.1002/gps.5567] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/06/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES In response to a commissioned research update on dementia during the COVID-19 pandemic, a UK-based working group, comprising dementia researchers from a range of fields and disciplines, aimed to describe the impact of the pandemic on dementia wellbeing and identify priorities for future research. METHODS We supplemented a rapid literature search (including unpublished, non-peer reviewed and ongoing studies/reports) on dementia wellbeing in the context of COVID-19 with expert group members' consensus about future research needs. From this we generated potential research questions the group judged to be relevant that were not covered by the existing literature. RESULTS Themes emerged from 141 studies within the six domains of the NHS England COVID-19 Dementia Wellbeing Pathway: Preventing Well, Diagnosing Well, Treating Well, Supporting Well, Living Well and Dying Well. We describe current research findings and knowledge gaps relating to the impact on people affected by dementia (individuals with a diagnosis, their carers and social contacts, health and social care practitioners and volunteers), services, research activities and organisations. Broad themes included the potential benefits and risks of new models of working including remote healthcare, the need for population-representative longitudinal studies to monitor longer-term impacts, and the importance of reporting dementia-related findings within broader health and care studies. CONCLUSIONS The COVID-19 pandemic has had a disproportionately negative impact on people affected by dementia. Researchers and funding organisations have responded rapidly to try to understand the impacts. Future research should highlight and resolve outstanding questions to develop evidence-based measures to improve the quality of life of people affected by dementia.
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Affiliation(s)
- Kathy Y. Liu
- Division of PsychiatryUniversity College LondonLondonUK
| | - Robert Howard
- Division of PsychiatryUniversity College LondonLondonUK
| | | | - Adelina Comas‐Herrera
- Department of Health PolicyLondon School of Economics and Political ScienceCare Policy and Evaluation CentreLondonUK
| | - Joanne Goddard
- Economic and Social Research CouncilUK Research and InnovationSwindonUK
| | - Martin Knapp
- Department of Health PolicyLondon School of Economics and Political ScienceCare Policy and Evaluation CentreLondonUK
| | | | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care WorkforceKing's College LondonLondonUK
| | - John T. O'Brien
- Department of PsychiatryUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Ross W. Paterson
- Dementia Research CentreQueen Square UCL Institute of NeurologyUniversity College LondonLondonUK
| | - Louise Robinson
- Population Health Sciences InstituteFaculty of Medical SciencesNewcastle UniversityNewcastleUK
| | - Martin Rossor
- Dementia Research CentreQueen Square UCL Institute of NeurologyUniversity College LondonLondonUK
| | - James B. Rowe
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeUK,Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - David J. Sharp
- Department of Brain SciencesImperial College LondonLondonUK,UK Dementia Research InstituteCare Research and Technology Centre, Imperial College LondonLondonUK
| | | | - Aida Suárez‐González
- Dementia Research CentreQueen Square UCL Institute of NeurologyUniversity College LondonLondonUK
| | - Alistair Burns
- Division of Neuroscience and Experimental PsychologyThe University of ManchesterManchesterUK
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27
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McCarron RH, Swann P, Artingstall J, Burn AM, Deakin J, Ellis F, Gandamaneni PK, Griffith J, Ireland A, Leadbetter J, Man J, Mitchell S, Praseedom A, Rokkou I, Rose C, Russell G, Worsnip P, Murray GK, Thompson F. Factors in Psychiatric Admissions: Before and During the Covid-19 Pandemic. CLINICAL NEUROPSYCHIATRY 2021; 18:270-277. [PMID: 34984070 PMCID: PMC8696285 DOI: 10.36131/cnfioritieditore20210505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has impacted community mental health, but the effect on psychiatric admissions is unknown. We investigated factors contributing to acute psychiatric admissions, and whether this changed during the first UK lockdown. METHOD A retrospective case-note review study with an exploratory mixed-methods design to examine factors for psychiatric admissions following the first UK 2020 lockdown compared to the same time periods in 2019 and 2018. RESULTS Themes of psychopathology, risk, social stressors, community treatment issues, and physical health concerns were generated. The mean number of codes per case was 6.19 (s . d. = 2.43), with a mean number of categories per case of 3.73, (s. d. = 0.98). Changes in routines and isolation were common factors in the study year; accommodation and substance abuse were more prominent in the control year. Relationship stressors featured strongly in both groups. There were significantly more women (χ2(1, N = 98) = 20.80, p < 0.00001) and older adults (χ2(1, N = 98) = 8.61, p = 0.0033) in the study group than the control. Single people, compared to those in a relationship (χ2(1, N = 45) = 4.46, p = 0.035), and people with affective disorders compared to psychotic disorders ((χ2(1, N = 28) = 5.19, p = 0.023), were more likely to have a COVID-19 related admission factor. CONCLUSIONS Early stages of the COVID-19 pandemic amplified pre-existing psychosocial vulnerabilities with a disproportionate psychiatric admissions impact on the mental health of women, older adults and those with affective disorders.
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Affiliation(s)
- Robyn H McCarron
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK,Corresponding author Dr Robyn McCarron, E-mail:
| | - Peter Swann
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK, University of Cambridge, Department of Psychiatry, Cambridge, UK
| | | | - Anne-Marie Burn
- University of Cambridge, Department of Psychiatry, Cambridge, UK
| | - Julia Deakin
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Fiona Ellis
- Research Design Service East of England, National Institute of Health Research (NIHR) Research Design Service (RDS), UK
| | | | - Joannah Griffith
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Amanda Ireland
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jim Leadbetter
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Joyce Man
- University of Cambridge, Department of Psychiatry, Cambridge, UK
| | - Simon Mitchell
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Asha Praseedom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Ilyana Rokkou
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Clare Rose
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Ginny Russell
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Patricia Worsnip
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Graham K Murray
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK, University of Cambridge, Department of Psychiatry, Cambridge, UK
| | - Fiona Thompson
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Further Adaptations and Reflections by an Assertive Community Treatment Team to Serve Clients with Severe Mental Illness During COVID-19. Community Ment Health J 2021; 57:1217-1226. [PMID: 34146189 PMCID: PMC8214380 DOI: 10.1007/s10597-021-00860-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/10/2021] [Indexed: 11/25/2022]
Abstract
In September of 2020, Guan and colleagues wrote about their experience of an Assertive Community Psychiatry Program responding to the COVID-19 pandemic. We describe our own experience as an Assertive Community Treatment team in Minnesota responding to challenges of effectively and safely delivering service to clients. As the pandemic has progressed since last year, so has the literature, and updated references are highlighted. Common threads are woven between our experience, the experience of Guan and colleagues, and others to suggest the beginnings of a template to adapt services to a new post-pandemic world.
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Beghi M, Brandolini R, Biondi L, Corsini C, Fraticelli C, Sant'Angelo R, De Paoli G. Effects after the lockdown on emergency room admissions for psychiatric evaluation: An observational study from the province of Forlì-Cesena, Italy. EMERGENCY CARE JOURNAL 2021. [DOI: 10.4081/ecj.2021.9827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim was to study the number of accesses to the Emergency Room (ER) requiring psychiatric evaluation in the four months following the lockdown period for the COVID-19 outbreak (May 4th, 2020-August 31th, 2020). The study is a retrospective longitudinal observational study of the ER admissions of the Hospitals of Cesena and Forlì (Emilia Romagna region) leading to psychiatric assessment. Sociodemographic variables, history for medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge and measures taken by the psychiatrist were collected. An increase of 9.4% of psychiatric assessments was observed. The difference was more pronounced in the first two months after lockdown, with a 21.7% increase of number of ER accesses, while after two months numbers were the same as those of the year before. Admission with anxiety symptoms and history of psychiatric disorder decreased significantly. Moreover, there is an age trend with an increasing age of admission.
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Patten SB, Kutcher S, Streiner D, Gratzer D, Kurdyak P, Yatham L. Population Mental Health and COVID-19: Why Do We Know So Little? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:782-784. [PMID: 33871302 PMCID: PMC8495301 DOI: 10.1177/07067437211010523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Scott B Patten
- Department of Community Health Sciences, University of Calgary, Alberta, Canada
| | - Stanley Kutcher
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David Streiner
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - David Gratzer
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lakshmi Yatham
- The University of British Columbia, Vancouver, British Columbia, Canada
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Hansen JP, van Sas TQB, Fløjstrup M, Brabrand M, Hvolby A. The effect of the March 2020 COVID-19 lockdown on national psychiatric contacts in Denmark: An interrupted time series analysis. Brain Behav 2021; 11:e2264. [PMID: 34213091 PMCID: PMC8413741 DOI: 10.1002/brb3.2264] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/09/2021] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED The COVID-19 pandemic resulted in national lockdowns in several countries. Previous global epidemics led to an increase in the number of psychiatric patients presenting symptoms of anxiety or depression. Knowledge about the impact of early lockdown initiatives during the COVID-19 pandemic on the number of healthcare interactions is sparse. Contacts in this study include all recorded face-to-face (FTF) and virtual treatment interactions between patients and healthcare systems. AIM To investigate both the impact of the Danish lockdown event on psychiatric patients' contact with the healthcare system, stratified by type of contact (FTF or virtual) and ICD-10 diagnosis, and how acute contacts were impacted in the five regions in Denmark. METHODS An interrupted time series analysis was applied to determine the effect of the COVID-19 lockdown event on the number of contacts with psychiatric hospitals in Denmark, from February 25, 2019 to May 3, 2020. The analyses took a Box-Jenkins approach to fit an autoregressive integrated moving average (ARIMA) model. RESULTS Virtual contacts replaced most FTF contacts during the lockdown. For most patient groups, the total number of contacts did not decrease significantly. However, for adult patients diagnosed with ICD-10 F 0-10, 10-19, and 60-69 and child and adolescent patients diagnosed with F 10-19, 70-79, and 80-89, the number of contacts decreased during lockdown. The number of acute contacts with the psychiatric system decreased significantly in all regions in Denmark during lockdown. DISCUSSION The Danish healthcare system was forced to introduce innovative tele-psychiatry to mental health care during the lockdown. Disruption to service delivery was minimized because the resources were in place to sustain the transition from FTF to virtual contacts.
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Affiliation(s)
- Jens Peter Hansen
- Mental Health Department Esbjerg, University Clinic, Mental Health Services in the Region of Southern Denmark, Esbjerg, Denmark.,Centre for Mental Health Nursing and Health Research (CPS), Mental Health Services in the Region of Southern Denmark, Esbjerg, Denmark
| | - Tessa Quirina Bang van Sas
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Marianne Fløjstrup
- The Research Unit for Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark.,Department of Regional Health Research, Centre South West Jutland, University of Southern Denmark, Esbjerg, Denmark
| | - Mikkel Brabrand
- The Research Unit for Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark.,Department of Regional Health Research, Centre South West Jutland, University of Southern Denmark, Esbjerg, Denmark
| | - Allan Hvolby
- Child and Adolescent Psychiatry in the Region of Southern Denmark, Esbjerg, Denmark
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Dellazizzo L, Léveillé N, Landry C, Dumais A. Systematic Review on the Mental Health and Treatment Impacts of COVID-19 on Neurocognitive Disorders. J Pers Med 2021; 11:jpm11080746. [PMID: 34442390 PMCID: PMC8401453 DOI: 10.3390/jpm11080746] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/10/2023] Open
Abstract
Objectives. The COVID-19 pandemic has had many public health impacts, especially on vulnerable individuals including adults with neurocognitive disorders (NCD). With increasing literature, this systematic literature review aimed to address the mental health effects of COVID-19 on people with NCD in addition to examine the impact of the pandemic on treatments/resources for NCD. Methods. A literature search was conducted in the electronic databases of PubMed, PsycINFO, Web of Science and Google Scholar. Studies were included so long as they assessed the mental health or therapeutic effects of COVID-19 on NCD. Results. Among the retrieved articles, 59 met eligibility criteria. First, the pandemic and resulting self-isolation led to many detrimental effects on psychological well-being. Exacerbation and relapses of neurocognitive and behavioral symptoms were observed, as well as emergences of new psychological symptoms (i.e., depression, anxiety). Second, therapeutic and community services for individuals suffering from NCD, such as social support services and outpatient clinics, were disrupted or reduced leading to postponed appointments and evaluations, as well as reduced access to medications. These issues were somewhat palliated with the growth of telemedicine. Conclusions. This systematic review highlights the extent of the effects of the pandemic, and the topics addressed should be taken into consideration by healthcare practitioners, institutions, and policymakers to ensure that proper measures are employed to protect this population from additional harm.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Nayla Léveillé
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Clara Landry
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC H1N 3V2, Canada; (L.D.); (N.L.); (C.L.)
- Faculty of Medicine, Université de Montréal, 2900 Edouard Montpetit Blvd, Montreal, QC H3T 1J4, Canada
- Institut National de Psychiatrie Légale Philippe-Pinel, 10905 Blvd Henri-Bourassa E, Montreal, QC H1C 1H1, Canada
- Correspondence:
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Mukadam N, Sommerlad A, Wright J, Smith A, Szczap A, Solomou S, Bhome R, Thayalan R, Abrol E, Aref-Adib G, Maconick L, Aubrey-Jones D, Tugrul S, Knowles M, Menys H, Sathanandan S, Moslehi S, Huntley J, Liu K, Carlos Bazo-Alvarez J. Acute mental health presentations before and during the COVID-19 pandemic. BJPsych Open 2021; 7:e134. [PMID: 34266510 PMCID: PMC8314272 DOI: 10.1192/bjo.2021.970] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A number of community based surveys have identified an increase in psychological symptoms and distress but there has been no examination of symptoms at the more severe end of the mental health spectrum. AIMS We aimed to analyse numbers and types of psychiatric presentations to inform planning for future demand on mental health services in light of the COVID-19 pandemic. METHOD We analysed electronic data between January and April 2020 for 2534 patients referred to acute psychiatric services, and tested for differences in patient demographics, symptom severity and use of the Mental Health Act 1983 (MHA), before and after lockdown. We used interrupted time-series analyses to compare trends in emergency department and psychiatric presentations until December 2020. RESULTS There were 22% fewer psychiatric presentations the first week and 48% fewer emergency department presentations in the first month after lockdown initiated. A higher proportion of patients were detained under the MHA (22.2 v. 16.1%) and Mental Capacity Act 2005 (2.2 v. 1.1%) (χ2(2) = 16.3, P < 0.0001), and they experienced a longer duration of symptoms before seeking help from mental health services (χ2(3) = 18.6, P < 0.0001). A higher proportion of patients presented with psychotic symptoms (23.3 v. 17.0%) or delirium (7.0 v. 3.6%), and fewer had self-harm behaviour (43.8 v. 52.0%, χ2(7) = 28.7, P < 0.0001). A higher proportion were admitted to psychiatric in-patient units (22.2 v. 18.3%) (χ2(6) = 42.8, P < 0.0001) after lockdown. CONCLUSIONS UK lockdown resulted in fewer psychiatric presentations, but those who presented were more likely to have severe symptoms, be detained under the MHA and be admitted to hospital. Psychiatric services should ensure provision of care for these patients as well as planning for those affected by future COVID-19 waves.
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Affiliation(s)
- Naaheed Mukadam
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | - Andrew Sommerlad
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | | | | | | | | | - Rohan Bhome
- Camden and Islington NHS Foundation Trust, UK
| | | | - Esha Abrol
- Camden and Islington NHS Foundation Trust, UK
| | - Golnar Aref-Adib
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | - Lucy Maconick
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | | | | | | | - Helen Menys
- Camden and Islington NHS Foundation Trust, UK
| | | | | | - Jonathan Huntley
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | - Kathy Liu
- Division of Psychiatry, University College London, UK; and Camden and Islington NHS Foundation Trust, UK
| | - Juan Carlos Bazo-Alvarez
- Department of Primary Care and Population Health, University College London, UK; and School of Medicine, César Vallejo University, Peru
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Bakolis I, Stewart R, Baldwin D, Beenstock J, Bibby P, Broadbent M, Cardinal R, Chen S, Chinnasamy K, Cipriani A, Douglas S, Horner P, Jackson CA, John A, Joyce DW, Lee SC, Lewis J, McIntosh A, Nixon N, Osborn D, Phiri P, Rathod S, Smith T, Sokal R, Waller R, Landau S. Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 'lockdown' policy in 10 UK sites: a regression discontinuity in time design. BMJ Open 2021; 11:e049721. [PMID: 34039579 PMCID: PMC8159668 DOI: 10.1136/bmjopen-2021-049721] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/14/2021] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 'lockdown' policy in Spring 2020. DESIGN A regression discontinuity in time (RDiT) analysis of daily service-level activity. SETTING AND PARTICIPANTS Mental healthcare data were extracted from 10 UK providers. OUTCOME MEASURES Daily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 'lockdown' policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites. RESULTS Pooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect. CONCLUSIONS MH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.
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Affiliation(s)
- Ioannis Bakolis
- Department of Biostatistics and Health Informatics, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - David Baldwin
- Southern Health NHS Foundation Trust, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jane Beenstock
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| | - Paul Bibby
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| | | | - Rudolf Cardinal
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
- Liaison Psychiatry Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Shanquan Chen
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
| | | | - Andrea Cipriani
- Department of Psychiatry, University of Oxford Medical Sciences Division, Oxford, Oxfordshire, UK
- Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Simon Douglas
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Philip Horner
- Lancashire and South Cumbria NHS Foundation Trust, Preston, UK
| | - Caroline A Jackson
- Usher Institute of Population Health Sciences & Informatics, University of Edinburgh Division of Medical and Radiological Sciences, Edinburgh, UK
| | - Ann John
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Dan W Joyce
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sze Chim Lee
- Population Data Science, Swansea University Medical School, Swansea, UK
| | - Jonathan Lewis
- Cambridgeshire and Peterborough NHS Foundation Trust, Fulbourn, Cambridgeshire, UK
| | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh Division of Medical and Radiological Sciences, Edinburgh, UK
| | - Neil Nixon
- Division of Psychiatry and Applied Psychology, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - David Osborn
- Division of Psychiatry, University College London Faculty of Medical Sciences, London, UK
| | - Peter Phiri
- Southern Health NHS Foundation Trust, Southampton, UK
| | | | - Tanya Smith
- Oxford Health NHS Foundation Trust, Oxford, Oxfordshire, UK
| | - Rachel Sokal
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Rob Waller
- Lothian Primary Care NHS Trust, Edinburgh, UK
| | - Sabine Landau
- Department of Biostatistics and Health Informatics, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
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