Prolonged increase in psychotropic drug use among young women following the COVID-19 pandemic: a French nationwide retrospective study.

BACKGROUND: The COVID-19 pandemic has had a significant impact on mental health, with evidence suggesting an enduring mental health crisis. Studies worldwide observed increased usage of antidepressants, anxiolytics, and hypnotics during the pandemic, notably among young people and women. However, few studies tracked consumption post-2021. Our study aimed to fill this gap by investigating whether the surge in the number psychotropic drug consumers in France persisted 2 years after the first lockdown, particularly focusing on age and gender differences. METHODS: We conducted a national retrospective observational study based on the French national insurance database. We retrieved all prescriptions of anxiolytics, hypnotics, and antidepressants dispensed in pharmacies in France for the period 2015-2022. We performed interrupted time series analyses based on Poisson models for five age classes (12-18; 19-25; 26-50; 51-75; 76 and more) to assess the trend before lockdown, the gap induced and the change in trend after. RESULTS: In the overall population, the number of consumers remained constant for antidepressants while it decreased for anxiolytics and hypnotics. Despite this global trend, a long-term increase was observed in the 12-18 and 19-25 groups for the three drug classes. Moreover, for these age classes, the increases were more pronounced for women than men, except for hypnotics where the trends were similar. CONCLUSIONS: The number of people using antidepressants continues to increase more than 2 years after the first lockdown, showing a prolonged effect on mental health. This effect is particularly striking among adolescents and young adults confirming the devastating long-term impact of the pandemic on their mental health.

Organization of French outpatient psychiatric clinics and delay to appointment.

OBJECTIVES: The goals of the study were to obtain a glimpse of the several types of organization of outpatient psychiatric clinics, as well as an overview of delays between a request for and the first appointment. We also look at geographical variability of appointment scheduling delays and assess the impact of the number of new applications on delays. METHODS: We analyzed information collected from a phone survey conducted with the 103 adult outpatient psychiatric clinics of the French region Hauts-de-France. This survey had a one-week inclusion period in November 2022 and focused on the organization and delays before obtaining an appointment. RESULTS: This study indicates that organizations seem to be homogeneous. Eighty-one outpatient psychiatric clinics (96.4%) receive with scheduled appointments. The initial evaluation by a nurse followed with a proposal for the organization of care seems to be the common practice. It also appears that primary psychiatric structures were capable of providing a response within a reasonable time frame in making a first appointment with a mental health professional. On the other hand, delays were much longer and heterogeneous for first appointments with psychiatrists and psychologists. CONCLUSIONS: The organizations of the outpatient psychiatric clinics of the French region Hauts-de-France seem homogeneous. The evaluation by a nurse followed with a care proposal is the common practice. Primary psychiatric structures are able to provide a response within a reasonable time, with half the centers proposing an appointment with a nurse within 10.0 days.

Opening the black box of hospitalizations in French high-secure psychiatric forensic units.

INTRODUCTION: Basic epidemiological data are rare concerning the activity of specialized forensic psychiatric facilities in France. Here, we investigated the activity of the ten (640 beds) French "units for difficult patients" (unités pour malades difficiles [UMDs]). METHOD: We used the Programme de médicalisation des systèmes d'information (PMSI) database to describe the characteristics and evolution of psychiatric hospitalisations in UMDs between 2012 and 2021, as well as the age, sex, and principal diagnoses of the patients hospitalized in these facilities. RESULTS: Between 2012 and 2021, 4857 patients were hospitalized in UMDs (6082 stays). Among them, 897 (18.5%) had more than one stay. The number of admissions ranged from a minimum of 434 to a maximum of 632 per year. The number of discharges ranged from a minimum of 473 to a maximum of 609 per year. The mean length of stay was 13.5 (SD: 22.64) months with a median of 7.3 months (IQR: 4.0-14.4). Among the 6082 stays, 5721 (94.1%) involved male patients. The median age was 33 (IQR: 26-41) years. The most frequent principal psychiatric diagnoses were psychotic disorders and personality disorders. CONCLUSION: The number of individuals hospitalized in specialized forensic psychiatric facilities has been stable for 10 years in France and remains lower than in most European countries.

Data Lake, Data Warehouse, Datamart, and Feature Store: Their Contributions to the Complete Data Reuse Pipeline.

Unlabelled: The growing adoption and use of health information technology has generated a wealth of clinical data in electronic format, offering opportunities for data reuse beyond direct patient care. However, as data are distributed across multiple software, it becomes challenging to cross-reference information between sources due to differences in formats, vocabularies, and technologies and the absence of common identifiers among software. To address these challenges, hospitals have adopted data warehouses to consolidate and standardize these data for research. Additionally, as a complement or alternative, data lakes store both source data and metadata in a detailed and unprocessed format, empowering exploration, manipulation, and adaptation of the data to meet specific analytical needs. Subsequently, datamarts are used to further refine data into usable information tailored to specific research questions. However, for efficient analysis, a feature store is essential to pivot and denormalize the data, simplifying queries. In conclusion, while data warehouses are crucial, data lakes, datamarts, and feature stores play essential and complementary roles in facilitating data reuse for research and analysis in health care.

Assessing Health Data Science Internships: A Comprehensive Study at the University of Lille.

Data Science emerged as a new cross-disciplinary discipline at the intersection of statistics, computer science, and expertise in a specific domain, such as health and biology. The data science field, alongside other data-related professions, is continuously evolving. We conducted a study examining tasks assigned to first-year internship students pursuing a Master's degree in Health Data Science, exploring the missions, technologies employed and skills required, and internship alignment with students' training through semi-structured interviews with 32 participants. Three quarters of the students were placed in teams within the public sector. Among these entities, there were 11 hospitals and 12 universities. Although the majority of students did their internship as part of a methodological team, they often had a healthcare professional on their team. Nearly half of the missions involved descriptive analysis, followed by 9 missions focused on etiology or prediction and 8 missions on implementing a data warehouse. The majority of students had to perform data management and produce graphs, while only half conducted statistical analysis. The findings highlighted that data management remains a major challenge, and it should be taken into consideration when designing training programs. In future, it remains to determine whether this trend will continue with second-year students or if, with experience, they are more often assigned statistical analyses.

Variations in Dispensing Psychotropic Drugs to Adolescents Depending on School Periods: A French Nationwide Retrospective Study.

Seasonality patterns are reported for various psychiatric disorders. Concerning adolescents, there is an increased frequency of general emergency department visits for mental health disorders observed between March and May, as well as in October and November. We conducted a retrospective cohort study using the French health insurance medico-administrative database. We extracted psychotropic drug deliveries occurring between 2015 and 2019 for patients aged between 12 and 18 years old. Each drug delivery was classified as occurring during a school period (Sc), the summer holidays (SumH) or other shorter holidays periods (ShH). We compared the number of distinct patients, as well as the proportion of new consumers, according to week status. Anxiolytics and hypnotics were more frequently dispensed during the school periods and short breaks than during the summer holidays. Conversely, antidepressants were more commonly dispensed during the short breaks rather than school periods and summer holidays. The stressful effects induced by schooling appear to be addressed in the first line by anxiolytics and hypnotics, while antidepressants are more frequently introduced during school holidays.

Reuse of Adverse Effect Reports from the French National Agency of Medicines: A Visual Analytic Tool to Improve Patient Safety.

Adverse drug reaction are defined as "harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product". In France, adverse effects due to medicines are reported to the French National Agency of Medicines (ANSM) by the healthcare professionals or consumers. The objective of this study was to implement a tool that facilitates the utilization of ANSM reports by synthesizing information to effectively inform prescribers and users. We focused on 3 psychotropic classes: antidepressants, antipsychotics and anxiolytics. We extracted relevant data from the ANSM website through a webscraping process, based on the names of molecules in these 3 classes: antidepressants, antipsychotics, and anxiolytics. We implemented a web interface with R Shiny that provides three panels: (i) a presentation of the active ingredient with the fewest reports for a selected adverse effect category, (ii) the adverse reactions for a selected active ingredient ranked in descending order, and (iii) a comparison of two active ingredients where, for each adverse effect, the active ingredient with the fewest reported adverse drug events (ADEs) is displayed. Our application allows for synthesizing information to effectively inform prescribers and users. In the ANSM existing interface, molecules can only be viewed one by one, and the ratio needs to be calculated manually, making it difficult to compare molecules. It is important to note that this is not a prescription assistance device but rather for informational purposes. In the future, the application may be expanded to include other categories of molecules. Finally, the indicators provided by our tool could be compared to those from other pharmacovigilance databases.

Exploring seasonality in catatonia diagnosis: Evidence from a large-scale population study.

Catatonia is a severe psychomotor syndrome mainly associated with psychiatric disorders, such as mood disorders and schizophrenia. Seasonal patterns have been described for these psychiatric disorders, and a previous study conducted in South London showed for the first time a seasonal pattern in the onset of catatonia. In this study, we aim to extend those findings to a larger national sample of patients admitted to French metropolitan hospitals, between 2015 and 2022, and to perform subgroup analyses by the main associated psychiatric disorder. A total of 6225 patients diagnosed with catatonia were included. A seasonal pattern for catatonia diagnosis was described, using cosinor models. Two peaks of diagnoses for catatonic cases were described in March and around September-October. Depending on the associated psychiatric disorder, the seasonality of catatonia diagnosis differed. In patients suffering with mood disorders, peaks of catatonia diagnosis were found in March and July. For patients suffering with schizophrenia, no seasonal pattern was found.

Home Care Nursing on Long-Term Illness Management in the French Healthcare System.

This study explores the role of home care nurses in managing long-term illnesses (L-TI) within the French healthcare system, utilizing data from the SNDS. Focused on data from 2022, it categorizes nursing actions into medical procedures, care procedures, and nursing processes, revealing significant involvement in patient care. The findings highlight the crucial, evolving role of home care nurses in addressing the complex needs of millions suffering from chronic conditions like diabetes and cardiovascular diseases in France.

OpenDataPsy: An Open-Data Repository with Standardized Storage and Description for Research in Psychiatry.

Sharing health data could avoid duplication of effort in data collection, reduce unnecessary costs in future studies, and encourage collaboration and data flow within the scientific community. Several repositories from national institutions or research teams have making their datasets available. These data are mainly aggregated at spatial or temporal level, or dedicated to a specific field. The objective of this work is to propose a standardized storage and description of open datasets for research purposes. For this, we selected 8 publicly accessible datasets, covering the fields of demographics, employment, education and psychiatry. Then, we studied the format, nomenclature (i.e., files and variables names, modalities of recurrent qualitative variables) and descriptions of these datasets and we proposed on common and standardized format and description. We made available these datasets in an open gitlab repository. For each dataset, we proposed the raw data file in its original format, the cleaned data file in csv format, the variables description, the data management script and the descriptive statistics. Statistics are generated according to the type of variables previously documented. After one year of use, we will evaluate with the users if the standardization of the data sets is relevant and how they use the dataset in real life.

Automated Monitoring Reports of the Activity of the French National Professional Suicide Prevention Helpline.

The French Professional Suicidal Helpline 3114 was launched on October 1st, 2021. The objective of this study was to implement automated reports of the activity of the suicidal helpline. We developed automated reports and presentations with Rmarkdown. Two formats were developed, national reports to present for a funding agency and regional reports for each calling center. These reports fulfill a critical need to adjust call distribution patterns, identify problems, adjust communication across the territory and ensure that 3114 is delivering the service it is supposed to provide.

Data Management for Health Data Reuse: Proposal of a Standard Workflow and a R Tutorial with Jupyter Notebook.

The data collected in the clinical registries or by data reuse require some modifications in order to suit the research needs. Several common operations are frequently applied to select relevant patients across the cohort, combine data from multiple sources, add new variables if needed and create unique tables depending on the research purpose. We carried out a qualitative survey by conducting semi-structured interviews with 7 experts in data reuse and proposed a standard workflow for health data management. We implemented a R tutorial based on a synthetic data set using Jupyter Notebook for a better understanding of the data management workflow.