意大利伦巴第地区 COVID-19 大流行对青少年心理健康的影响：一项回顾性数据库研究。
Burden of the COVID-19 pandemic on adolescent mental health in the Lombardy Region, Italy: a retrospective database review.
机构信息
Laboratory of Child Health and Development Epidemiology, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
Laboratory of Geriatric Epidemiology, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy.
出版信息
BMJ Paediatr Open. 2024 Sep 28;8(1):e002524. doi: 10.1136/bmjpo-2024-002524.
BACKGROUND
Previous research has assessed the impact of the COVID-19 pandemic on adolescent mental health (MH). How the pandemic changed healthcare resource utilisation for MH conditions was investigated less, however, in particular in Italy.
METHODS
Data concerning outpatient visits in child and adolescent mental health services (CAMHSs), access to emergency departments (EDs), hospital admissions and drug prescriptions collected in administrative databases of the Lombardy Region, Italy, concerning adolescents 12-17 years old and occurring in the 2016-2021 period were analysed.Annual and monthly prevalence of healthcare (CAHMS/ED visits/hospital admissions) use for MH conditions and of psychotropic drug prescriptions were estimated. A negative binomial regression model was used to model the pre-pandemic monthly number of prevalent cases by gender. The total number of pandemic (1 March 2020 to 31 December 2021) cases predicted from the model was compared with the number of observed cases.
RESULTS
The overall annual rate of healthcare service utilisation slightly increased in the 2016-2019 period (from 63.8‰ to 67.8‰), decreased in 2020 (57.1‰) and returned to values similar to 2016 (64.9‰) the following year. A 2% relative increase was observed in girls, and a 10% decrease in boys, when comparing the prevalence in 2021 with that in 2019. Differences between genders were particularly evident for ED attendance, with an observed/predicted cases ratio in 2021 of 0.81 (95% CI 0.79 to 0.83) in boys, and 1.18 (95% CI 1.16 to 1.20) in girls, and for psychotropic drug prescriptions (0.83 (95% CI 0.82 to 0.84) and 1.24 (95% CI 1.23 to 1.25), respectively).
CONCLUSIONS
The current study confirms that the use of health services for MH conditions during the COVID-19 pandemic increased among adolescent girls but decreased among boys, and that gender differences emerged in the MH impact of the pandemic.
背景
先前的研究评估了 COVID-19 大流行对青少年心理健康 (MH) 的影响。然而，对于大流行如何改变 MH 疾病的医疗资源利用情况，研究较少，特别是在意大利。
方法
分析了意大利伦巴第地区儿童和青少年心理健康服务 (CAMHS) 的门诊就诊、急诊部 (ED) 就诊、住院和药物处方等数据，这些数据来自于 2016 年至 2021 年期间 12-17 岁青少年的行政数据库。估计了 MH 疾病的医疗保健 (CAMHS/ED 就诊/住院) 使用和精神药物处方的年度和月度流行率。使用负二项回归模型按性别对流行前每月的病例数进行建模。从模型中预测的大流行期间 (2020 年 3 月 1 日至 2021 年 12 月 31 日) 的总病例数与观察到的病例数进行了比较。
结果
2016-2019 年期间，整体医疗服务利用率的年增长率略有上升 (从 63.8‰上升到 67.8‰)，2020 年下降 (57.1‰)，次年恢复到与 2016 年相似的水平 (64.9‰)。与 2019 年相比，2021 年女孩的发病率增加了 2%，男孩的发病率下降了 10%。男孩和女孩在 ED 就诊方面的性别差异尤为明显，2021 年的观察到的/预测到的病例比为 0.81(95%CI 0.79-0.83)，女孩为 1.18(95%CI 1.16-1.20)，精神药物处方也存在类似差异(0.83(95%CI 0.82-0.84)和 1.24(95%CI 1.23-1.25)。
结论
本研究证实，COVID-19 大流行期间，青少年女孩对 MH 服务的使用增加，但男孩减少，大流行对 MH 的影响出现了性别差异。
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