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1.
Bull Menninger Clin ; 85(3): 254-270, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34468214

RESUMO

Sleep problems among frontline medical staff during the COVID-19 epidemic require attention. A total of 249 frontline medical staff who were recruited to support Wuhan completed this cross-sectional study. A web-based questionnaire about insomnia, depression, anxiety, and fatigue was used to assess mental health status. The prevalence of sleep disorders among frontline medical staff was 50.6%. More time spent in Wuhan and a history of insomnia, depression, anxiety, and fatigue were associated with a higher risk of insomnia. People who stayed in Wuhan for a long time with a history of insomnia, depression, anxiety, and fatigue symptoms might be at high risk of insomnia.


Assuntos
Adaptação Psicológica , COVID-19/psicologia , Corpo Clínico Hospitalar/psicologia , Transtornos Mentais/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , China , Comorbidade , Estudos Transversais , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Transtornos Mentais/psicologia , SARS-CoV-2 , Transtornos do Sono-Vigília/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Fatores de Tempo
3.
Sci Rep ; 11(1): 15828, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34349156

RESUMO

Precise remote evaluation of both suicide risk and psychiatric disorders is critical for suicide prevention as well as for psychiatric well-being. Using questionnaires is an alternative to labor-intensive diagnostic interviews in a large general population, but previous models for predicting suicide attempts suffered from low sensitivity. We developed and validated a deep graph neural network model that increased the prediction sensitivity of suicide risk in young adults (n = 17,482 for training; n = 14,238 for testing) using multi-dimensional questionnaires and suicidal ideation within 2 weeks as the prediction target. The best model achieved a sensitivity of 76.3%, specificity of 83.4%, and an area under curve of 0.878 (95% confidence interval, 0.855-0.899). We demonstrated that multi-dimensional deep features covering depression, anxiety, resilience, self-esteem, and clinico-demographic information contribute to the prediction of suicidal ideation. Our model might be useful for the remote evaluation of suicide risk in the general population of young adults for specific situations such as the COVID-19 pandemic.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Redes Neurais de Computação , Ideação Suicida , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Ansiedade/psicologia , Área Sob a Curva , Depressão/psicologia , Feminino , Humanos , Masculino , Transtornos Mentais/prevenção & controle , Prognóstico , Escalas de Graduação Psiquiátrica , República da Coreia , Resiliência Psicológica , Fatores de Risco , Autoimagem , Sensibilidade e Especificidade , Tentativa de Suicídio/prevenção & controle , Inquéritos e Questionários , Adulto Jovem
4.
Przegl Epidemiol ; 75(1): 51-57, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34338410

RESUMO

PURPOSE: This study was conducted to examine the effect of quarantine caused by COVID-19 on people's mental health and social trust. METHOD: In this study, the sample size covers 2919 people in the southwest of Iran that was selected cluster sample method and was evaluated online using tools of social trust and a checklist of mental disorder syndrome. RESULTS: Due to the results, COVID-19 affected all people's mental health negatively, but there was a significant difference between the rates of COVID-19 caused anxiety and the dimensions of the psychological problems and social trust different between men and women and married and single people, and also the education level. There was no significant relationship between any of the demographic variables and social trust variables, corona anxiety, and dimensions of psychological problems. And there was a negative and significant relationship between the dimensions of social trust and the dimensions of psychological problems. Moreover, the social trust rate in the subjects was desirable. Based on the results and the cutoff point of 2.5 as a border of healthy and unhealthy psychological dimensions, 4.5% had pathological anxiety, 7.3% had pathological depression, 5% had aggression, and 5.9 % had pathological obsessive-compulsive disorder. Depression had the highest scores, and aggression had the lowest scores. CONCLUSION: Due to this study's results, policymakers should consider measures that should be taken in crisis to support all people, especially vulnerable people in psychological, economic, social, spiritual, and psychological fields. On the other hand, the government must train the public through the mass media to cope with COVID-19.


Assuntos
COVID-19/prevenção & controle , COVID-19/psicologia , Transtornos Mentais/etiologia , Transtornos Mentais/psicologia , Saúde Mental/estatística & dados numéricos , Quarentena/psicologia , Confiança , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Polônia , SARS-CoV-2 , Fatores Sexuais , Inquéritos e Questionários
5.
Am J Health Behav ; 45(4): 771-784, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34340743

RESUMO

Objectives: COVID-19 has become a global concern, affecting both physical and mental health. In this study, we measured knowledge, fear, anxiety, and psychological distress related to COVID-19 among residents of the United Arab Emirates (UAE). Methods: A total of 1053 adult participants completed a Web-based cross-sectional survey. Results: Our data revealed 75.7% of the sample to be knowledgeable about COVID-19, 15.3% had experienced anxiety and 50.4%, psychological distress about COVID-19. Being knowledgeable about COVID-19 was significantly associated with having spent one to 2 hours reading about COVID-19. There was also an association between being knowledgeable about COVID-19 and low levels of anxiety and psychological distress. Psychological distress was associated with a history of mental illness (76.2%), anxiety (85.1%), and fear of COVID-19 (21±6.6). Age, history of mental illness (OR = 3.70, 95% CI = 2.35-5.82, p < .001), and COVID-19 anxiety (OR = 2.48, 95% CI = 1.48-4.13, p < .001) and fear (OR = 1.17, 95% CI = 1.14-1.20, p < .001) were risk factors for psychological distress. Conclusion: Our results showed significant psychological distress in the UAE population. Providing pre-recorded workshops and continuous telemedicine on biopsychosocial perspectives of COVID-19 may enhance the COVID-19 insight and reduce the COVID-19 anxiety and psychological distress.


Assuntos
Ansiedade/psicologia , COVID-19 , Medo/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Transtornos Mentais/psicologia , Angústia Psicológica , Adulto , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Emirados Árabes Unidos
6.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34342476

RESUMO

During the start of the first wave of the coronavirus disease 2019 (COVID-19) pandemic, two family physicians in Tshwane, South Africa, reviewed the people at high-risk within their Health Catchment Area. The largest residential mental health care facility in Gauteng fell under their care, and they were responsible for providing care and support to this facility. Family physicians have to lead the primary care team and simultaneously take care of the well-being of their team members. This report discusses how these family physicians used digital platforms and virtual care to successfully coordinate and manage the response to an outbreak of COVID-19 at this mental healthcare facility.


Assuntos
COVID-19/prevenção & controle , Continuidade da Assistência ao Paciente , Transtornos Mentais/terapia , Pandemias , Médicos de Família , Telemedicina , COVID-19/epidemiologia , Humanos , Transtornos Mentais/psicologia , Saúde Mental , SARS-CoV-2 , África do Sul/epidemiologia
8.
Lancet Child Adolesc Health ; 5(9): 631-641, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34273304

RESUMO

BACKGROUND: The spectrum of neurological and psychiatric complications associated with paediatric SARS-CoV-2 infection is poorly understood. We aimed to analyse the range and prevalence of these complications in hospitalised children and adolescents. METHODS: We did a prospective national cohort study in the UK using an online network of secure rapid-response notification portals established by the CoroNerve study group. Paediatric neurologists were invited to notify any children and adolescents (age <18 years) admitted to hospital with neurological or psychiatric disorders in whom they considered SARS-CoV-2 infection to be relevant to the presentation. Patients were excluded if they did not have a neurological consultation or neurological investigations or both, or did not meet the definition for confirmed SARS-CoV-2 infection (a positive PCR of respiratory or spinal fluid samples, serology for anti-SARS-CoV-2 IgG, or both), or the Royal College of Paediatrics and Child Health criteria for paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). Individuals were classified as having either a primary neurological disorder associated with COVID-19 (COVID-19 neurology group) or PIMS-TS with neurological features (PIMS-TS neurology group). The denominator of all hospitalised children and adolescents with COVID-19 was collated from National Health Service England data. FINDINGS: Between April 2, 2020, and Feb 1, 2021, 52 cases were identified; in England, there were 51 cases among 1334 children and adolescents hospitalised with COVID-19, giving an estimated prevalence of 3·8 (95% CI 2·9-5·0) cases per 100 paediatric patients. 22 (42%) patients were female and 30 (58%) were male; the median age was 9 years (range 1-17). 36 (69%) patients were Black or Asian, 16 (31%) were White. 27 (52%) of 52 patients were classified into the COVID-19 neurology group and 25 (48%) were classified into the PIMS-TS neurology group. In the COVID-19 neurology group, diagnoses included status epilepticus (n=7), encephalitis (n=5), Guillain-Barré syndrome (n=5), acute demyelinating syndrome (n=3), chorea (n=2), psychosis (n=2), isolated encephalopathy (n=2), and transient ischaemic attack (n=1). The PIMS-TS neurology group more often had multiple features, which included encephalopathy (n=22 [88%]), peripheral nervous system involvement (n=10 [40%]), behavioural change (n=9 [36%]), and hallucinations at presentation (n=6 [24%]). Recognised neuroimmune disorders were more common in the COVID-19 neurology group than in the PIMS-TS neurology group (13 [48%] of 27 patients vs 1 [<1%] of 25 patients, p=0·0003). Compared with the COVID-19 neurology group, more patients in the PIMS-TS neurology group were admitted to intensive care (20 [80%] of 25 patients vs six [22%] of 27 patients, p=0·0001) and received immunomodulatory treatment (22 [88%] patients vs 12 [44%] patients, p=0·045). 17 (33%) patients (10 [37%] in the COVID-19 neurology group and 7 [28%] in the PIMS-TS neurology group) were discharged with disability; one (2%) died (who had stroke, in the PIMS-TS neurology group). INTERPRETATION: This study identified key differences between those with a primary neurological disorder versus those with PIMS-TS. Compared with patients with a primary neurological disorder, more patients with PIMS-TS needed intensive care, but outcomes were similar overall. Further studies should investigate underlying mechanisms for neurological involvement in COVID-19 and the longer-term outcomes. FUNDING: UK Research and Innovation, Medical Research Council, Wellcome Trust, National Institute for Health Research.


Assuntos
COVID-19 , Criança Hospitalizada , Transtornos Mentais/psicologia , Doenças do Sistema Nervoso/diagnóstico , Medicina Estatal , COVID-19/complicações , COVID-19/epidemiologia , Criança , Estudos de Coortes , Feminino , Hospitalização , Humanos , Masculino , Alta do Paciente , Estudos Prospectivos , Reino Unido/epidemiologia
9.
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
13.
Arch Psychiatr Nurs ; 35(4): 375-394, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34176579

RESUMO

CONTEXT: Globally, governments have introduced a variety of public health measures including restrictions and reducing face-to-face contact, to control the spread of COVID-19. This has implications for mental health services in terms of support and treatment for vulnerable groups such as people with pre-existent mental health conditions. However, there is limited evidence of the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. OBJECTIVES: To identify the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. METHODS: A scoping review of the literature was employed. Eight electronic databases (PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL, Scopus, Academic Search Complete) were searched and 2566 papers identified. 30 papers met the criteria for this review and findings were summarised under three key review questions. RESULTS: COVID-19 and its related restrictions have had a notable effect on people with pre-existent mental health conditions. Public health restrictions have contributed to increased levels of social isolation, loneliness, and reduced opportunities for people to connect with others. Reduced access to health services and treatments has compounded matters for those seeking support. Exacerbation and deterioration of symptoms are commonly reported and can lead to greater susceptibility to COVID-19 infection. IMPLICATIONS: The importance of proactive planning, alternative accessible healthcare services and supports for vulnerable and at-risk groups is illuminated. Increased monitoring, early intervention and individually tailored care strategies are advocated. Recommendations revolve around the need for enhanced provision of remote support strategies facilitated using technology enhanced resources. ACCESSIBLE SUMMARY.


Assuntos
COVID-19/psicologia , Transtornos Mentais/psicologia , Serviços de Saúde Mental/provisão & distribuição , Saúde Mental , COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Pandemias/prevenção & controle , SARS-CoV-2
14.
J Law Health ; 34(2): 190-214, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34185973

RESUMO

Effective July 1, 1972, California's Lanterman-Petris-Short Act (LPS Act) set the precedent for modern mental health commitment procedures in the U.S. named after its authors, State Assemblyman Frank Lanterman and State Senators Nicholas C. Petris and Alan Short, the LPS Act sought to "end the inappropriate, indefinite, and involuntary commitment of persons with mental health disorder"; to "provide prompt evaluation and treatment of persons with mental health disorders or impaired by chronic alcoholism"; and to "guarantee and protect public safety." Despite citing to these articles of intent, the LPS Act violates its own legislative intent through its inclusion of "gravely disabled" in its enforcement of involuntary psychiatric hold designations (also known as "5150 designations"). First, police officers are not required to make a medical diagnosis of a mental health disorder at the time of a 5150 designation; the broad scope of "gravely disabled" increases the number of persons police officers can involuntarily transport, increasing the likelihood of inappropriate and involuntary commitment of persons with mental health disorders. Second, the broad scope of "gravely disabled" produces an onslaught of 5150-designated persons (whether improperly designated or not) being sent to LPS-designated hospitals with limited resources (e.g., lack of beds and psychiatric staff); this results in patients waiting for an inordinate amount of time for a psychiatric evaluation and/or a hospital bed. Third, it is unclear whether the LPS Act sought to provide protection for the mentally ill or to provide protection from the mentally ill in its guarantee of protecting "public safety"; the inclusion of "gravely disabled" in 5150 designations indicates that the LPS Act provided the public with a duplicitous means of removing the mentally ill, impoverished, and houseless from the streets under the guise of "public safety." This Paper suggests the following to help remedy the effects of implementing the broadly defined "gravely disabled" in 5150 designations: (1) Remove "gravely disabled" from the 5150 criteria; (2) integrate the community with mental health advocacy efforts by creating outreach and education programs; and (3) implement a client-centric approach to interacting with persons with mental health disorders through restorative policing and the establishment of a restorative court.


Assuntos
Internação Compulsória de Doente Mental/legislação & jurisprudência , Pessoas com Deficiência/legislação & jurisprudência , Pessoas com Deficiência/psicologia , Internação Involuntária/legislação & jurisprudência , Transtornos Mentais/psicologia , Polícia/legislação & jurisprudência , California/epidemiologia , Participação da Comunidade , Humanos , Aplicação da Lei/métodos , Segurança , Terminologia como Assunto
15.
Pain Res Manag ; 2021: 5515629, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34188734

RESUMO

Background: It is well known that cancer patients more seldom have a psychiatric disorder than noncancer patients with chronic pain. Conversely, earlier studies have suggested that, at the psychiatric level, long-term cancer survivors (LCSs) have more in common with noncancer patients affected by chronic pain. Materials and Methods: We investigated 89 cancer patients with acute pain (Acute Cancer Pain Patients, ACPPs) treated at a university outpatient chemotherapy department and compared these with 61 LCSs (living >5 yr after the first diagnosis) admitted by general practitioners for the treatment of noncancer pain. Upon administration, each patient was psychiatrically assessed by a liaison-psychiatrist conducting a semistructured interview. In a second step, we compared the LCS patients with hitherto treated noncancer patients suffering from chronic pain and ACPPs with data published by Derogatis in 1983. Results: In a comparison of LCSs with ACPPs, LCSs have more patients with brain organic disorders and more addictions. The largest cancer group within the LCSs is patients with urogenital (Uro) cancer (44.3%), while within the ACPPs, these are patients with cancer of the gastrointestinal (GI) tract (ACPP-GI, 57.2%). As far as the distribution of mental disorders is concerned, long-term cancer survivors show some similarities to noncancer patients. The data of ACPPs are similar to those of cancer patients, published by Derogatis. Discussion. The higher values of addiction and brain organic disorders, in particular, and the slight differences for psychic disorders in general of LCSs vs. ACPPs may result from the different cancer types and a longer survival time for urogenital tract cancer compared to GI cancer. In an additional examination, we compared patients with acute cancer of the GI tract (ACPP-GI, n = 50) with those of the urogenital tract (ACPP-Uro, n = 43). ACPP-Uro had the lowest percentage of patients with psychiatric disorders in general (ACPP-Uro 37.2%, ACPP-GI 50.0%, all LCSs 65.6%, and LCS-Uro 74.1%) and addiction, in particular (ACPP-Uro 2.3%, ACPP-GI 4.0%, and LCSs 13.1%). Conclusion: Cancer patients can develop a process of chronification with an increase in the prevalence of mental disorders. For urogenital cancer, an increase in the probability to develop mental disorders is a function of time.


Assuntos
Dor do Câncer/etiologia , Hospitalização/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Pacientes Ambulatoriais/estatística & dados numéricos , Centros Médicos Acadêmicos/estatística & dados numéricos , Idoso , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Estudos Retrospectivos
17.
Alcohol Clin Exp Res ; 45(7): 1448-1457, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34081349

RESUMO

BACKGROUND: There are significant concerns that the COVID-19 pandemic may have negative effects on substance use and mental health, but most studies to date are cross-sectional. In a sample of emerging adults, over a two-week period during the pandemic, the current study examined: (1) changes in drinking-related outcomes, depression, anxiety, and posttraumatic stress disorder and (2) differences in changes by sex and income loss. The intra-pandemic measures were compared to pre-pandemic measures. METHODS: Participants were 473 emerging adults (Mage  = 23.84; 41.7% male) in an existing longitudinal study on alcohol misuse who were assessed from June 17 to July 1, 2020, during acute public health restrictions in Ontario, Canada. These intra-pandemic data were matched to participant pre-pandemic reports, collected an average of 5 months earlier. Assessments included validated measures of drinking, alcohol-related consequences, and mental health indicators. RESULTS: Longitudinal analyses revealed significant decreases in heavy drinking and adverse alcohol consequences, with no moderation by sex or income loss, but with substantial heterogeneity in changes. Significant increases in continuous measures of depression and anxiety were present, both of which were moderated by sex. Females reported significantly larger increases in depression and anxiety. Income loss >50% was significantly associated with increases in depression. CONCLUSIONS: During the initial phase of the pandemic, reductions in heavy drinking and alcohol consequences were present in this sample of emerging adults, perhaps due to restrictions on socializing. In contrast, there was an increase in internalizing symptoms , especially in females, highlighting disparities in the mental health impacts of the pandemic.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/psicologia , COVID-19/psicologia , Saúde Mental/tendências , Caracteres Sexuais , Classe Social , Consumo de Bebidas Alcoólicas/economia , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/economia , Alcoolismo/epidemiologia , COVID-19/economia , COVID-19/epidemiologia , Estudos de Coortes , Estudos Transversais/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/economia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Saúde Mental/economia , Ontário/epidemiologia , Adulto Jovem
18.
Environ Health Prev Med ; 26(1): 67, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34154531

RESUMO

BACKGROUND: Identifying individual and contextual factors that influence adolescent well-being is a research priority. This study aimed to assess the prevalence of symptoms of mental health problems and some related factors in Italian adolescents in 2017-2018. METHODS: The present study was a cross-sectional survey among 3002 students aged 15-16 years who resided in two Italian provinces, in North and South Italy. Symptoms of mental health problems were assessed using the SDQ and CES-DC, and students' risk-taking behaviors and school climate perception were assessed. All information was collected anonymously. Logistic regression models were used to assess the associations of tobacco and alcohol use, screen time, bullying, and school climate with symptoms of mental health problems. RESULTS: One student out of five reported symptoms of mental health problems, with a more than double proportion among girls than boys (28.7% vs 10.4% with depressive symptoms, respectively). Thirty percent and 40% of students smoked tobacco or drank alcoholic beverages at least once in the past month, and more than 40% reported being victims or authors of bullying in the past 6 months. Smoking behavior, alcohol consumption, screen time, bullying, and negative school climate had 1.2- to 3.3-fold increased odds of symptoms of mental health problems without substantial differences between sexes and geographical areas. CONCLUSIONS: Tobacco and alcohol use, screen time, bullying, and school climate were independently associated with symptoms of mental health problems in a large sample of 15-16-year-old Italian adolescents without substantial gender and geographical differences.


Assuntos
Comportamento do Adolescente , Transtornos Mentais/epidemiologia , Adolescente , Comportamento do Adolescente/psicologia , Bullying/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Escalas de Graduação Psiquiátrica , Fatores de Risco , Instituições Acadêmicas , Estudantes
20.
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
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