Hildersley Rosanna, Easter Abigail, Bakolis Ioannis, Carson Lauren, Howard Louise M
Section of Women's Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
Section of Women's Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK.
BJPsych Open. 2022 Jun 3;8(4):e96. doi: 10.1192/bjo.2022.66.
Domestic violence and abuse (DVA) and mental illness during pregnancy have long-lasting and potentially serious consequences, which may have been exacerbated during the COVID-19 pandemic.
To investigate how the UK COVID-19 lockdown policy influenced the identification of DVA and depressive symptoms during pregnancy in health services in South-East London in Spring 2020, using eLIXIR (Early-Life Data Cross-Linkage in Research) maternity and mental routine healthcare data.
We used a regression discontinuity approach, with a quasi-experimental study design, to analyse the effect of the transition into and out of the COVID-19 lockdown on the rates of positive depression screens, DVA recorded in maternity and secondary mental health services, and contact with secondary mental health services during pregnancy.
We analysed 26 447 pregnancies from 1 October 2018 to 29 August 2020. The rate of DVA recorded in maternity services was low throughout the period (<0.5%). Within secondary mental health services, rates of DVA dropped by 78% (adjusted odds ratio 0.219, = 0.012) during lockdown, remaining low after lockdown. The rate of women screening positive for depression increased by 40% (adjusted odds ratio 1.40, = 0.023), but returned to baseline after lockdown lifted.
Rates of DVA identification in secondary mental health services dropped during and after lockdown, whereas overall rates of DVA identified in maternity services were concerningly low. Healthcare services must adopt guidance to facilitate safe enquiry, particularly in remote consultations. Further research is vital to address the longer-term impact on women's mental health caused by the increase in depression during the lockdown.
孕期的家庭暴力和虐待（DVA）以及精神疾病会产生长期且可能严重的后果，在新冠疫情期间这些后果可能会加剧。
利用eLIXIR（研究中的早期生活数据交叉关联）产妇和精神疾病常规医疗保健数据，调查2020年春季英国新冠疫情封锁政策如何影响伦敦东南部医疗服务中孕期DVA和抑郁症状的识别情况。
我们采用回归断点法和准实验研究设计，分析进入和解除新冠疫情封锁对抑郁筛查阳性率、产妇和二级精神卫生服务中记录的DVA以及孕期与二级精神卫生服务接触情况的影响。
我们分析了2018年10月1日至2020年8月29日期间的26447例妊娠。在此期间，产妇服务中记录的DVA发生率较低（<0.5%）。在二级精神卫生服务中，封锁期间DVA发生率下降了78%（调整后的优势比为0.219，P = 0.012），封锁解除后仍保持在较低水平。抑郁筛查呈阳性的女性比例增加了40%（调整后的优势比为1.40，P = 0.023），但封锁解除后又恢复到基线水平。
封锁期间及之后，二级精神卫生服务中DVA的识别率下降，而产妇服务中DVA的总体识别率低得令人担忧。医疗服务机构必须采用相关指南以促进安全问诊，尤其是在远程会诊中。进一步的研究对于解决封锁期间抑郁症增加对女性心理健康造成的长期影响至关重要。
