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1.
Curr Psychiatry Rep ; 23(8): 46, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34196826

RESUMO

PURPOSE: To examine mental health outcomes of unaccompanied refugee minors during global policy shift. Additionally, to consider mental health service delivery and placement type for this group. METHODS: A rapid systematic search of research published since 2018 which related to mental health outcomes of unaccompanied refugee minors. Data extracted, risk of bias assessed and outcomes reviewed qualitatively. RESEARCH FINDINGS: We found 181 papers, of which 14 met inclusion criteria. This review found consistently high levels of PTSD and PTSS among URMs in various contexts. Exposure to trauma, being unaccompanied (compared to accompanied), being female and being older are associated with poor outcomes. Depression and anxiety were consistently high among URMs and associated with discrimination, limited language attainment and daily hassles. High rates of mental illness and symptoms among unaccompanied refugee minors were consistent across national and settlement contexts but the quality of the evidence is variable with significant heterogeneity of assessment. We relate persistence of poor mental health outcomes with problems accessing mental health services and discuss the role of key post-migration factors influencing outcomes-in particular placement type and the use of detention centres.


Assuntos
Transtornos Mentais , Serviços de Saúde Mental , Refugiados , Transtornos de Estresse Pós-Traumáticos , Feminino , Humanos , Transtornos Mentais/epidemiologia , Menores de Idade , Avaliação de Resultados em Cuidados de Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia
2.
BMC Health Serv Res ; 21(1): 653, 2021 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-34225719

RESUMO

BACKGROUND: Patients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits. METHODS: We studied 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge. RESULTS: Patients with SMI from the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients from the most disadvantaged communities had 7.3 % greater 30-day observation stay revisits. CONCLUSIONS: These results suggest that additional investments are needed to ensure that patients with SMI from the most disadvantaged communities are receiving appropriate post-discharge care.


Assuntos
Assistência ao Convalescente , Transtornos Mentais , Serviço Hospitalar de Emergência , Florida/epidemiologia , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , New York/epidemiologia , Alta do Paciente , Readmissão do Paciente , Estudos Retrospectivos , Fatores Socioeconômicos
3.
Actas Esp Psiquiatr ; 49(4): 180-193, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34195972

RESUMO

The World Health Organization declared a pandemic due to COVID-19 on 11 March 2020 and remarked on the relevance of studying its consequences on mental health. A cross-sectional study was conducted to evaluate the immediate psychological response to the pandemic and quarantine in Spain.


Assuntos
COVID-19/psicologia , Transtornos Mentais/epidemiologia , Distanciamento Físico , Quarentena/psicologia , SARS-CoV-2 , Estudos Transversais , Humanos , Transtornos Mentais/psicologia , Saúde Mental , Pandemias , Espanha , Inquéritos e Questionários
4.
Artigo em Inglês | MEDLINE | ID: mdl-34200056

RESUMO

BACKGROUND: The purpose of this study was to assess and compare the prevalence of self-reported mental disorders, psychological distress, and psychotropic drug consumption among people with diabetes mellitus (DM) and matched non-DM controls. METHODS: A case-controlled study using data from the Spanish National Health Interview Survey was conducted in 2017. We identified 2116 DM adults (aged ≥35 years). Non-DM controls were matched 1:1 by age, sex, and province of residence. RESULTS: Prevalence of mental disorders (25.0% vs. 19.2%; p < 0.001), psychological distress (29% vs. 19.5%; p < 0.001), and consumption of psychiatric medications (29.7% vs. 23.5%; p < 0.001) among DM cases were higher than those among matched non-DM controls. The DM patient variables associated with experiencing a mental disorder, psychological distress, and consumption of psychiatric medications were: being a woman, worse self-rated health, and a visit to a psychologist within the last year. Older age (≥80 years) was associated with a lower probability of reporting mental disorders and psychological distress among DM cases. Not practicing physical exercise was significantly associated with experiencing psychological distress. CONCLUSIONS: Adults with DM included in our investigation have a significantly higher prevalence of mental disorders, psychological distress, and consumption of psychiatric medications than non-DM controls. It is necessary to implement screening strategies and psychological interventions to improve the mental health of DM patients in Spain, focusing especially on women and those aged 35 to 59 years.


Assuntos
Diabetes Mellitus , Transtornos Mentais , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental , Prevalência , Espanha/epidemiologia , Estresse Psicológico/epidemiologia
5.
Ann Glob Health ; 87(1): 57, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249619

RESUMO

Globally, 10-20% of children and adolescents experience mental health conditions, but most of them do not receive the appropriate care when it is needed. The COVID-19 deaths and prevention measures, such as the lockdowns, economic downturns, and school closures, have affected many communities physically, mentally, and economically and significantly impacted the already-neglected children and adolescents' mental health. As a result, evidence has shown that many children and adolescents are experiencing psychological effects such as depression and anxiety without adequate support. The consequences of not addressing the mental health conditions in children and adolescents extend through adulthood and restrict them from reaching their full potential. The effects of COVID-19 on children and adolescents' mental health highlight the urgent need for multisectoral home-grown solutions to provide early diagnosis and treatment and educate caregivers on home-based interventions and community outreach initiatives to address children and adolescents' mental health challenges during this pandemic and beyond.


Assuntos
COVID-19 , Serviços Comunitários de Saúde Mental , Intervenção Médica Precoce/organização & administração , Transtornos Mentais , Quarentena/psicologia , Adolescente , COVID-19/epidemiologia , COVID-19/prevenção & controle , Criança , Controle de Doenças Transmissíveis/métodos , Serviços Comunitários de Saúde Mental/métodos , Serviços Comunitários de Saúde Mental/tendências , Educação à Distância , Saúde Global , Necessidades e Demandas de Serviços de Saúde , Humanos , Colaboração Intersetorial , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Saúde Mental/tendências , Carência Psicossocial , Ruanda/epidemiologia , SARS-CoV-2
6.
CMAJ ; 193(23): E835-E843, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34099467

RESUMO

BACKGROUND: It is unclear whether the clinical burden of postpartum mental illness has increased during the COVID-19 pandemic. We sought to compare physician visit rates for postpartum mental illness in Ontario, Canada, during the pandemic with rates expected based on prepandemic patterns. METHODS: In this population-based, repeated cross-sectional study using linked health administrative databases in Ontario, Canada, we used negative binomial regression to model expected visit rates per 1000 postpartum people for March-November 2020 based on prepandemic data (January 2016-February 2020). We compared observed visit rates to expected visit rates for each month of the pandemic period, generating absolute rate differences, incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). The primary outcome was a visit to a primary care physician or a psychiatrist for any mental disorder. We stratified analyses by maternal sociodemographic characteristics. RESULTS: In March 2020, the visit rate was 43.5/1000, with a rate difference of 3.11/1000 (95% CI 1.25-4.89) and an IRR of 1.08 (95% CI 1.03-1.13) compared with the expected rate. In April, the rate difference (10.9/1000, 95% CI 9.14-12.6) and IRR (1.30, 95% CI 1.24-1.36) were higher; this level was generally sustained through November 2020. From April-November, we observed elevated visit rates across provider types and for diagnoses of anxiety, depressive and alcohol or substance use disorders. Observed increases from expected visit rates were greater for people 0-90 days postpartum compared with 91-365 days postpartum; increases were small among people living in low-income neighbourhoods. Public health units in the northern areas of the province did not see sustained elevations in visit rates after July; southern health units had elevated rates through to November. INTERPRETATION: Increased visits for mental health conditions among postpartum people during the first 9 months of the COVID-19 pandemic suggest an increased need for effective and accessible mental health care for this population as the pandemic progresses.


Assuntos
COVID-19/epidemiologia , Transtornos Mentais/epidemiologia , Saúde Mental , Pandemias , Vigilância da População , Período Pós-Parto , Adulto , Comorbidade , Estudos Transversais , Feminino , Humanos , Transtornos Mentais/psicologia , Ontário/epidemiologia , Estudos Retrospectivos , SARS-CoV-2
7.
MMWR Morb Mortal Wkly Rep ; 70(24): 879-887, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34138835

RESUMO

Early during the COVID-19 pandemic, nearly two thirds of unpaid caregivers of adults reported adverse mental or behavioral health symptoms, compared with approximately one third of noncaregivers† (1). In addition, 27% of parents of children aged <18 years reported that their mental health had worsened during the pandemic (2). To examine mental health during the COVID-19 pandemic among U.S. adults on the basis of their classification as having a parenting role (i.e., unpaid persons caring for children and adolescents aged <18 years, referred to as children in this report) or being an unpaid caregiver of adults (i.e., persons caring for adults aged ≥18 years),§ CDC analyzed data from cross-sectional surveys that were administered during December 2020 and February-March 2021 for The COVID-19 Outbreak Public Evaluation (COPE) Initiative.¶ Respondents were categorized as parents only, caregivers of adults only, parents-caregivers (persons in both roles), or nonparents/noncaregivers (persons in neither role). Adjusted odds ratios (aORs) for any adverse mental health symptoms, particularly suicidal ideation, were higher among all respondents who were parents, caregivers of adults, or both compared with respondents who were nonparents/noncaregivers and were highest among persons in both roles (parents-caregivers) (any adverse mental health symptoms: aOR = 5.1, 95% confidence interval [CI] = 4.1-6.2; serious suicidal ideation: aOR = 8.2, 95% CI = 6.5-10.4). These findings highlight that parents and caregivers, especially those balancing roles both as parents and caregivers, experienced higher levels of adverse mental health symptoms during the COVID-19 pandemic than adults without these responsibilities. Caregivers who had someone to rely on for support had lower odds of experiencing any adverse mental health symptoms. Additional measures are needed to improve mental health among parents, caregivers, and parents-caregivers.


Assuntos
COVID-19/psicologia , Cuidadores/psicologia , Transtornos Mentais/epidemiologia , Pais/psicologia , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Cuidadores/economia , Cuidadores/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
9.
J Affect Disord ; 291: 344-351, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34087630

RESUMO

BACKGROUND: Suicide is a major but preventable public health problem in the world. Mental disorders are related to suicide, and can predict suicidal ideation (SI). This study aims to compare the differences in the prevalence and risk factors of SI among patients with five types of mental disorders. METHODS: This study involved adult inpatients with five types of mental disorders in Beijing Anding Hospital. Text mining was used to extract information from the electronic medical records. We performed the Pearson's Chi-square analysis and multivariable unconditional logistic regression to filter factors to assess odds of SI for each type of mental disorders. RESULTS: Of the 21,287 participants included, 2,619 had experienced SI. For both sexes, the highest risk of SI was found for patients with recurrent depressive disorder (OR = 7.096; P <.001), followed by patients with depressive episode and bipolar affective disorder when comparing with those with substance use disorder. Gender, age, occupation, drinking, single child, personal relationship, family history of mental disorder, family history of suicide and psychological trauma were associated with SI after adjusting for confounding factors, but the risk factors and their effects in each type were different. LIMITATIONS: The clear causal associations between mental disorders and SI cannot be elucidated. In addition, the ability to study the predictors of SI is constrained by the fact that the sample excluded people who completed suicide. CONCLUSIONS: SI is common and distinct strategies should be taken in suicide prevention for patients with different types of mental disorders.


Assuntos
Transtornos Mentais , Suicídio , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Pacientes Internados , Masculino , Transtornos Mentais/epidemiologia , Prevalência , Fatores de Risco , Ideação Suicida
11.
PLoS One ; 16(6): e0253805, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34191850

RESUMO

OBJECTIVE: To estimate the association between COVID-19 and Emergency Department (ED) psychiatric presentations, including suicidal ideation. METHODS: Using an interrupted time series design, we analyzed psychiatric presentations using electronic health record data in an academic medical center ED between 2018 and 2020. We used regression models to assess the association between the onset of the COVID-19 outbreak and certain psychiatric presentations. The period February 26-March 6, 2020 was used to define patterns in psychiatric presentations before and after the coronavirus outbreak. RESULTS: We found a 36.2% decrease (unadjusted) in ED psychiatric consults following the coronavirus outbreak, as compared to the previous year. After accounting for underlying trends, our results estimate significant differential change associated with suicidal ideation and substance use disorder (SUD) presentations following the outbreak. Specifically, we noted a significant differential increase in presentations with suicidal ideation six weeks after the outbreak (36.4 percentage points change; 95% CI: 5.3, 67.6). For presentations with SUD, we found a differential increase in the COVID-19 time series relative to the comparison time series at all post-outbreak time points and this differential increase was significant three weeks (32.8 percentage points; 95% CI: 4.0, 61.6) following the outbreak. Our results estimate no differential changes significant at the P value < 0.05 level associated with affective disorder or psychotic disorder presentations in the COVID-19 time series relative to the comparator time series. CONCLUSIONS: The COVID-19 outbreak in Boston was associated with significant differential increases in ED presentations with suicidal ideation and SUD.


Assuntos
COVID-19/psicologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Ideação Suicida , Adulto , COVID-19/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pandemias , Centros de Atenção Terciária/estatística & dados numéricos
13.
Int J Equity Health ; 20(1): 147, 2021 06 23.
Artigo em Inglês | MEDLINE | ID: covidwho-1282259

RESUMO

BACKGROUND: Chronic pain affects about 20 % of the Canadian population and can lead to physical, psychological and social vulnerabilities. However, this condition remains poorly recognized and undertreated. During 2020, as the COVID-19 pandemic disrupted daily living and health care systems, the situation of people with chronic pain has drawn little public attention. METHODS: This qualitative study was part of a pan-Canadian mixed-methods project and aimed to understand the experiences and challenges of people living with chronic pain during the COVID-19 pandemic in Canada. Between May and August 2020, we conducted in-depth semi-structured interviews with 22 individuals living with chronic pain across the country. We used reflexive thematic analysis to interpret data. RESULTS: Our findings underscored four dimensions of the chronic pain experience during the pandemic: (1) Reinforced vulnerability due to uncertainties regarding pain and its management; (2) Social network as a determinant of pain and psychological condition; (3) Increasing systemic inequities intermingling with the chronic pain experience; (4) More viable living conditions due to confinement measures. Though several participants reported improvements in their quality of life and reduced social pressure in the context of stay-at-home orders, participants from socio-economically deprived groups and minorities reported more challenges in accessing pain relief, health care services, and psychosocial support. CONCLUSIONS: The COVID-19 pandemic has revealed and intensified pre-existing disparities and challenges among people living with chronic pain in terms of material resources, psychosocial condition, social support, and access to care. In post-pandemic times, it will be essential to address flaws in health and welfare policies to foster equity and social inclusiveness of people with chronic pain.


Assuntos
COVID-19/psicologia , Dor Crônica/psicologia , Qualidade de Vida/psicologia , Apoio Social , Atividades Cotidianas , Adulto , COVID-19/epidemiologia , Canadá , Dor Crônica/epidemiologia , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estresse Psicológico/psicologia , Adulto Jovem
15.
Health Aff (Millwood) ; 40(6): 904-909, 2021 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1280643

RESUMO

COVID-19 interrupted delivery of mental health care in the US. During the initial course of the COVID-19 pandemic new starts of antidepressants declined by 7.5 percent, anxiolytics by 5.6 percent, and antipsychotics by 2.6 percent compared with expected levels. Our findings suggest that there is large unmet need for mental health treatment in the US due to COVID-19.


Assuntos
Antipsicóticos , COVID-19 , Transtornos Mentais , Antipsicóticos/uso terapêutico , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Pandemias , Psicotrópicos/uso terapêutico , SARS-CoV-2
16.
MMWR Morb Mortal Wkly Rep ; 70(24): 879-887, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: covidwho-1278792

RESUMO

Early during the COVID-19 pandemic, nearly two thirds of unpaid caregivers of adults reported adverse mental or behavioral health symptoms, compared with approximately one third of noncaregivers† (1). In addition, 27% of parents of children aged <18 years reported that their mental health had worsened during the pandemic (2). To examine mental health during the COVID-19 pandemic among U.S. adults on the basis of their classification as having a parenting role (i.e., unpaid persons caring for children and adolescents aged <18 years, referred to as children in this report) or being an unpaid caregiver of adults (i.e., persons caring for adults aged ≥18 years),§ CDC analyzed data from cross-sectional surveys that were administered during December 2020 and February-March 2021 for The COVID-19 Outbreak Public Evaluation (COPE) Initiative.¶ Respondents were categorized as parents only, caregivers of adults only, parents-caregivers (persons in both roles), or nonparents/noncaregivers (persons in neither role). Adjusted odds ratios (aORs) for any adverse mental health symptoms, particularly suicidal ideation, were higher among all respondents who were parents, caregivers of adults, or both compared with respondents who were nonparents/noncaregivers and were highest among persons in both roles (parents-caregivers) (any adverse mental health symptoms: aOR = 5.1, 95% confidence interval [CI] = 4.1-6.2; serious suicidal ideation: aOR = 8.2, 95% CI = 6.5-10.4). These findings highlight that parents and caregivers, especially those balancing roles both as parents and caregivers, experienced higher levels of adverse mental health symptoms during the COVID-19 pandemic than adults without these responsibilities. Caregivers who had someone to rely on for support had lower odds of experiencing any adverse mental health symptoms. Additional measures are needed to improve mental health among parents, caregivers, and parents-caregivers.


Assuntos
COVID-19/psicologia , Cuidadores/psicologia , Transtornos Mentais/epidemiologia , Pais/psicologia , Adolescente , Adulto , Idoso , COVID-19/epidemiologia , Cuidadores/economia , Cuidadores/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: covidwho-1278570

RESUMO

Objective: To study the pattern of admissions in a psychiatry ward during the coronavirus disease 2019 (COVID-19) pandemic and compare the sociodemographic and clinical profiles of patients admitted in 2020 with admissions in 2019.Methods: The case record files of an inpatient psychiatric unit from March 23 to September 22, 2019, and March 23 to September 22, 2020 were retrieved. Sociodemographic data, admission criteria of the patients, clinical diagnosis (as per ICD-10 criteria), duration of stay in the ward, and details of capacity assessment were assessed. The data collected were tabulated as per coding system and analyzed and compared using statistical analysis system software.Results: Of a total of 312 admissions, 236 were in 2019 and 76 were in 2020 (P < .05), which was a significant (P < .05) decrease. More patients admitted in 2020 were in the age group of 30-39 years (P < .05), were residents of Chandigarh (P < .05), were housewives by occupation (P < .05), had incomes < 3,500 Indian rupees (US$ 48.01) per month (P < .01), were Hindu, and belonged to extended families (P < .05). The predominant reasons for admission in 2020 were complicated withdrawals, noncompliance to treatment (P < .05), and aggravation of psychiatric illness due to comorbid substance use. The ICD diagnoses schizophrenia, schizotypal and delusional disorder (F20-29) and mood disorders, predominantly mania (F30-31) were significantly higher and mental and behavioral disorder due to psychoactive substance use (F10-19) was lower among patients admitted in 2020.Conclusions: The results show that the numbers of admissions to the psychiatry ward in 2020 were significantly lower than pre-COVID 2019, and the predominant reasons for admission were complicated withdrawals due to psychoactive substance abuse and noncompliance to treatment. Also, the mean duration of stay was longer in 2020 compared to the previous year.


Assuntos
COVID-19/epidemiologia , Hospitalização/estatística & dados numéricos , Transtornos Mentais/terapia , Centros de Atenção Terciária/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Feminino , Humanos , Índia/epidemiologia , Tempo de Internação/estatística & dados numéricos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
18.
Isr J Health Policy Res ; 10(1): 36, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: covidwho-1277972

RESUMO

BACKGROUND: During the COVID-19 outbreak, (March 1 - June 15, 2020) citizens expressed sympathy and gratitude towards medical staff through the media, while the entire hospital staff faced the same danger of infection as other citizens. This might have made hospital staff develop sympathy, understanding for the patients` and family's needs, and a better communication. OBJECTIVES: To investigate if there is a relation between the mutual change in attitude between citizens and hospital staff during the first COVID-19 outbreak, and the incidence of violence cases. MATERIALS AND METHODS: This is a cross sectional study conducted at Rambam Medical Center (RMC) in Israel. The data about the number of violence cases were collected from the security department, and the data about hospital wards activity were collected from the hospital Business Intelligence (BI) software. The number of violence cases in relation to the number of Emergency Department (ED) visits, admissions to hospital wards, and length of stay (LOS) were compared during the COVID-19 outbreak to the corresponding period in 2019 using the T- test. The difference in the incidence of violence between general population and people with a psychiatric or social disorder (like drug abuse and criminal background) in both periods were also compared using the Fisher exact test. RESULTS: During the first COVID-19 outbreak, there were 6 violence cases against medical staff out of 24,740 visits to the ED, vs. 21 cases out of 30,759 visits during the same periods in 2019 (P < 0.05). There were 19 violence cases in the whole hospital with 14,482 admissions in 2020 vs. 51 violence cases of 17,599 admissions in 2019 (P < 0.05). Violence against security guards in the entire hospital dropped from 20 to 11 cases, and in the set of the ED, from 13 to 4 cases in both periods respectively. A 20 % decrease in the number of visits to the ED, might have influenced the average LOS during the study period, 2020 compared to 2019 (4.4 + 0.45 vs. 5.4 + 0.36 h. (P < 0.001). The ratio of violence among general population vs. people with a psychiatric or social background revealed a non-significant change in both periods (P = 0.75 and P = 0.69) respectively. DISCUSSION: The COVID-19 outbreak supplied some evidence that a change in environmental conditions, trust, waiting time, personal attitude and communication might have reduced violence against hospital staff. CONCLUSIONS: Except for violence coming from patients with psychiatric or social disorders, most other violence cases might be reduced if the environment conditions and attitudes of both citizens and staff are improved.


Assuntos
COVID-19/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Recursos Humanos em Hospital , Violência no Trabalho/estatística & dados numéricos , Estudos Transversais , Surtos de Doenças , Humanos , Israel , Tempo de Internação/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Admissão do Paciente/estatística & dados numéricos
19.
PLoS One ; 16(6): e0252441, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1249578

RESUMO

BACKGROUND: As a result of the novel coronavirus disease 2019 (COVID-19), there have been widespread changes in healthcare access. We conducted a retrospective population-based study in Alberta, Canada (population 4.4 million), where there have been approximately 1550 hospital admissions for COVID-19, to determine the impact of COVID-19 on hospital admissions and emergency department (ED visits), following initiation of a public health emergency act on March 15, 2020. METHODS: We used multivariable negative binomial regression models to compare daily numbers of medical/surgical hospital admissions via the ED between March 16-September 23, 2019 (pre COVID-19) and March 16-September 23, 2020 (post COVID-19 public health measures). We compared the most frequent diagnoses for hospital admissions pre/post COVID-19 public health measures. A similar analysis was completed for numbers of daily ED visits for any reason with a particular focus on ambulatory care sensitive conditions (ACSC). FINDINGS: There was a significant reduction in both daily medical (incident rate ratio (IRR) 0.86, p<0.001) and surgical (IRR 0.82, p<0.001) admissions through the ED in Alberta post COVID-19 public health measures. There was a significant decline in daily ED visits (IRR 0.65, p<0.001) including ACSC (IRR 0.75, p<0.001). The most common medical/surgical diagnoses for hospital admissions did not vary substantially pre and post COVID-19 public health measures, though there was a significant reduction in admissions for chronic obstructive pulmonary disease and a significant increase in admissions for mental and behavioral disorders due to use of alcohol. CONCLUSIONS: Despite a relatively low volume of COVID-19 hospital admissions in Alberta, there was an extensive impact on our healthcare system with fewer admissions to hospital and ED visits. This work generates hypotheses around causes for reduced hospital admissions and ED visits which warrant further investigation. As most publicly funded health systems struggle with health-system capacity routinely, understanding how these reductions can be safely sustained will be critical.


Assuntos
COVID-19/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pandemias , Admissão do Paciente/estatística & dados numéricos , SARS-CoV-2/patogenicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/epidemiologia , COVID-19/transmissão , Canadá/epidemiologia , Feminino , Regulamentação Governamental , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Distanciamento Físico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Estudos Retrospectivos
20.
J Adolesc Health ; 69(1): 26-32, 2021 07.
Artigo em Inglês | MEDLINE | ID: covidwho-1275414

RESUMO

PURPOSE: This study examines the mental health impact of the COVID-19 pandemic on adolescents in the United Kingdom as well as social, demographic, and economic variations in the impact. METHODS: Nationally representative longitudinal panel data from the Understanding Society COVID-19 survey were analyzed. The analytical sample comprises 886 adolescents aged 10-16 years surveyed both before and during the pandemic. The Strengths and Difficulties Questionnaire was used to measure adolescents' mental health. RESULTS: The results from person fixed-effects regression models show that adolescents with better-than-median mental health before the pandemic have experienced an increase in their emotional problems, conduct problems, hyperactivity, and peer relationship problems, but a decrease in their prosocial tendency during the pandemic. In contrast, adolescents with worse-than-median mental health before the pandemic have experienced opposite changes in each Strengths and Difficulties Questionnaire domain. Further results from lagged dependent variable regression models show that compared with girls, boys have experienced a smaller increase in emotional problems but a greater decrease in prosocial tendency. The negative mental health impact is particularly prominent among adolescents in one-parent, one-child, and low-income households. Adult household members' COVID-19 symptoms and illness have undermined adolescents' peer relationships. CONCLUSIONS: The results reveal the pandemic's diverse impacts on adolescent mental health, which vary with adolescents' prepandemic mental health and sociodemographic backgrounds. The findings underline the need for tailored mental health support for adolescents and targeted measures to mitigate inequalities in the mental health impact of the pandemic.


Assuntos
COVID-19 , Transtornos Mentais , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Saúde Mental , Pandemias , SARS-CoV-2 , Reino Unido/epidemiologia
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