Moin John S, Vigod Simone N, Plumptre Lesley, Troke Natalie, Papanicolas Irene, Wodchis Walter P, Anderson Geoff
Institute of Health Policy Management and Evaluation (Moin, Wodchis, Anderson), Dalla Lana School of Public Health, University of Toronto; Women's College Hospital (Vigod); ICES Central (Plumptre, Troke), Toronto, Ont.; The London School of Economics and Political Science (Papanicolas), Health Policy London, London, UK; Brown School of Public Health (Papanicolas), Providence, RI; Institute for Better Health (Wodchis), Trillium Health Partners, Mississauga, Ont.
CMAJ Open. 2023 Nov 28;11(6):E1093-E1101. doi: 10.9778/cmajo.20220239. Print 2023 Nov-Dec.
The COVID-19 pandemic and nonpharmaceutical interventions that reduced the spread of infection had impacts on social interaction, schooling and employment. Concerns have been raised about the impact of these disruptions on the mental health of high-risk groups, including birthing parents of young children.
This population-based, repeated cross-sectional study used health administrative databases in Ontario, Canada, to link children to birth parents and to measure subsequent mental health visits of birthing parents of younger (age 0-5 yr) and school-aged (6-12 yr) children. We used a repeated cross-sectional study design to estimate expected rates for visits to physicians for mental health diagnoses, based on prepandemic trends (March 2016-February 2020), and to compare those to observed visit rates during the March 2020-November 2021 period of the pandemic.
We identified 2 cohorts: 986 870 birthing parents of younger children and 1 012 997 birthing parents of school-aged children. In both cohorts, observed visit rates were higher than expected in the June 2020-August 2020 quarter (incidence rate ratio [IRR] 1.13, 95% confidence interval [CI] 1.10-1.16; and IRR 1.10, 95% CI 1.07-1.13, respectively), peaked in December 2020-February 2021 (IRR 1.24, 95% CI 1.20-1.27; and IRR 1.20, 95% CI 1.16-1.23) and remained higher than expected in September 2021-November 2021 (IRR 1.12, 95% CI 1.08-1.16; and IRR 1.09, 95% CI 1.06-1.13). The increases were driven mostly by visits for mood and anxiety disorders, and trends in increases were similar across physician type, birthing-parent age and deprivation quintile.
The COVID-19 pandemic was associated with increased mental health visits for parents of young children. This raises concerns about mental health impacts and highlights the need to address these concerns.
2019年冠状病毒病（COVID-19）大流行以及减少感染传播的非药物干预措施对社交互动、学校教育和就业产生了影响。人们对这些干扰因素对高危人群心理健康的影响表示担忧，其中包括幼儿的生育父母。
这项基于人群的重复横断面研究利用加拿大安大略省的卫生行政数据库，将儿童与其生育父母进行关联，并对年龄较小（0至5岁）和学龄（6至12岁）儿童的生育父母随后的心理健康就诊情况进行测量。我们采用重复横断面研究设计，根据疫情前的趋势（2016年3月至2020年2月）估算心理健康诊断的医生就诊预期率，并将其与2020年3月至2021年11月疫情期间观察到的就诊率进行比较。
我们确定了两个队列：986870名幼儿的生育父母和1012997名学龄儿童的生育父母。在两个队列中，2020年6月至2020年8月季度观察到的就诊率均高于预期（发病率比[IRR]分别为1.13，95%置信区间[CI]为1.10 - 1.16；以及IRR为1.10，95%CI为1.07 - 1.13），在2020年12月至2021年2月达到峰值（IRR分别为1.24，95%CI为1.20 - 1.27；以及IRR为1.20，95%CI为1.16 - 1.23），并在2021年9月至2021年11月期间仍高于预期（IRR分别为1.12，95%CI为1.08 - 1.16；以及IRR为1.09，95%CI为1.06 - 1.13）。增加主要由情绪和焦虑障碍就诊推动，不同医生类型、生育父母年龄和贫困五分位数的增加趋势相似。
COVID-19大流行与幼儿父母心理健康就诊增加有关。这引发了对心理健康影响的担忧，并凸显了解决这些担忧的必要性。
