Institute of Psychology, University of Bern, Bern, Switzerland.
Department of Psychiatry, Child and Adolescent Psychiatry Service, Lausanne University Hospital, Lausanne, Switzerland.
Eur Psychiatry. 2020 May 29;63(1):e58. doi: 10.1192/j.eurpsy.2020.56.
The pandemic caused by coronavirus disease 2019 (COVID-19) has forced governments to implement strict social mitigation strategies to reduce the morbidity and mortality from acute infections. These strategies, however, carry a significant risk for mental health, which can lead to increased short-term and long-term mortality and is currently not included in modeling the impact of the pandemic.
We used years of life lost (YLL) as the main outcome measure, applied to Switzerland as an example. We focused on suicide, depression, alcohol use disorder, childhood trauma due to domestic violence, changes in marital status, and social isolation, as these are known to increase YLL in the context of imposed restriction in social contact and freedom of movement. We stipulated a minimum duration of mitigation of 3 months based on current public health plans.
The study projects that the average person would suffer 0.205 YLL due to psychosocial consequence of COVID-19 mitigation measures. However, this loss would be entirely borne by 2.1% of the population, who will suffer an average of 9.79 YLL.
The results presented here are likely to underestimate the true impact of the mitigation strategies on YLL. However, they highlight the need for public health models to expand their scope in order to provide better estimates of the risks and benefits of mitigation.
由 2019 年冠状病毒病(COVID-19)引起的大流行迫使各国政府实施严格的社会缓解策略,以降低急性感染的发病率和死亡率。然而,这些策略对心理健康存在重大风险,可能导致短期和长期死亡率增加,而目前这一风险并未纳入大流行影响的建模中。
我们以瑞士为例,使用生命损失年(YLL)作为主要结果衡量标准。我们关注自杀、抑郁、酒精使用障碍、因家庭暴力而导致的儿童创伤、婚姻状况变化和社会隔离,因为这些因素在社会接触和行动自由受到限制的情况下已知会增加 YLL。我们根据当前的公共卫生计划规定缓解措施的最短持续时间为 3 个月。
研究预计,由于 COVID-19 缓解措施的心理社会后果,普通人将损失 0.205 个 YLL。然而,这一损失将完全由 2.1%的人口承担,他们将损失平均 9.79 个 YLL。
这里呈现的结果可能低估了缓解策略对 YLL 的实际影响。然而,它们强调了公共卫生模型需要扩大其范围,以便更好地估计缓解的风险和收益。