Romanyukha Alexei Alexeevich, Novikov Konstantin Alexandrovich, Avilov Konstantin Konstantinovich, Nestik Timofey Alexandrovich, Sannikova Tatiana Evgenevna
Marchuk Institute of Numerical Mathematics of the Russian Academy of Sciences, Gubkina str., 8, Moscow, 119333, Russia.
Institute of Psychology of the Russian Academy of Sciences, Yaroslavskaya str., 13, Moscow, 129366, Russia.
Infect Dis Model. 2023 Jun;8(2):403-414. doi: 10.1016/j.idm.2023.04.003. Epub 2023 Apr 10.
During the COVID-19 pandemic, many countries used lockdowns as a containment measure. While lockdowns successfully contributed to slowing down the contagion, the related mobility restrictions were reportedly associated with an increased risk of major depressive and anxiety disorders. We aimed to quantify the trade-off between the quality-adjusted life years (QALY) gain due to lower COVID-19 incidence as a result of a lockdown and QALY loss due to lockdown-induced mental disorders.
We developed an agent-based model of COVID-19 epidemic and coupled mental disorder development in the population of a large city. We used data sources on the places of living, studying and working, public health and census surveys. Modeling of mental disorders was based on diathesis-stress concept. We quantified mental and physical health burden in terms of QALY taking into account major depressive and anxiety disorder episodes, lethal and non-lethal cases of COVID-19, and immunization.
We evaluated the dynamics of new major depressive disorder (MDD) and anxiety disorder (AD) cases during the period between September 2020 and December 2021 in Moscow, Russia. We found that lockdown imposition increases the daily chances of getting MDD or ADD by a vulnerable person by 16.79% (95% CI [12.36%, 21.23%]). The QALY loss associated with COVID-19-induced and lockdown-induced mental disorders was estimated to be 18.93% (95% CI [16.94%, 19.73%]) of the total QALY loss caused by COVID-19, immunization, and all kinds of mental disorders. For a synthetic "strong" lockdown, it had been shown that QALY loss is minimized when about 70% of the population are isolated.
The burden associated with mental disorders amounts to a considerable part of COVID-19-related losses. Our findings demonstrate that cost-benefit analysis of mobility restriction should include a forecast of mental disorder development in the population.
在新冠疫情期间，许多国家将封锁作为一种防控措施。虽然封锁成功地减缓了病毒传播，但据报道，相关的出行限制与重度抑郁和焦虑症风险增加有关。我们旨在量化因封锁导致新冠发病率降低而获得的质量调整生命年（QALY）收益与因封锁引发的精神障碍导致的QALY损失之间的权衡。
我们开发了一个基于主体的新冠疫情模型，并将精神障碍发展情况与一个大城市的人口情况相耦合。我们使用了关于居住、学习和工作地点、公共卫生及人口普查调查的数据源。精神障碍建模基于素质-应激概念。我们在考虑重度抑郁和焦虑症发作、新冠的致死和非致死病例以及免疫接种的情况下，从QALY角度量化了精神和身体健康负担。
我们评估了2020年9月至2021年12月期间俄罗斯莫斯科新的重度抑郁症（MDD）和焦虑症（AD）病例的动态情况。我们发现，实施封锁使弱势群体患MDD或ADD的每日几率增加了16.79%（95%置信区间[12.36%，21.23%]）。与新冠引发和封锁引发的精神障碍相关的QALY损失估计占新冠、免疫接种及各类精神障碍导致的总QALY损失的18.93%（95%置信区间[16.94%，19.73%]）。对于一种综合的“严格”封锁措施，结果表明，当约70%的人口被隔离时，QALY损失最小。
与精神障碍相关的负担占新冠相关损失的相当一部分。我们的研究结果表明，出行限制的成本效益分析应包括对人群中精神障碍发展的预测。
