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Mental health disorders before, during and after the COVID-19 pandemic: a nationwide study
Brain ( IF 10.6 ) Pub Date : 2024-11-06 , DOI: 10.1093/brain/awae360
Clara S Grønkjær, Rune H B Christensen, Daniel Kondziella, Michael E Benros

The COVID-19 pandemic and lockdowns prompted a major concern for mental health effects. Comprehensive nationwide studies are lacking on the indirect effect of the COVID-19 pandemic on the population’s mental health. We aimed to determine whether the COVID-19 pandemic and lockdowns affected mental health service usage, suicide attempts, and suicides. This comprehensive nationwide register-linked study followed all individuals in Denmark from 1990. The main outcomes were rates of psychiatric admissions, use of psychotropic medication, suicide attempts, suicides, patients in community-based private psychiatry or psychology practices, and referrals to psychiatric hospitals. The impact of the pandemic (March 11, 2020–June 30, 2023) and lockdowns was assessed with log-normal models adjusted for pre-pandemic trends (January 1, 2017–March 10, 2020). We reported Rate Ratios (RR) of the observed and counterfactual rates. We identified the 5 807 714 (50.3% females) individuals living in Denmark on March 1, 2020. The rates of psychiatric admissions (RR: 0.95, 95% Confidence Interval (CI): 0.91 to 0.99, p-value: 0.017) and suicide attempts (RR: 0.85, 95% CI: 0.76 to 0.95, p-value: 0.007) were lower during the pandemic compared to the pre-pandemic trend. The rates of suicides (RR: 0.89, 95% CI: 0.75-1.05, p-value: 0.173), patients in private practices (RR: 1.00, 95% CI: 0.96-1.04, p-value: 0.986), and referrals (RR: 1.06, 95% CI: 0.95-1.18, p-value: 0.307) were not significantly different during the pandemic compared to the pre-pandemic trend. During the first lockdown, rates were lower for psychiatric admissions (RR: 0.85, 95% CI: 0.80 to 0.90, p-value <0.001), suicide attempts (RR: 0.80, 95% CI: 0.69 to 0.94, p-value: 0.007), suicides (RR: 0.67, 95% CI: 0.52 to 0.86, p-value: 0.002), patients in private practices (RR: 0.88, 95% CI: 0.82 to 0.93, p-value <0.001), and referrals (RR: 0.69, 95% CI: 0.60 to 0.81, p-value < 0.001) compared to the pre-pandemic trend. However, during the pandemic, the rate of psychotropic medication users increased by 6% compared to the pre-pandemic trend (RR: 1.06, 95% CI: 1.05 to 1.06, p-value < 0.001). The COVID-19 pandemic and lockdowns did not severely influence pre-pandemic trends of the mental health burden in Denmark’s population on a nationwide level.

中文翻译:


COVID-19 大流行之前、期间和之后的心理健康障碍:一项全国性研究



COVID-19 大流行和封锁引发了人们对心理健康影响的重大担忧。缺乏关于 COVID-19 大流行对人群心理健康的间接影响的全面全国性研究。我们旨在确定 COVID-19 大流行和封锁是否影响了心理健康服务的使用、自杀未遂和自杀。这项全面的全国性注册链接研究跟踪了 1990 年以来丹麦的所有个体。主要结局是精神病入院率、精神药物使用率、自杀未遂率、自杀率、社区私人精神病学或心理学诊所的患者率以及转诊至精神病医院的比率。使用根据大流行前趋势(2017 年 1 月 1 日至 2020 年 3 月 10 日)调整的对数正态模型评估了大流行(2020 年 3 月 11 日至 2023 年 6 月 30 日)和封锁的影响。我们报告了观察到的比率和反事实比率 (RR)。我们确定了 2020 年 3 月 1 日居住在丹麦的 5 807 714 人(50.3% 为女性)。与大流行前趋势相比,大流行期间精神病入院率 (RR: 0.95,95% 置信区间 (CI): 0.91 至 0.99,p 值: 0.017) 和自杀未遂率 (RR: 0.85,95% CI: 0.76 至 0.95,p 值: 0.007) 较低。与大流行前趋势相比,大流行期间的自杀率 (RR: 0.89, 95% CI: 0.75-1.05, p 值: 0.173)、私人诊所患者 (RR: 1.00,95% CI: 0.96-1.04, p 值: 0.986) 和转诊率 (RR: 1.06,95% CI: 0.95-1.18,p 值: 0.307) 没有显着差异。在第一次封锁期间,精神病入院率较低(RR:0.85,95% CI:0.80 至 0.90,p 值 <0.001)、自杀未遂率(RR:0.80,95% CI:0.69 至 0.94,p 值:0.007)、自杀率(RR:0.67,95% CI:0.52 至 0.86,p 值:0。002)、私人诊所患者(RR:0.88,95% CI:0.82 至 0.93,p 值 <0.001)和转诊患者(RR:0.69,95% CI:0.60 至 0.81,p 值 < 0.001)与大流行前趋势相比。然而,在大流行期间,与大流行前的趋势相比,精神药物使用者率增加了 6%(RR:1.06,95% CI:1.05 至 1.06,p 值 < 0.001)。COVID-19 大流行和封锁并未在全国范围内严重影响丹麦人口心理健康负担的大流行前趋势。
更新日期:2024-11-06
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