Division of Population Health and Genomics, University of Dundee, Dundee, UK.
Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
Br J Clin Pharmacol. 2024 Jul;90(7):1627-1636. doi: 10.1111/bcp.16044. Epub 2024 Mar 31.
Norway and Sweden had different early pandemic responses that may have impacted mental health management. The aim was to assess the impact of the early COVID-19 pandemic on mental health-related care.
We used national registries in Norway and Sweden (1 January 2018-31 December 2020) to define 2 cohorts: (i) general adult population; and (ii) mental health adult population. Interrupted times series regression analyses evaluated step and slope changes compared to prepandemic levels for monthly rates of medications (antidepressants, antipsychotics, anxiolytics, hypnotics/sedatives, lithium, opioid analgesics, psychostimulants), hospitalizations (for anxiety, bipolar, depressive/mood, eating and schizophrenia/delusional disorders) and specialist outpatient visits.
In Norway, immediate reductions occurred in the general population for medications (-12% antidepressants to -7% hypnotics/sedatives) except for antipsychotics; and hospitalizations (-33% anxiety disorders to -17% bipolar disorders). Increasing slope change occurred for all medications except psychostimulants (+1.1%/month hypnotics/sedatives to +1.7%/month antidepressants); and hospitalization for anxiety disorders (+5.5%/month), depressive/mood disorders (+1.7%/month) and schizophrenia/delusional disorders (+2%/month). In Sweden, immediate reductions occurred for antidepressants (-7%) and opioids (-10%) and depressive/mood disorder hospitalizations (-11%) only with increasing slope change in psychostimulant prescribing of (0.9%/month). In contrast to Norway, increasing slope changes occurred in specialist outpatient visits for depressive/mood disorders, eating disorders and schizophrenia/delusional disorders (+1.5, +1.9 and +2.3%/month, respectively). Similar changes occurred in the pre-existing mental health cohorts.
Differences in early COVID-19 policy response may have contributed to differences in adult mental healthcare provision in Norway and Sweden.
挪威和瑞典在疫情早期采取了不同的应对措施，这可能对精神卫生管理产生了影响。本研究旨在评估 COVID-19 大流行早期对精神卫生相关护理的影响。
我们使用挪威和瑞典的全国性登记处（2018 年 1 月 1 日至 2020 年 12 月 31 日），定义了两个队列：（i）一般成年人群；（ii）精神卫生成年人群。采用中断时间序列回归分析评估了与大流行前水平相比，每月药物（抗抑郁药、抗精神病药、抗焦虑药、镇静催眠药、锂、阿片类镇痛药、精神兴奋剂）、住院（焦虑症、双相情感障碍、抑郁症/情绪障碍、进食障碍和精神分裂症/妄想障碍）和专科门诊就诊的月度率的阶跃和斜率变化。
在挪威，一般人群中的药物使用（抗抑郁药减少 12%至镇静催眠药减少 7%，但抗精神病药除外）和住院治疗（焦虑症减少 33%至双相情感障碍减少 17%）立即减少。除精神兴奋剂外，所有药物的斜率变化均增加（镇静催眠药每月增加 1.1%至抗抑郁药每月增加 1.7%）；焦虑症（每月增加 5.5%）、抑郁症/情绪障碍（每月增加 1.7%）和精神分裂症/妄想障碍（每月增加 2%）的住院率也增加。在瑞典，抗抑郁药（减少 7%）和阿片类药物（减少 10%）的使用以及抑郁症/情绪障碍的住院治疗（减少 11%）立即减少，而精神兴奋剂的处方量呈斜率增加（每月增加 0.9%）。与挪威相反，抑郁症/情绪障碍、进食障碍和精神分裂症/妄想障碍的专科门诊就诊量呈斜率增加（每月分别增加 1.5%、1.9%和 2.3%）。在预先存在的精神卫生队列中也出现了类似的变化。
早期 COVID-19 政策应对的差异可能导致了挪威和瑞典在成年精神卫生保健方面的差异。
