Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel.
Ramat-Chen Brüll Mental Health Center, Tel-Aviv District, Clalit Health Services Community Division. 9 Hatzvi St., Tel-Aviv, Israel.
Compr Psychiatry. 2023 May;123:152383. doi: 10.1016/j.comppsych.2023.152383. Epub 2023 Mar 9.
Contemporary evidence notes the COVID-19 pandemic greatly impacted the utilization of physical and mental health services worldwide. The present study was therefore designed to evaluate the changes in the utilization of mental health services during the first year of the COVID-19 pandemic compared to previous years as well as to estimate the moderating role age had on these changes.
Psychiatric data was collected from n = 928,044 individuals living in Israel. Rates of receipt of psychiatric diagnoses and purchases of psychotropic medication were extracted for the first year of the COVID-19 pandemic and for two comparison years. The odds of receiving a diagnosis or of purchasing a psychotropic medication during the pandemic were compared to control years using uncontrolled logistic regression models and controlled and logistic regression that accounted for differences between ages.
There was a general reduction of about 3-17% in the odds of receiving a psychiatric diagnosis or purchasing psychotropic medications during the pandemic year compared to control years. The bulk of tests conducted showed that reduction in the rates of receiving diagnoses and purchasing medications during the pandemic were evident or more profound in the older age groups. An analysis of a combined measure conclusive of all other measures revealed decreased rates of utilizing any service examined during 2020, with rates decreasing as age increases up to a decrease of 25% in the oldest age group (80-96).
Changes in utilization of mental health services reveal the interplay between psychological distress that has been documented to increase during the pandemic and people's reluctance to seek professional assistance. This appears to be especially prominent among the vulnerable elderly, who may have received even less professional help for their emerging distress. The results obtained in Israel are likely to be replicated in other countries as well, given the global impact of the pandemic on adults' mental health and individuals' readiness to utilize mental healthcare services. Future research on the long-term impact of the pandemic on utilization of mental healthcare services is warranted, with an emphasis on the response of different populations to emergency situations.
现有证据表明，新冠疫情极大地影响了全球范围内的身心健康服务利用情况。因此，本研究旨在评估与前几年相比，新冠疫情第一年心理健康服务的利用变化情况，并估计年龄对这些变化的调节作用。
从居住在以色列的 928044 名个体中收集了精神科数据。提取了新冠疫情第一年和两个对照年的精神科诊断和精神药物购买率。使用非对照逻辑回归模型和控制及逻辑回归比较了大流行期间获得诊断或购买精神药物的几率与对照年的差异，该回归模型考虑了年龄差异。
与对照年相比，大流行年获得精神科诊断或购买精神药物的几率普遍降低了 3%-17%。大部分测试结果表明，在较年长的年龄组中，大流行期间诊断率和药物购买率的降低更为明显或更为显著。对所有其他措施的综合措施的分析显示，2020 年利用任何检查服务的比率降低，随着年龄的增加，比率下降，在最年长的年龄组（80-96 岁）下降了 25%。
心理健康服务利用的变化揭示了在大流行期间已经记录到的心理困扰增加与人们不愿寻求专业帮助之间的相互作用。这在脆弱的老年人中尤为明显，他们的新出现的困扰可能得到的专业帮助更少。鉴于大流行对成年人心理健康和个人利用心理健康保健服务的准备情况的全球影响，以色列获得的结果可能在其他国家也得到复制。需要对大流行对心理健康保健服务利用的长期影响进行未来研究，重点关注不同人群对紧急情况的反应。
