PDF(Pubmed)
Abstract：
BACKGROUND: Most studies on the impact of the COVID-19 pandemic on depression burden focused on the earlier pandemic phase specific to lockdowns, but the longer-term impact of the pandemic is less well-studied. In this population-based cohort study, we examined the short-term and long-term impacts of COVID-19 on depression incidence and healthcare service use among patients with depression.
METHODS: Using the territory-wide electronic medical records in Hong Kong, we identified all patients aged ≥ 10 years with new diagnoses of depression from 2014 to 2022. We performed an interrupted time-series (ITS) analysis to examine changes in incidence of medically attended depression before and during the pandemic. We then divided all patients into nine cohorts based on year of depression incidence and studied their initial and ongoing service use patterns until the end of 2022. We applied generalized linear modeling to compare the rates of healthcare service use in the year of diagnosis between patients newly diagnosed before and during the pandemic. A separate ITS analysis explored the pandemic impact on the ongoing service use among prevalent patients with depression.
RESULTS: We found an immediate increase in depression incidence (RR = 1.21, 95% CI: 1.10-1.33, p < 0.001) in the population after the pandemic began with non-significant slope change, suggesting a sustained effect until the end of 2022. Subgroup analysis showed that the increases in incidence were significant among adults and the older population, but not adolescents. Depression patients newly diagnosed during the pandemic used 11% fewer resources than the pre-pandemic patients in the first diagnosis year. Pre-existing depression patients also had an immediate decrease of 16% in overall all-cause service use since the pandemic, with a positive slope change indicating a gradual rebound over a 3-year period.
CONCLUSIONS: During the pandemic, service provision for depression was suboptimal in the face of increased demand generated by the increasing depression incidence during the COVID-19 pandemic. Our findings indicate the need to improve mental health resource planning preparedness for future public health crises.
METHODS: Using the territory-wide electronic medical records in Hong Kong, we identified all patients aged ≥ 10 years with new diagnoses of depression from 2014 to 2022. We performed an interrupted time-series (ITS) analysis to examine changes in incidence of medically attended depression before and during the pandemic. We then divided all patients into nine cohorts based on year of depression incidence and studied their initial and ongoing service use patterns until the end of 2022. We applied generalized linear modeling to compare the rates of healthcare service use in the year of diagnosis between patients newly diagnosed before and during the pandemic. A separate ITS analysis explored the pandemic impact on the ongoing service use among prevalent patients with depression.
RESULTS: We found an immediate increase in depression incidence (RR = 1.21, 95% CI: 1.10-1.33, p < 0.001) in the population after the pandemic began with non-significant slope change, suggesting a sustained effect until the end of 2022. Subgroup analysis showed that the increases in incidence were significant among adults and the older population, but not adolescents. Depression patients newly diagnosed during the pandemic used 11% fewer resources than the pre-pandemic patients in the first diagnosis year. Pre-existing depression patients also had an immediate decrease of 16% in overall all-cause service use since the pandemic, with a positive slope change indicating a gradual rebound over a 3-year period.
CONCLUSIONS: During the pandemic, service provision for depression was suboptimal in the face of increased demand generated by the increasing depression incidence during the COVID-19 pandemic. Our findings indicate the need to improve mental health resource planning preparedness for future public health crises.
摘要：
背景：大多数关于COVID-19大流行对抑郁负担的影响的研究都集中在以封锁为具体的早期大流行阶段，但对大流行的长期影响研究较少。在这项基于人群的队列研究中，我们研究了COVID-19对抑郁症患者抑郁发生率和医疗服务使用的短期和长期影响.
方法：使用全港电子病历，我们确定了2014年至2022年间所有年龄≥10岁新诊断为抑郁症的患者.我们进行了中断的时间序列（ITS）分析，以检查大流行之前和期间医学上看抑郁症的发生率变化。然后，我们根据抑郁症发病率将所有患者分为9个队列，并研究了他们的初始和持续服务使用模式，直到2022年底。我们应用广义线性模型来比较大流行之前和期间新诊断的患者在诊断年份的医疗服务使用率。一项单独的ITS分析探讨了大流行对抑郁症患者持续使用服务的影响。
结果：我们发现，大流行开始后，人群中抑郁症发病率立即增加（RR=1.21，95％CI：1.10-1.33，p<0.001），这表明在2022年底之前会有持续的影响。亚组分析显示，发病率在成年人和老年人群中显著增加，但不是青少年。在大流行期间新诊断的抑郁症患者在第一个诊断年度使用的资源比大流行前患者少11％。自大流行以来，先前存在的抑郁症患者在所有原因服务使用方面也立即减少了16％，正斜率变化表明在3年内逐渐反弹。
结论：在大流行期间，面对COVID-19大流行期间抑郁症发病率增加产生的需求增加，抑郁症的服务提供并不理想。我们的研究结果表明，有必要为未来的公共卫生危机改善精神卫生资源规划准备。
方法：使用全港电子病历，我们确定了2014年至2022年间所有年龄≥10岁新诊断为抑郁症的患者.我们进行了中断的时间序列（ITS）分析，以检查大流行之前和期间医学上看抑郁症的发生率变化。然后，我们根据抑郁症发病率将所有患者分为9个队列，并研究了他们的初始和持续服务使用模式，直到2022年底。我们应用广义线性模型来比较大流行之前和期间新诊断的患者在诊断年份的医疗服务使用率。一项单独的ITS分析探讨了大流行对抑郁症患者持续使用服务的影响。
结果：我们发现，大流行开始后，人群中抑郁症发病率立即增加（RR=1.21，95％CI：1.10-1.33，p<0.001），这表明在2022年底之前会有持续的影响。亚组分析显示，发病率在成年人和老年人群中显著增加，但不是青少年。在大流行期间新诊断的抑郁症患者在第一个诊断年度使用的资源比大流行前患者少11％。自大流行以来，先前存在的抑郁症患者在所有原因服务使用方面也立即减少了16％，正斜率变化表明在3年内逐渐反弹。
结论：在大流行期间，面对COVID-19大流行期间抑郁症发病率增加产生的需求增加，抑郁症的服务提供并不理想。我们的研究结果表明，有必要为未来的公共卫生危机改善精神卫生资源规划准备。
