Impact of the COVID-19 pandemic on mental health, access to care, and health disparities in the perinatal period.
Impact of the COVID-19 pandemic on mental health, access to care, and health disparities in the perinatal period.
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DOI：
10.1016/j.jpsychires.2021.02.056
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发表时间：
2021-05
影响因子：
4.8
通讯作者：
Byatt N
中科院分区：
文献类型：
--
作者：
Masters GA;Asipenko E;Bergman AL;Person SD;Brenckle L;Moore Simas TA;Ko JY;Robbins CL;Byatt N
COVID-19大流行影响了心理健康，并为医疗保健制造了障碍。在这项研究中，我们试图阐明这一流行病对围产期个体心理健康和获得护理的影响。这项针对马萨诸塞州孕妇或产后三个月内有抑郁症状史的个体的横断面研究，考察了人口统计学和精神症状（通过经验证的精神健康筛查工具）与COVID-19大流行对心理健康和获得护理的影响之间的关联。采用卡方相关和多元回归模型。在163名参与者中，80.8%的人认为由于大流行病，抑郁症状增加，88.8%的人感到焦虑。在访谈、高等教育和收入时对抑郁、焦虑和/或创伤后应激障碍的阳性筛查与大流行引起的抑郁和焦虑症状增加相关。抑郁、焦虑和/或创伤后应激障碍的阳性筛查也与获得精神保健的感知变化相关。与非西班牙裔白色受试者相比，有色人种（黑人、亚洲人、多种族和/或西班牙裔/拉丁裔）受试者更有可能报告大流行改变了他们的精神卫生保健服务（aOR：3.25，95%CI：1.23，8.59）。局限性包括研究的普遍性，考虑到参与者有抑郁症状史，以及横断面设计。这一流行病增加了围产期抑郁和焦虑的症状，并影响了人们对获得护理的感知。自我报告的抑郁和焦虑增加以及医疗保健服务的变化因教育、种族/民族、收入和积极筛查而异。了解这些差异对于解决围产期心理健康问题和提供公平的护理非常重要。
The COVID-19 pandemic has affected mental health and created barriers to healthcare. In this study, we sought to elucidate the pandemic's effects on mental health and access to care for perinatal individuals. This cross-sectional study of individuals in Massachusetts who were pregnant or up to three months postpartum with a history of depressive symptoms examined associations between demographics and psychiatric symptoms (via validated mental health screening instruments) and the COVID-19 pandemic's effects on mental health and access to care. Chi-square associations and multivariate regression models were used. Of 163 participants, 80.8% perceived increased symptoms of depression and 88.8% of anxiety due to the pandemic. Positive screens for depression, anxiety, and/or PTSD at time of interview, higher education, and income were associated with increased symptoms of depression and anxiety due to the pandemic. Positive screens for depression, anxiety, and/or PTSD were also associated with perceived changes in access to mental healthcare. Compared to non-Hispanic White participants, participants of color (Black, Asian, Multiracial, and/or Hispanic/Latinx) were more likely to report that the pandemic changed their mental healthcare access (aOR:3.25, 95%CI:1.23, 8.59). Limitations included study generalizability, given that participants have a history of depressive symptoms, and cross-sectional design. The pandemic has increased symptoms of perinatal depression and anxiety and impacted perceived access to care. Self-reported increases in depression and anxiety and changes to healthcare access varied by education, race/ethnicity, income, and positive screens. Understanding these differences is important to address perinatal mental health and provide equitable care.
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