The early impact of COVID-19 on mental health and community physical health services and their patients' mortality in Cambridgeshire and Peterborough, UK.
The early impact of COVID-19 on mental health and community physical health services and their patients' mortality in Cambridgeshire and Peterborough, UK.
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DOI：
10.1016/j.jpsychires.2020.09.020
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发表时间：
2020-12
影响因子：
4.8
通讯作者：
Cardinal RN
中科院分区：
文献类型：
--
作者：
Chen S;Jones PB;Underwood BR;Moore A;Bullmore ET;Banerjee S;Osimo EF;Deakin JB;Hatfield CF;Thompson FJ;Artingstall JD;Slann MP;Lewis JR;Cardinal RN
COVID-19影响了全球的社交互动和医疗保健。我们研究了在剑桥郡和彼得伯勒，英国（人口约0.86万），加上服务活动和死亡的心理健康和社区卫生服务的主要提供者的介绍和转介的变化。我们就英国“封城”时间（即该地区COVID-19感染高峰期前不久）进行了间断时间序列分析。我们检查了患有和不患有严重精神疾病（SMI）的患者的标准化死亡率的变化。在封锁期间，几乎所有精神和身体健康服务的推荐和介绍都下降了，有证据表明供应（服务提供）和需求（寻求帮助）都发生了变化。其次是对某些服务的需求增加。这种模式在所有主要形式的精神病学联络服务中都可以看到，除了进食障碍，没有证据表明它发生了变化。住院人数下降，但根据《精神卫生法》新拘留的人数没有变化。许多服务从面对面转向远程接触。死亡率过高的主要是70岁以上的人。SMI患者的死亡率增加更大，这不能用种族来解释。COVID-19与全系统范围内精神卫生服务使用的下降有关，随后活动有所恢复。“供应”的变化可能减少了一些人获得心理健康服务的机会。“需求”的变化可能反映需求的真正减少或因需求被压抑而缺乏寻求帮助。在大流行期间，重度精神病感染患者的死亡率不成比例地增加。
COVID-19 has affected social interaction and healthcare worldwide. We examined changes in presentations and referrals to the primary provider of mental health and community health services in Cambridgeshire and Peterborough, UK (population ~0·86 million), plus service activity and deaths. We conducted interrupted time series analyses with respect to the time of UK “lockdown”, which was shortly before the peak of COVID-19 infections in this area. We examined changes in standardized mortality ratio for those with and without severe mental illness (SMI). Referrals and presentations to nearly all mental and physical health services dropped at lockdown, with evidence for changes in both supply (service provision) and demand (help-seeking). This was followed by an increase in demand for some services. This pattern was seen for all major forms of presentation to liaison psychiatry services, except for eating disorders, for which there was no evidence of change. Inpatient numbers fell, but new detentions under the Mental Health Act were unchanged. Many services shifted from face-to-face to remote contacts. Excess mortality was primarily in the over-70s. There was a much greater increase in mortality for patients with SMI, which was not explained by ethnicity. COVID-19 has been associated with a system-wide drop in the use of mental health services, with some subsequent return in activity. “Supply” changes may have reduced access to mental health services for some. “Demand” changes may reflect a genuine reduction of need or a lack of help-seeking with pent-up demand. There has been a disproportionate increase in death among those with SMI during the pandemic.
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影响因子：
7.7
作者：
Bernal JL;Cummins S;Gasparrini A
通讯作者：
Gasparrini A
影响因子：
64.3
作者：
Holmes, Emily A.;O'Connor, Rory C.;Bullmore, Ed
通讯作者：
Bullmore, Ed
影响因子：
7.9
作者：
McElroy, Eoin;Patalay, Praveetha;Waite, Polly
通讯作者：
Waite, Polly
影响因子：
16.4
作者：
Rettie, Hannah;Daniels, Jo
通讯作者：
Daniels, Jo
影响因子：
1.8
作者：
Pridmore, Saxby;Ahmadi, Jamshid;Pridmore, William
通讯作者：
Pridmore, William