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Sculco C, Bano B, Prina E, Tedeschi F, Bartucz MB, Barbui C, Purgato M, Albanese E. Access and use of general and mental health services before and during the COVID-19 pandemic: a systematic review and meta-analysis. BMJ Open 2025; 15:e091342. [PMID: 40074252 PMCID: PMC11904334 DOI: 10.1136/bmjopen-2024-091342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Accepted: 02/10/2025] [Indexed: 03/14/2025] Open
Abstract
OBJECTIVES To quantify access to health services during the COVID-19 pandemic and measure the change in use between the prepandemic and the pandemic periods in a population with assessment of psychological distress or diagnosis of mental disorders. DATA SOURCES We developed and piloted a search syntax and adapted it to enter the following databases from 1 January 2020 to 31 March 2023: PubMed/MEDLINE, PsycINFO, Web of Science, Epistemonikos and the WHO International Clinical Trials Registry Platform. We reran the searches from the end of the original search to 3 December 2024. DESIGN We systematically screened titles, abstracts and full texts of retrieved records. ELIGIBILITY CRITERIA We included observational studies on any populations and regions, covering health services such as doctor visits, hospital admissions, diagnostic examinations, pharmaceutical therapies and mental health (MH) services. Only studies using validated scales to assess psychological distress or mental disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders were included. DATA EXTRACTION AND SYNTHESIS We extracted data using a purposefully designed form and evaluated the studies' quality with the Newcastle-Ottawa Scale. We measured the incidence rate (IR) of access to health services and the IR ratio (IRR) between the prepandemic and the pandemic periods. We calculated contacts days and catchment areas in the different periods. We used the random effects DerSimonian-Laird inverse-variance model and calculated heterogeneity with statistics I² and τ². We computed pooled IR and pooled IRR and tested the hypothesis of no variation (IRR=1). RESULTS We retrieved 10 014 records and examined the full text of 580 articles. We included 136 primary studies of which 44 were meta-analysed. The IR of access to services during the pandemic was 2.59 contact months per 10 000 inhabitants (IR=2.592; 95% CI: 1.301 to 5.164). We observed a reduction of 28.5% in the use of services with negligible differences by age group and type of services (IRR=0.715; 95% CI: 0.651 to 0.785). We observed significant differences in effect sizes across studies (τ2=5.44; p<0.001 and τ2=0.090; p<0.001). CONCLUSION By considering MH, our study provides consolidated evidence and quantifies the reduction in the use of health services during the COVID-19 pandemic. PROSPERO REGISTRATION NUMBER CRD42023403778.
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Affiliation(s)
- Camilla Sculco
- Institute of Public Health, Universita della Svizzera italiana, Lugano, Ticino, Switzerland
| | - Beatrice Bano
- Institute of Public Health, Universita della Svizzera italiana, Lugano, Ticino, Switzerland
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Tedeschi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Monica Bianca Bartucz
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Emiliano Albanese
- Institute of Public Health, Universita della Svizzera italiana, Lugano, Ticino, Switzerland
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Nyquist CB, Torgersen L, David LW, Diseth TH, Magnus P, Biele GPE, Waehre A. Population-adjusted numbers, demographics and mental health among children and adolescents referred to the Norwegian National Center for Gender Incongruence over two decades. Eur Child Adolesc Psychiatry 2025; 34:647-657. [PMID: 39008097 PMCID: PMC11868193 DOI: 10.1007/s00787-024-02508-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/17/2024] [Indexed: 07/16/2024]
Abstract
Over the last decade, there has been a sharp increase in young people seeking medical treatment for gender dysphoria/gender incongruence (GD/GI). The aims of this study were to calculate yearly population-adjusted numbers of children and adolescents referred to the Norwegian National Center for Gender Incongruence (NCGI) at Oslo University Hospital (OUS) from 2000 to 2022; to describe the demographic characteristics and prevalence of psychiatric diagnoses, self-harm and suicide attempts among the referred from 2000 to 2020; and to investigate time trends. The study used data from the Gender Incongruence Registry for Children and Adolescents (GIRCA) in Norway. All persons under 18 years (n = 1258) referred to the NCGI between 2000 and 2020 were included: 68.4% assigned female gender at birth (AFAB) and 31.6% assigned male gender at birth (AMAB). We found a sharp increase in referrals to the NCGI favouring AFAB over AMAB. Nearly two in three (64.5%) had one or more registered psychiatric diagnoses. Self-harm was registered among 35.5%, and 12.7% had attempted suicide. Registered psychiatric diagnoses were significantly (p ≤ 0.001) more prevalent among AFAB (67.8%) than AMAB (57.4%). The number of registered diagnoses per person decreased significantly over time, with an average reduction of 0.02 diagnoses per person per year. Although there was a downward time trend in registered diagnoses per person, the total mental health burden among children and adolescents with GI emphasizes the need for a holistic approach.
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Affiliation(s)
- Cecilie Bjertness Nyquist
- Department of Child and Adolescent Mental Health in Hospitals, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Leila Torgersen
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Linda W David
- Department of Child and Adolescent Mental Health in Hospitals, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Trond Haaken Diseth
- Department of Child and Adolescent Mental Health in Hospitals, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Anne Waehre
- Department of Child and Adolescent Mental Health in Hospitals, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
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Cosma A, Martin G, de Looze ME, Walsh SD, Paakkari L, Bilz L, Gobina I, Page N, Hulbert S, Inchley J, Ravens-Sieberer U, Gaspar T, Stevens GWJM. Cross-National Trends in Adolescents Psychological and Somatic Complaints Before and After the Onset of COVID-19 Pandemic. J Adolesc Health 2025; 76:254-264. [PMID: 39530972 DOI: 10.1016/j.jadohealth.2024.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 08/22/2024] [Accepted: 09/24/2024] [Indexed: 11/16/2024]
Abstract
PURPOSE Building on research suggesting that the COVID-19 pandemic may have led to an exacerbation of deteriorating trends in mental health among adolescents, this paper examined trends in adolescents' psychological and somatic complaints across 35 countries from 2010 to 2022, and tested trends in sociodemographic inequalities in these outcomes between 2018 and 2022. METHODS Using data from 792,606 adolescents from 35 countries (51% girls; mean age = 13.5; standard deviation 1.6) across four Health Behaviour in School-aged Children surveys (2010, 2014, 2018, 2022), hierarchical multilevel models estimated cross-national trends in adolescent psychological and somatic complaints. We tested whether observed values in 2022 were in line with predicted values based on 2010-2018 linear trends. Finally, moderation effects of age, family affluence, and family structures on the outcomes were tested (2018-2022). RESULTS Both girls and boys showed substantially higher levels of psychological complaints in 2022 compared with the predicted values. For somatic complaints, higher levels than predicted in 2022 were observed only in girls. Moderation analyses revealed an increase from 2018 to 2022 in age gaps and a narrowing in the socioeconomic gap for both outcomes. Also, there was a widening gap between adolescents living with 2 parents and those living in a single parent household in 2022 compared to 2018. DISCUSSION Cross-national increases in adolescent psychological and somatic complaints were higher than expected in 2022, based on previous trends. Magnitudes of change varied across different sociodemographics groups, with implications for pre-existing mental health inequalities.
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Affiliation(s)
- Alina Cosma
- Department of Sociology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Trinity College Dublin, Dublin, Ireland.
| | - Gina Martin
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada; Department of Geography and Environment, Western University, London, Ontario, Canada
| | - Margreet E de Looze
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Sophie D Walsh
- Faculty of Social Sciences, Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Leena Paakkari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ludwig Bilz
- Faculty of Human Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany
| | - Inese Gobina
- Department of Public Health and Epidemiology, Riga Stradins University, Riga, Latvia; Department of Education and Research, Children's Clinical University Hospital, Riga, Latvia
| | - Nicholas Page
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, United Kingdom
| | - Sabina Hulbert
- Centre for Health Services Studies, University of Kent, Kent, United Kingdom
| | - Jo Inchley
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tania Gaspar
- Lusíada Center for Research in Social Work and Social Intervention (CLISSIS), Lusíada University of Lisbon, Lisbon, Portugal
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
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Lund IO, Jensen P, Madsen C, Hauge LJ, Havdahl A, Reneflot A, Brandlistuen R, Ask H. Patterns of psychiatric healthcare use during pandemic times among boys and girls with pre-existing diagnoses: a Norwegian nationwide primary and specialist healthcare registry study. BMC Psychiatry 2025; 25:68. [PMID: 39844080 PMCID: PMC11756222 DOI: 10.1186/s12888-024-06422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 12/18/2024] [Indexed: 01/24/2025] Open
Abstract
BACKGROUND The COVID-19 pandemic introduced complexities that were likely more demanding for some groups, such as children and adolescents, and especially those with pre-existing mental health diagnoses. This study examines long-term patterns of psychiatric healthcare use among this vulnerable group, providing insights into shifts in psychiatric healthcare use during a global health crisis. METHODS We use data from the primary and specialist healthcare registries available from the Norwegian emergency preparedness register for COVID-19 (Beredt C19) to estimate patterns of psychiatric healthcare use. The data spans 2017 to 2022, covering children and adolescents aged 6-19. We identified young people with recent diagnoses of mental health conditions and compared weekly consultation volumes before and during the pandemic for mental health conditions overall and the following diagnostic or symptom categories separately: anxiety/depression and Attention-Deficit Hyperactivity Disorders (ADHD). Analyses were stratified by gender. RESULTS There was a consistent trend of lower-than-predicted weekly healthcare consultations among young people with pre-existing mental health diagnoses in both primary and specialist healthcare during the pandemic. The reduction was more pronounced in later follow-up periods. The study highlights gender disparities, with boys experiencing more notable declines in healthcare consultations, especially in specialist care. Additionally, the time trends varied across different diagnostic groups. While consultations for anxiety/depression were consistently below the predicted levels, declines in ADHD occurred later in the pandemic. The data suggests an overall decline in healthcare use rather than a shift between sectors. CONCLUSION The findings offer insights into healthcare use during pandemic times among children and adolescents with pre-existing mental health diagnoses. The study underscores the importance of continuous monitoring and support for this group, ensuring accessible and responsive healthcare during public health emergencies.
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Affiliation(s)
- Ingunn Olea Lund
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway.
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Pia Jensen
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian Madsen
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Lars Johan Hauge
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Alexandra Havdahl
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, PROMENTA, University of Oslo, Oslo, Norway
| | - Anne Reneflot
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild Brandlistuen
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Helga Ask
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, PROMENTA, University of Oslo, Oslo, Norway
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Koet LBM, Velek P, Bindels PJE, Bohnen AM, de Schepper EIT, Gerger H. Children and young people's consultation rates for psychosocial problems between 2016 and 2021 in the Netherlands. Eur J Gen Pract 2024; 30:2357780. [PMID: 38832626 DOI: 10.1080/13814788.2024.2357780] [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: 11/03/2023] [Accepted: 05/14/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Worldwide, there are concerns about declining mental health of children and young people (CYP). OBJECTIVES To examine trends in GP consultation rates for psychosocial problems and the impact of the COVID-19 pandemic. METHODS We performed a population-based cohort study using electronic GP records of CYP (0-24 years) living in the Rotterdam metropolitan area between 2016 and 2021. We calculated monthly consultation rates for psychosocial problems, stratified by age group and sex. We used negative binomial models to model the pre-COVID-19 trend, and estimate expected rates post-COVID-19 onset. We modelled the effect of COVID-19 infection rate and school closure on consultation rates per sex and age group. RESULTS The cohort increased from 64801 to 92093 CYP between January 2016 and December 2021. Median age was 12.5 years and 49.3% was female. Monthly consultation rates increased from 2,443 to 4,542 consultations per 100,000 patient months over the six years. This trend (RR 1.009, 95%CI 1.008-1.011) started well before the COVID-19 pandemic. Consultation rates of adolescent girls and young women increased most strongly. Between March and May 2020, there was a temporary reduction in consultation rates, whereupon these returned to expected levels. COVID-19 infection rate and school closures showed small but significant associations with consultation rates for psychosocial problems but this did not affect the overall trend. Although consultation rates for psychosocial problems increased, this increment was stable over the entire study period. CONCLUSION The COVID-19 pandemic did not significantly increase consultation rates for psychosocial problems in CYP. The consultation rates increased, especially in adolescent girls and young women.
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Affiliation(s)
- Lukas B M Koet
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Premysl Velek
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Arthur M Bohnen
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Evelien I T de Schepper
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Heike Gerger
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Clinical Psychology, Open University, Heerlen, The Netherlands
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Di Lorenzo R, Cutino A, Morgante M, Panini G, Rovesti S, Filippini T, Ferri P. Psychiatric hospitalizations among adolescents during the pandemic in Italy: a retrospective study. Int J Adolesc Med Health 2024; 36:561-570. [PMID: 39425976 DOI: 10.1515/ijamh-2024-0088] [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: 06/15/2024] [Accepted: 10/03/2024] [Indexed: 10/21/2024]
Abstract
OBJECTIVES The COVID-19 pandemic has negatively impacted child and adolescent mental health. The study outcome was the evaluation of the pandemic impact on adolescents' hospitalizations in an acute psychiatric ward. METHODS With an observational and retrospective design, we collected selected variables among adolescents hospitalized in an acute psychiatric ward from 01/07/2017 to 30/06/2022. Data were statistically processed. RESULTS Our sample consisted of 118 minors with an average age of 15.7 ± 1.2 SD, mostly represented by females (61 %) and Italians (60.2 %), who made 204 hospitalizations in the study period. The admissions by years drastically decreased in 2020 concomitantly with the lockdown and increased in the first half of 2022. The admission rate was higher in winter and spring, except in 2020 when all admissions decreased (p=0.000). Females more frequently were hospitalized for suicidal behavior and acute anxiety (p=0.000) and were discharged with acute stress reactions, eating disorders, and mood disorder diagnoses (p=0.000). Differently, males more frequently were hospitalized for aggressive behavior (p=0.000) and discharged with ADHD diagnosis (p=0.000). At multiple linear regression, the duration of hospitalization (dependent variable) was negatively associated with "the pandemic period" (p=0.017) and "absent aggressive behavior" (p=0.003), and positively with "autism" diagnosis (p=0.000). CONCLUSIONS We highlighted the more stressful impact of COVID-19 pandemic on female adolescents, who required more frequently psychiatric hospitalizations due to suicidal behavior, anxiety and mood disorders.
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Affiliation(s)
| | - Anna Cutino
- Mental Health Department and Drug Abuse, ASP-Trapani, Trapani, Italy
| | - Martina Morgante
- Mental Health Department and Drug Abuse, AUSL-Modena, Modena, Italy
| | - Giulia Panini
- Mental Health Department and Drug Abuse, AUSL-Modena, Modena, Italy
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tommaso Filippini
- Department of Biomedical, Metabolic and Neural Sciences, Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Valtuille Z, Trebossen V, Ouldali N, Bourmaud A, Gandré C, Aupiais C, Katsahian S, Delorme R, Peyre H, Kaguelidou F. Pediatric Hospitalizations and Emergency Department Visits Related to Mental Health Conditions and Self-Harm. JAMA Netw Open 2024; 7:e2441874. [PMID: 39470637 PMCID: PMC11522941 DOI: 10.1001/jamanetworkopen.2024.41874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 08/29/2024] [Indexed: 10/30/2024] Open
Abstract
Importance Mental disorders among the pediatric population are a major area of public health concern. Little is known regarding changes in pediatric hospital resource use related to mental health (MH) long after the onset of the COVID-19 pandemic in March 2020. Objective To assess rates and trends of hospitalizations and emergency department (ED) visits related to MH and self-harm (SH) among children before and during the 3 years following the pandemic onset. Design, Setting, and Participants This cross-sectional study used national hospital data. The study sample included all MH- and SH-related hospitalizations and ED visits among children aged 6 to 17 years in France between January 1, 2016, to May 31, 2023. Main Outcomes and Measures Interrupted time-series analysis of monthly rates of MH- and SH-related hospitalizations and ED visits per 100 000 children was conducted to assess changes before and every year after the pandemic onset. Rate ratios (RRs) between estimated and expected rates were calculated. Results Overall, 583 244 hospitalizations (81.4% for MH and 18.6% for SH) and 432 725 ED visits (79.9% for MH and 20.1% for SH) were analyzed. The mean (SD) age of the children was 13.7 (2.9) and 14.8 (1.7) years for MH-related and SH-related hospitalizations, respectively, and 14.2 (2.6) and 14.6 (2.1) years for MH-related and SH-related ED visits, respectively. For MH-related hospitalizations, 52.6% were female and 47.4% were male; for SH-related hospitalizations, 83.1% were female and 16.9% were male. For MH-related ED visits, 62.8% were female and 37.2% were male; for SH-related ED visits, 77.4% were female and 22.6% were male. Before the pandemic, an increasing trend in all monthly rates, except that of MH-related hospitalizations, was observed. After an immediate decrease in hospitalization and ED visit rates during the initial pandemic period (March 1 to May 31, 2020), trends increased in the first 2 years following the pandemic onset and decreased thereafter. Overall, rates of MH-related hospitalizations and ED visits exceeded expected rates in only the second year after the pandemic onset, with increases of 6.0% (RR, 1.06 [95% CI, 1.05-1.06]) and 5.0% (RR, 1.05 [95% CI, 1.04-1.05]), respectively. However, rates of hospitalizations and ED visits for behavioral syndromes (mainly eating and sleeping disorders) persistently exceeded expected rates, with increases of 29.0% (RR, 1.29 [95% CI, 1.25-1.34]) and 26.0% (RR, 1.26 [95% CI, 1.21-1.31]) in the third year, respectively. Likewise, rates of SH-related hospitalizations and ED visits persistently rose above expected rates, with increases of 29.0% (RR, 1.29 [95% CI, 1.26-1.32]) and 43.0% (RR, 1.43 [95% CI, 1.40-1.47]) in the third year, respectively. Conclusions and Relevance In this cross-sectional study, persistent increases in the use of hospital resources to treat eating and sleeping disorders and intentional SH among pediatric patients were observed long after the onset of the COVID-19 pandemic. These findings warrant future research to identify persistent stress factors in children.
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Affiliation(s)
- Zaba Valtuille
- Center of Clinical Investigations, INSERM CIC1426, Robert Debré University Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP) Nord, Paris, France
- URP7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris Cité University, Paris, France
| | - Vincent Trebossen
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, AP-HP Nord, Paris Cité University, Paris, France
| | - Naim Ouldali
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, AP-HP Nord, Paris Cité University, Paris, France
| | - Aurélie Bourmaud
- Clinical Epidemiology Unit, INSERM CIC1426, Robert Debré University Hospital, AP-HP Nord, Paris, France
- UMR-S 1123, Épidémiologie Clinique et Évaluation Économique Appliqué aux Populations Vulnérables, Paris Cité University, Paris, France
| | - Coralie Gandré
- Department of Medical Informatics, Robert Debré University Hospital, AP-HP Nord, Paris, France
- Institute for Research and Information in Health Economics, Paris, France
| | - Camille Aupiais
- UMR-S 1123, Épidémiologie Clinique et Évaluation Économique Appliqué aux Populations Vulnérables, Paris Cité University, Paris, France
- Department of Pediatric Emergency Care, AP-HP Hôpital Jean-Verdier, Seine- Saint-Denis, France
| | - Sandrine Katsahian
- Unité de Recherche Clinique, AP-HP Hôpital Européen Georges Pompidou, AP-HP Centre, Paris, France
- HeKA Team, INRIA, INSERM CIC1218-Epidémiologie Clinique, Université Paris Cité, Paris, France
| | - Richard Delorme
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, AP-HP Nord, Paris Cité University, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Hugo Peyre
- Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, AP-HP Nord, Paris Cité University, Paris, France
- CESP, INSERM U1178, Centre de Recherche en Épidémiologie et Santé des Populations, Villejuif, France
| | - Florentia Kaguelidou
- Center of Clinical Investigations, INSERM CIC1426, Robert Debré University Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP) Nord, Paris, France
- URP7323 Perinatal and Pediatric Pharmacology and Therapeutic Assessment, Paris Cité University, Paris, France
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Freeman SJ, Nisenbaum R, Jegathesan T, Sgro MD. Healthcare visits for new neurodevelopmental problems before and during the COVID-19 pandemic. Pediatr Res 2024; 96:1364-1368. [PMID: 38796534 DOI: 10.1038/s41390-024-03279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/11/2024] [Accepted: 05/06/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND The COVID-19 pandemic disrupted healthcare delivery. We hypothesized that children with neurodevelopmental problems would have reduced healthcare utilization during the pandemic compared to before the pandemic. METHODS We conducted a population-based study of healthcare visits for new neurodevelopmental problems among children ages 0-6 years in Ontario, Canada. Our outcome measure was rate per 1000 children-months for healthcare visits for new neurodevelopmental problems. We compared changes in monthly rates before and during the pandemic using interrupted time series analysis (ITSA). RESULTS The rate of new neurodevelopmental problems before the pandemic was 6.31 per 1000 children-months and during the pandemic was 6.58 per 1000 children-months. However, using ITSA, there were no differences in monthly rates of healthcare visits for new neurodevelopmental problems before and during the pandemic. The observed rate during the first 30 days of the pandemic dropped to 3.40 per 1000 children-months. CONCLUSION We found no significant difference in rates of healthcare visits for new neurodevelopmental problems before and during the pandemic. There was a decrease in the number of visits during the first 30 days of the pandemic compared to all months prior. IMPACT This study found no significant difference in rates of healthcare visits for new neurodevelopmental problems before and during the pandemic. There was a decrease in the number of visits during the first 30 days of the pandemic compared to all months prior. This study adds information on healthcare access for children during the COVID-19 pandemic. The rapid deployment of virtual healthcare delivery in Ontario, Canada may explain the fast recovery of healthcare utilization for children with neurodevelopmental problems.
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Affiliation(s)
- Sloane J Freeman
- Women and Children's Health Program, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Thivia Jegathesan
- Women and Children's Health Program, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michael D Sgro
- Women and Children's Health Program, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
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9
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Di Lorenzo R, Bonasegla P, Bardelli Canzio A, Morgante M, Rovesti S, Ferri P. Adolescents Hospitalized in an Acute Psychiatric Ward: The Difference between Males and Females in the Pre- and Pandemic/Post-Pandemic Periods. J Clin Med 2024; 13:4658. [PMID: 39200799 PMCID: PMC11355395 DOI: 10.3390/jcm13164658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/05/2024] [Accepted: 08/07/2024] [Indexed: 09/02/2024] Open
Abstract
(1) Background: The pandemic lowered by 10% the psychological wellness among adolescents worldwide. (2) Methods: This observational retrospective study compared the demographic and clinical variables of male and female adolescents hospitalized in an acute psychiatric ward during the pre-pandemic, from 1 July 2017 to 28 February 2020, and the pandemic/post-pandemic, from 1 March 2020 to 30 June 2023. (3) Results: In total, 153 adolescents of 15.8 years on average (±1.14 DS) were more frequently hospitalized (n = 131, 54.4%) in the pre-pandemic than in the pandemic/post-pandemic (n = 110, 45.6%), but female hospitalizations increased in the post-pandemic more than male hospitalizations (62.9% vs. 37.1%) (Pearson Chi2 = 8.54, p = 0.003); in the pandemic/post-pandemic, we reported increased aggressive behavior and schizophrenia spectrum and emotional disorders in males, whereas in females, depressive and emotional disorders were prevalent; more adolescents previously treated in Child Mental Health Services were hospitalized in the pandemic/post-pandemic period; and males hospitalized in the study period reported higher Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) scores. (4) Conclusions: In the pandemic/post-pandemic, females more frequently required hospitalizations for depressive behavior and males for aggressive behavior and schizophrenia spectrum disorders, whereas, in both males and females, hospitalizations due to emotional disorders increased. Our results suggest the need for mental health prevention in adolescents, who represent the most vulnerable population in the case of disaster.
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Affiliation(s)
- Rosaria Di Lorenzo
- Mental Health Department and Drug Abuse, AUSL-Modena, 41121 Modena, Italy;
| | - Pietro Bonasegla
- School of Specialization in Psychiatry, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | | | - Martina Morgante
- Mental Health Department and Drug Abuse, AUSL-Modena, 41121 Modena, Italy;
| | - Sergio Rovesti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.R.); (P.F.)
| | - Paola Ferri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (S.R.); (P.F.)
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10
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Pettersen JH, Hannigan LJ, Gustavson K, Lund IO, Pearson RM, Jensen P, Nesvåg R, Brandlistuen RE, Ask H. COVID-19 Pandemic Quarantines and Mental Health Among Adolescents in Norway. JAMA Netw Open 2024; 7:e2422189. [PMID: 38995642 PMCID: PMC11245726 DOI: 10.1001/jamanetworkopen.2024.22189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/15/2024] [Indexed: 07/13/2024] Open
Abstract
Importance Adolescence is a critical developmental phase when mental health disorders, such as anxiety and depression, often emerge. Stringent public health measures and quarantine mandates during the COVID-19 pandemic could threaten adolescent mental health. Objective To investigate the associations of public health measures and quarantine experiences with mental distress among Norwegian adolescents and to explore if certain vulnerability factors moderate these associations. Design, Setting, and Participants This longitudinal cohort study used repeated measures to capture variations in mental distress explained by the stringency of public health measures and quarantine experiences. Data from the Norwegian Mother, Father, and Child cohort study were linked to national health registries and a national stringency index from April 1, 2020, to February 17, 2021. Participant included 7787 Norwegian adolescents aged 16 to 18 years. Data were analyzed from October 2022 to October 2023. Exposures Stringency index of public health measures and quarantine experiences including recent quarantine (within the last 2 weeks) and quarantine frequency (cumulative number of quarantine episodes). Main Outcome and Measures Mental distress was measured using the Hopkins Symptom Checklist across 6 data collection waves. Results In this study, 7787 participants were included in the analysis (4473 female [57%]; mean [SD] age, 17.0 [0.6] years). Stringent public health measures (β = 0.18; SE, 0.02; P < .001), recent quarantine (β = 0.11; SE, 0.02; P < .001), and frequent quarantine (β = 0.08; SE, 0.01; P < .001) were associated with higher levels of mental distress. The associations between public health measures and mental distress were not moderated by sex, age, prepandemic anxiety or depression, or genetic liability for mental health conditions. Frequency of quarantine appeared to be more strongly associated with mental distress among younger adolescents (β = -0.04; SE, 0.01; P = .008), those with parents with lower education (β = -0.04; SE, 0.01; P = .007), and those with lower genetic risk for depression (β = -0.03; SE, 0.01; P = .006). Conclusions and Relevance In this study, younger adolescents, those with parents with lower education, or those with low genetic liability for depression appeared more vulnerable when being quarantined several times. These findings emphasize the need for targeted support strategies to better protect adolescent well-being during future crises. Adolescents who experienced increased mental distress during the COVID-19 pandemic may be at risk of continued mental health problems and in need of ongoing support.
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Affiliation(s)
- Johanne H. Pettersen
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Laurie J. Hannigan
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kristin Gustavson
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Children and Families, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingunn O. Lund
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Rebecca M. Pearson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Department of Psychology, Manchester Metropolitan University, Bristol, Untied Kingdom
| | - Pia Jensen
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ragnar Nesvåg
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ragnhild E. Brandlistuen
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- The Norwegian Mother, Father, and Child Cohort Study (MoBa), Norwegian Institute of Public Health, Oslo, Norway
| | - Helga Ask
- PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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11
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Francia L, De Giorgi R, Lara E, del Castellar BD, Castelletti C, Rodríguez-Prada C, Domènech-Abella J, Olaya B, Haro JM, Ayuso Mateos JL. Treatment coverage for depression in the general Spanish population and the impact of the Covid-19 pandemic. Heliyon 2024; 10:e32594. [PMID: 38961986 PMCID: PMC11219982 DOI: 10.1016/j.heliyon.2024.e32594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Background Despite the availability of effective antidepressant strategies, numerous people with depressive disorders remain untreated. The Covid-19 pandemic has affected healthcare services, especially the mental health sector. This study aims to explore the coverage of depression treatments in the general Spanish population and the impact of the Covid-19 pandemic. Methods We used longitudinal data (2018 and 2022) from the general Spanish population: pre-pandemic n = 1512; mean age = 65.43 years ± 14.90; 56 % females; post-pandemic n = 909; mean age = 68.00 years ± 14.24; 54 % women. The International Classification of Disease 10th edition was used to diagnose lifetime depressive episodes and severity. We explored psychological and pharmacological treatment coverage via multiple logistic regressions adjusted for 4 covariates (sex assigned at birth, education level, age, Covid-19 pandemic) for participants with a diagnosis of depression. Results Treatment coverage for depression in the pre-pandemic and post-pandemic samples was, respectively, 53.3 % and 51.9 %. We observed an association between severe depression and treatment coverage (OR = 2.77, 95%CI 1.05 to 7.75). We found no association between the COVID-19 pandemic and treatment coverage. Conclusions The pharmacological treatment coverage was associated with severe types of depression. The prevalence rates of treatment coverage were similar in the pre- and post-COVID-19 pandemic attesting to the resilience of the mental health system in Spain.
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Affiliation(s)
- Lea Francia
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Riccardo De Giorgi
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, X3 7JX, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
| | - Elvira Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Blanca Dolz del Castellar
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Chiara Castelletti
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Cristina Rodríguez-Prada
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Joan Domènech-Abella
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Unitat de Recerca Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Beatriz Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Unitat de Recerca Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Unitat de Recerca Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso Mateos
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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12
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Silva-Valencia J, Lapadula C, Westfall JM, Gaona G, de Lusignan S, Kristiansson RS, Ling ZJ, Goh LH, Soto-Becerra P, Cuba-Fuentes MS, Wensaas KA, Flottorp S, Baste V, Chi-Wai Wong W, Pui Ng AP, Ortigoza A, Manski-Nankervis JA, Hallinan CM, Zingoni P, Scattini L, Heald A, Tu K. Effect of the COVID-19 pandemic on mental health visits in primary care: an interrupted time series analysis from nine INTRePID countries. EClinicalMedicine 2024; 70:102533. [PMID: 38495523 PMCID: PMC10940140 DOI: 10.1016/j.eclinm.2024.102533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/19/2024] Open
Abstract
Background The COVID-19 pandemic impacted mental health disorders, affecting both individuals with pre-existing conditions and those with no prior history. However, there is limited evidence regarding the pandemic's impact on mental health visits to primary care physicians. The International Consortium of Primary Care Big Data Researchers (INTRePID) explored primary care visit trends related to mental health conditions in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden, and the USA. Methods We conducted an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021. Sub-group analysis considered service type (in-person/virtual) and six categories of mental health conditions (anxiety/depression, bipolar/schizophrenia/other psychotic disorders, sleep disorders, dementia, ADHD/eating disorders, and substance use disorder). Findings Mental health visit rates increased after the onset of the pandemic in most countries. In Argentina, Canada, China, Norway, Peru, and Singapore, this increase was immediate ranged from an incidence rate ratio of 1·118 [95% CI 1.053-1.187] to 2.240 [95% CI 2.057-2.439] when comparing the first month of pandemic with the pre-pandemic trend. Increases in the following months varied across countries. Anxiety/depression was the leading reason for mental health visits in most countries. Virtual visits were reported in Australia, Canada, Norway, Peru, Sweden, and the USA, accounting for up to 40% of the total mental health visits. Interpretation Findings suggest an overall increase in mental health visits, driven largely by anxiety/depression. During the COVID-19 pandemic, many of the studied countries adopted virtual care in particular for mental health visits. Primary care plays a crucial role in addressing mental ill-health in times of crisis. Funding Canadian Institutes of Health Research grant #173094 and the Rathlyn Foundation Primary Care EMR Research and Discovery Fund.
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Affiliation(s)
- Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Peru
| | - Carla Lapadula
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Zheng Jye Ling
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - William Chi-Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Angela Ortigoza
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christine Mary Hallinan
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Zingoni
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Luciano Scattini
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Adrian Heald
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, UK
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, Ontario, Canada
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13
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Martinsen K, Lisøy C, Wentzel-Larsen T, Neumer SP, Rasmussen LMP, Adolfsen F, Sund AM, Ingul JM. School children's mental health during the COVID-19 pandemic. Front Psychol 2024; 14:1290358. [PMID: 38327509 PMCID: PMC10848797 DOI: 10.3389/fpsyg.2023.1290358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/13/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction The COVID-19 pandemic significantly impacted the daily routines of children, with social distancing and quarantine leading to reduced social interactions and potential increased conflicts within families. These factors can increase the risk for anxiety and depression while reducing overall quality of life. Methods Our study included 1843 school children aged 8 to 12 from 56 schools over a 2.5-year period before and during the pandemic. This multi-wave cross-sectional study utilized baseline data from an optimization trial of an indicated preventive intervention. The main outcomes were self-reported symptoms of anxiety and depression, and quality of life was the secondary outcome measure. Furthermore, responses to COVID-relevant questions were measured using a self-composed scale. Our objectives were to compare anxiety and depression symptom levels between cohorts of children who participated in the study before and during the pandemic, to examine if anxiety or depression predicted the COVID response, and whether anxiety and depression and subtypes of anxiety had an impact on quality of life during the pandemic. Linear regression and interaction models were used to examine relevant associations. Results Levels of anxiety and depression were higher in all waves compared to pre-pandemic levels. Quality of life was lower during the pandemic than before the pandemic, particularly among children with generalized anxiety symptoms. Quality of life was negatively associated with loneliness. Discussion Our study revealed that children reported higher anxious and depressive symptoms during the pandemic compared to pre-pandemic levels, as well as reduced quality of life. Lockdowns and restrictions may have contributed to this burden. Additionally, self-reported loneliness was a significant possible consequence of the restrictive measures imposed on children during the pandemic. Additional research is needed to investigate the long-term effects of the pandemic on children, particularly regarding the stability of elevated levels of anxiety and depression. Such studies could examine whether these conditions are indicative of a trajectory toward more severe internalizing disorders.Clinical trial registration: NCT04263558.
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Affiliation(s)
- Kristin Martinsen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Carina Lisøy
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Tore Wentzel-Larsen
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Simon-Peter Neumer
- Regional Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Lene-Mari Potulski Rasmussen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Frode Adolfsen
- Regional Centre for Child and Youth Mental Health and Child Welfare - North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Jo Magne Ingul
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
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14
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Barbieri V, Wiedermann CJ, Piccoliori G, Mahlknecht A, Plagg B, Ausserhofer D, Ravens-Sieberer U, Engl A. Evolution of Youth's Mental Health and Quality of Life during the COVID-19 Pandemic in South Tyrol, Italy: Comparison of Two Representative Surveys. CHILDREN (BASEL, SWITZERLAND) 2023; 10:895. [PMID: 37238443 PMCID: PMC10217242 DOI: 10.3390/children10050895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has led to an increase in youth mental health problems worldwide. Studies have revealed substantial variation in the incidence of these problems across different regions. Longitudinal studies of children and adolescents in Italy are lacking. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health in Northern Italy by comparing surveys conducted in June 2021 and in March 2022. METHODS A representative, large cross-sectional, online survey investigated HRQoL, psychosomatic complaints, and symptoms of anxiety and depression among 5159 and 6675 children and adolescents in 2021 and 2022, respectively, using the KIDSCREEN-10 index, HBSC symptom checklist, SCARED, CES-DC, and PHQ-2 instruments. Statistical analyses included a multivariate linear regression analysis. RESULTS Baseline characteristics showed significant differences in demographic variables between the two surveys. Girls and their parents reported a significantly lower HRQoL in 2021 than in 2022. Psychosomatic complaints differed significantly between sexes, and the results showed no decrease in psychosomatic complaints, anxiety, or depression between 2021 and 2022. Predictors of HRQoL, anxiety, depressive symptoms, and psychosomatic complaints in 2022 differed from those in 2021. CONCLUSIONS The characteristics of the 2021 pandemic, including lockdowns and home schooling, may have contributed to the differences between the two surveys. As most pandemic restrictions ended in 2022, the results confirm the need for measures to improve the mental and physical health of children and adolescents after the pandemic.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, 6060 Hall, Austria
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
- Faculty of Education, Free University of Bolzano, 39100 Bolzano, Italy
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
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15
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Kaess M, Hoekstra PJ. Child and adolescent psychiatry in the post-COVID era: lessons learned and consequences for the future. Eur Child Adolesc Psychiatry 2023; 32:917-919. [PMID: 37095372 PMCID: PMC10124699 DOI: 10.1007/s00787-023-02208-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany.
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry and Accare Child Study Center, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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16
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Rotevatn TA, Nygård K, Espenhain L, Legarth R, Møller KL, Sarvikivi E, Helve O, Aspelund G, Ersson A, Nordahl M, Greve-Isdahl M, Astrup E, Johansen TB. When schools were open for in-person teaching during the COVID-19 pandemic - the nordic experience on control measures and transmission in schools during the delta wave. BMC Public Health 2023; 23:62. [PMID: 36624496 PMCID: PMC9828373 DOI: 10.1186/s12889-022-14906-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Extensive measures to control spread of SARS-CoV-2 have led to limited access to education for millions of children and adolescents during the COVID-19 pandemic. Education and access to schools is vital for children and adolescents' learning, health, and wellbeing. Based on high vaccine uptake and low incidence levels, the Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) decided to start the academic year 2021/22 with schools open for in-person teaching and moderate mitigation measures. We describe trends in SARS-CoV-2 infections and vaccination coverage among students during the first 12 weeks of the fall semester. METHODS In this multinational, retrospective, observational study, we have used surveillance and registry data from each of the Nordic countries to describe vaccine uptake (≥12 years), infection incidence (whole population) and transmission of SARS-CoV-2 among students. The study period, week 30 to 41 (Jul 26th - Oct 17th), represents the autumn semester from immediately before school started until fall break. In addition, we collected information on mitigation measures applied by the respective countries. RESULTS There were slight variations between the countries regarding existing infection prevention and control (IPC) measures, testing strategies and vaccination start-up among adolescents. All countries had high vaccine uptake in the adult population, while uptake varied more in the younger age groups. Incidence in the school-aged population differed between countries and seemed to be influenced by both vaccine uptake and test activity. Infection clusters among school-aged children were described for Denmark and Norway, and the number of clusters per week reflected the incidence trend of the country. Most events consisted of only 1-2 cases. Larger clusters appeared more frequently in the higher grades in Norway and in lower grades in Denmark. CONCLUSION Data from the Nordic countries indicate that vaccination of adults and adolescents, in addition to mitigation measures, enabled full in-person learning. As SARS-CoV-2 infection does not represent a severe medical risk for most children as previously thought, measures targeting this group should be carefully adjusted and kept at a minimum. Our data add to the evidence on incidence and transmission of SARS-CoV-2 among students in schools open for in-person teaching, and may be valuable for decision makers worldwide.
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Affiliation(s)
| | - Karin Nygård
- Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | - Emmi Sarvikivi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Otto Helve
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Annika Ersson
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Marie Nordahl
- The Public Health Agency of Sweden, Stockholm, Sweden
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Grøsland M, Larsen VB, Reneflot A, Hart RK. The COVID-19 pandemic's impact on mental health care use among Norwegian students in higher education: a nation-wide register-based pre-post cohort study. BMC Health Serv Res 2022; 22:1506. [PMID: 36496405 PMCID: PMC9736720 DOI: 10.1186/s12913-022-08816-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/09/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic, and its associated social distancing measures, gave profound changes to the everyday and academic life of students in higher education. The current study is the first to use nation-wide data to evaluate the long-term effect of the pandemic and its countermeasures on university students' mental health care use. METHODS Using nation-wide individual-level data, we studied mental health consultations in primary care (data available from January 2017 to February 2022) and dispensed prescription drugs used to treat anxiety, depression, and sleep disturbances (data available from October 2018 to February 2021) for first-year undergraduate university students. We compared changes over time in mental health care use in a pandemic cohort (12,501 first-year students enrolled in 2019) to the same change in a pre-pandemic cohort (25,990 first-year students enrolled in 2017 and 2018). Event study and difference-in-difference models allowed us to separate the impact of the pandemic, experienced by the pandemic cohort only, from secular and seasonal changes experienced by all cohorts. RESULTS The percentage of students with a mental health consultation temporarily decreased during the first period of strict social distancing measures in March 2020. At the end of the second round with strict measures in April 2021, the level of mental health consultations increased by 73% (95% CI 40-106.3). There was also a 42% (95% CI 5.7-79.5) increase in mental health consultations in November 2021. No similar increases were observed for dispensed prescription drugs between March 2020 and February 2021. CONCLUSIONS The COVID-19 pandemic was associated with increases in mental health consultations in primary care among students, especially during/after longer periods of strict social distancing measures. The benefits of social distancing measures in future pandemic preparedness should be weighed against the cost of potentially worsening mental health in vulnerable groups.
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Affiliation(s)
- Mari Grøsland
- Division for Health Services, Cluster for Health Services Research, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213, Oslo, Norway.
| | - Vilde Bergstad Larsen
- Division for Health Services, Cluster for Health Services Research, Norwegian Institute of Public Health, Postboks 222, Skøyen, 0213, Oslo, Norway
| | - Anne Reneflot
- Department for Mental Health and Suicide, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rannveig Kaldager Hart
- Department for Health and Inequality and Centre for Evaluation of Public Health Measures, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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Gutiérrez-Sacristán A, Serret-Larmande A, Hutch MR, Sáez C, Aronow BJ, Bhatnagar S, Bonzel CL, Cai T, Devkota B, Hanauer DA, Loh NHW, Luo Y, Moal B, Ahooyi TM, Njoroge WFM, Omenn GS, Sanchez-Pinto LN, South AM, Sperotto F, Tan ALM, Taylor DM, Verdy G, Visweswaran S, Xia Z, Zahner J, Avillach P, Bourgeois FT. Hospitalizations Associated With Mental Health Conditions Among Adolescents in the US and France During the COVID-19 Pandemic. JAMA Netw Open 2022; 5:e2246548. [PMID: 36512353 PMCID: PMC9856226 DOI: 10.1001/jamanetworkopen.2022.46548] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/21/2022] [Indexed: 12/15/2022] Open
Abstract
Importance The COVID-19 pandemic has been associated with an increase in mental health diagnoses among adolescents, though the extent of the increase, particularly for severe cases requiring hospitalization, has not been well characterized. Large-scale federated informatics approaches provide the ability to efficiently and securely query health care data sets to assess and monitor hospitalization patterns for mental health conditions among adolescents. Objective To estimate changes in the proportion of hospitalizations associated with mental health conditions among adolescents following onset of the COVID-19 pandemic. Design, Setting, and Participants This retrospective, multisite cohort study of adolescents 11 to 17 years of age who were hospitalized with at least 1 mental health condition diagnosis between February 1, 2019, and April 30, 2021, used patient-level data from electronic health records of 8 children's hospitals in the US and France. Main Outcomes and Measures Change in the monthly proportion of mental health condition-associated hospitalizations between the prepandemic (February 1, 2019, to March 31, 2020) and pandemic (April 1, 2020, to April 30, 2021) periods using interrupted time series analysis. Results There were 9696 adolescents hospitalized with a mental health condition during the prepandemic period (5966 [61.5%] female) and 11 101 during the pandemic period (7603 [68.5%] female). The mean (SD) age in the prepandemic cohort was 14.6 (1.9) years and in the pandemic cohort, 14.7 (1.8) years. The most prevalent diagnoses during the pandemic were anxiety (6066 [57.4%]), depression (5065 [48.0%]), and suicidality or self-injury (4673 [44.2%]). There was an increase in the proportions of monthly hospitalizations during the pandemic for anxiety (0.55%; 95% CI, 0.26%-0.84%), depression (0.50%; 95% CI, 0.19%-0.79%), and suicidality or self-injury (0.38%; 95% CI, 0.08%-0.68%). There was an estimated 0.60% increase (95% CI, 0.31%-0.89%) overall in the monthly proportion of mental health-associated hospitalizations following onset of the pandemic compared with the prepandemic period. Conclusions and Relevance In this cohort study, onset of the COVID-19 pandemic was associated with increased hospitalizations with mental health diagnoses among adolescents. These findings support the need for greater resources within children's hospitals to care for adolescents with mental health conditions during the pandemic and beyond.
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Affiliation(s)
| | - Arnaud Serret-Larmande
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
- Department of Biostatistics and Biomedical Informatics, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris-Cité, Paris, France
| | - Meghan R Hutch
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Carlos Sáez
- Biomedical Data Science Lab, Instituto Universitario de Tecnologías de la Información y Comunicaciones, Universitat Politècnica de València, València, Spain
| | - Bruce J Aronow
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Surbhi Bhatnagar
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Clara-Lea Bonzel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Tianxi Cai
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Batsal Devkota
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - David A Hanauer
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor
| | - Ne Hooi Will Loh
- Department of Anaesthesia, National University Health System, Singapore
| | - Yuan Luo
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Bertrand Moal
- Unité Informatique et Archivistique Médicale, Bordeaux University Hospital, Bordeaux, France
| | - Taha Mohseni Ahooyi
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Wanjiku F M Njoroge
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Gilbert S Omenn
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor
| | - L Nelson Sanchez-Pinto
- Department of Pediatrics (Critical Care), Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Andrew M South
- Department of Pediatrics-Section of Nephrology, Brenner Children's, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Francesca Sperotto
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amelia L M Tan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Deanne M Taylor
- Department of Biomedical and Health Informatics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Guillaume Verdy
- Unité Informatique et Archivistique Médicale, Bordeaux University Hospital, Bordeaux, France
| | - Shyam Visweswaran
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Zongqi Xia
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Janet Zahner
- Department of Information Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
| | - Florence T Bourgeois
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Mattiuzzi C, Lippi G. The Global Impact of COVID-19 on Threat Appraisals. Healthcare (Basel) 2022; 10:healthcare10091718. [PMID: 36141329 PMCID: PMC9498705 DOI: 10.3390/healthcare10091718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
We planned an infodemiological analysis to estimate the global impact of coronavirus disease 2019 (COVID-19) on threat appraisals. We accessed Google Trends using the search terms “Anxiety”, “Distress”, “Fear”, “Rumination”, “Stress” and “Worry” within the “topic” domain, setting the geographical location to “worldwide”, between July 2017 and July 2022. The weekly Google Trends score for the six search terms, thus, mirroring Web popularity and probable prevalence, was compared between the two search periods, “pre-COVID” (between July 2017 and February 2020) and COVID (between March 2020 and July 2022), thus, reflecting the volume of searches before and during the ongoing COVID-19 pandemic. The median weekly Google Trends score of all these search terms significantly increased during the COVID-19 pandemic, i.e., anxiety by 22%, distress by 13%, fear by 9%, rumination by 18%, stress by 13% and worry by 20%. With variable strength, the weekly Google Trends scores of each search term were found to be significantly associated (all p < 0.001). We can, hence, conclude that the enhanced burden of threat appraisals observed after SARS-CoV-2 spread leads the way to establish preventive, diagnostic and therapeutic measures in order to limit the unfavorable mental health consequences caused by the ongoing COVID-19 pandemic.
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Affiliation(s)
- Camilla Mattiuzzi
- Service of Clinical Governance, Provincial Agency for Social and Sanitary Services (APSS), 38123 Trento, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry and School of Medicine, University of Verona, 37126 Verona, Italy
- Correspondence: ; Tel.: +39-045-8124308
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