Seo Jun Ho, Kim Se Joo, Lee Myeongjee, Kang Jee In
Institute of Behavioral Science in Medicine & Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea; Graduate School, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Behavioral Science in Medicine & Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea.
J Affect Disord. 2021 Jul 1;290:279-283. doi: 10.1016/j.jad.2021.04.070. Epub 2021 May 3.
The aim was to explore the impact of the COVID-19 pandemic on mental health service use according to mental disorder diagnosis among psychiatric outpatients.
Psychiatric outpatient visits and patient diagnostic information were extracted from the EHR(electronic health records) of a Korean tertiary hospital during 3 months of the COVID-19 pandemic and 3 months before the COVID-19 outbreak. Visit rates of psychiatric outpatients according to primary psychiatric diagnosis category before and after the COVID-19 pandemic were compared using an over-dispersed Poisson regression model. The temporal associations between the number of daily outpatient visits and the daily number of newly confirmed cases were examined by time-series analysis within each diagnosis category.
Total daily outpatient visit rate was significantly reduced during the pandemic. Among the nine most prevalent diagnosis categories, the daily visit rates for anxiety disorders, depressive disorders, and schizophrenia-spectrum disorders were significantly reduced by about 29.8%, 14.8%, and 13.3% respectively. Time-series analysis showed significant temporal correlations between the daily number of newly confirmed cases and the daily visit rates for anxiety disorders and depressive disorders, whereas patients with schizophrenia-spectrum disorders showed no significant temporal association.
Potential confounding factors unrelated to the pandemic might have influenced the results.
The present findings suggest that patients with anxiety or depressive disorders may have concerns regarding the spread of COVID-19, and may be more reluctant to visit psychiatry outpatient clinics. Delivery strategies for mental healthcare services, such as telepsychiatry, would be helpful to enhance continuity of care during the pandemic.
目的是根据精神科门诊患者的精神障碍诊断,探讨新冠疫情对心理健康服务利用情况的影响。
从韩国一家三级医院的电子健康记录(EHR)中提取新冠疫情期间3个月以及新冠疫情爆发前3个月的精神科门诊就诊情况和患者诊断信息。使用过度分散泊松回归模型比较新冠疫情前后按主要精神科诊断类别划分的精神科门诊就诊率。通过对每个诊断类别进行时间序列分析,研究每日门诊就诊人数与每日新增确诊病例数之间的时间关联。
疫情期间每日门诊总就诊率显著降低。在九种最常见的诊断类别中,焦虑症、抑郁症和精神分裂症谱系障碍的每日就诊率分别显著降低了约29.8%、14.8%和13.3%。时间序列分析显示,每日新增确诊病例数与焦虑症和抑郁症的每日就诊率之间存在显著的时间相关性,而精神分裂症谱系障碍患者则未显示出显著的时间关联。
与疫情无关的潜在混杂因素可能影响了结果。
目前的研究结果表明,焦虑症或抑郁症患者可能担心新冠病毒的传播,可能更不愿意前往精神科门诊就诊。远程精神病学等精神卫生保健服务的提供策略,将有助于在疫情期间提高护理的连续性。