Changes in the identification and management of mental health and domestic abuse among pregnant women during the COVID-19 lockdown: regression discontinuity study.
Changes in the identification and management of mental health and domestic abuse among pregnant women during the COVID-19 lockdown: regression discontinuity study.
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DOI：
10.1192/bjo.2022.66
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发表时间：
2022-06-03
期刊：
影响因子：
5.4
通讯作者：
Howard, Louise M.
中科院分区：
文献类型：
--
作者：
Hildersley, Rosanna;Easter, Abigail;Bakolis, Ioannis;Carson, Lauren;Howard, Louise M.
关键词：
怀孕期间的家庭暴力和虐待（DVA）以及精神疾病具有长期和潜在的严重后果，在COVID-19大流行期间可能会加剧。研究英国COVID-19封锁政策如何影响2020年春季伦敦东南部卫生服务机构对妊娠期间DVA和抑郁症状的识别，使用eLIXIR（研究中的早期生命数据交叉链接）产妇和精神常规医疗保健数据。我们使用了一种回归不连续方法，采用准实验研究设计，分析了进入和退出COVID-19封锁对抑郁筛查阳性率、孕产妇和二级心理健康服务中记录的DVA以及怀孕期间与二级心理健康服务接触的影响。我们分析了2018年10月1日至2020年8月29日期间的26447例妊娠。在这一期间，产科服务部门记录的家庭暴力率很低（<0.5%）。在二级精神卫生服务中，DVA的发生率在封锁期间下降了78%（调整后的比值比为0.219，P = 0.012），封锁后仍然很低。女性抑郁症筛查阳性率增加了40%（调整后比值比1.40，P = 0.023），但在封锁解除后恢复到基线水平。二级精神卫生服务中DVA的识别率在封锁期间和封锁后下降，而产科服务中DVA的识别率则低得令人担忧。医疗保健服务必须采取指导，以促进安全查询，特别是在远程咨询。进一步的研究对于解决封锁期间抑郁症增加对女性心理健康的长期影响至关重要。
Domestic violence and abuse (DVA) and mental illness during pregnancy have long-lasting and potentially serious consequences, which may have been exacerbated during the COVID-19 pandemic. To investigate how the UK COVID-19 lockdown policy influenced the identification of DVA and depressive symptoms during pregnancy in health services in South-East London in Spring 2020, using eLIXIR (Early-Life Data Cross-Linkage in Research) maternity and mental routine healthcare data. We used a regression discontinuity approach, with a quasi-experimental study design, to analyse the effect of the transition into and out of the COVID-19 lockdown on the rates of positive depression screens, DVA recorded in maternity and secondary mental health services, and contact with secondary mental health services during pregnancy. We analysed 26 447 pregnancies from 1 October 2018 to 29 August 2020. The rate of DVA recorded in maternity services was low throughout the period (<0.5%). Within secondary mental health services, rates of DVA dropped by 78% (adjusted odds ratio 0.219, P = 0.012) during lockdown, remaining low after lockdown. The rate of women screening positive for depression increased by 40% (adjusted odds ratio 1.40, P = 0.023), but returned to baseline after lockdown lifted. Rates of DVA identification in secondary mental health services dropped during and after lockdown, whereas overall rates of DVA identified in maternity services were concerningly low. Healthcare services must adopt guidance to facilitate safe enquiry, particularly in remote consultations. Further research is vital to address the longer-term impact on women's mental health caused by the increase in depression during the lockdown.
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DOI：
10.3389/fgwh.2020.00001
发表时间：
2020
期刊：
Frontiers in global women's health
影响因子：
--
作者：
Davenport MH;Meyer S;Meah VL;Strynadka MC;Khurana R
通讯作者：
Khurana R
影响因子：
4.3
作者：
Ceulemans M;Foulon V;Ngo E;Panchaud A;Winterfeld U;Pomar L;Lambelet V;Cleary B;O'Shaughnessy F;Passier A;Richardson JL;Hompes T;Nordeng H
通讯作者：
Nordeng H
影响因子：
3.8
作者：
Atmuri, Kiran;Sarkar, Mahbub;Obudu, Efe;Kumar, Arunaz
通讯作者：
Kumar, Arunaz
DOI：
10.1016/s1470-0328(02)02926-4
发表时间：
2003-03-01
影响因子：
5.8
作者：
Johnson, JK;Haider, F;Lindow, SW
通讯作者：
Lindow, SW
影响因子：
6.1
作者：
Halford, Eric;Dixon, Anthony;Tilley, Nick
通讯作者：
Tilley, Nick