ABSTRACT
Purpose The CoMeH cohort was established to assess the impact of the COVID-19 pandemic on the use of mental health services in Italy in the short and long term, with a particular focus on socioeconomic and/or citizenship inequalities.Methods All residents subjects for at least 2 years, aged ≥ 10 years, and assisted by an NHS general practitioner (GP) of the area of residence, in three vast catchment areas (N = 5,167,043). Primary outcomes of interest are the following indicators of mental health care services’ use: first access to any mental health care service, total number of accesses to mental health care services, the consumption of psychiatric drugs, the number of psychiatric or psychological outpatient visits, the number of residential or day care days spent in psychiatric facilities, the number of emergency and/or inpatient admissions to hospitals.Results Incident users were 3.2% of the population for Bergamo LHA, 3.5% for Rome2 LHA, and 4.4% for the Tuscany Region. The overall crude incidence rate of access to mental health care was 3.3% in the pre-COVID-19 period and 2.6% during the pandemic. Prescriptions for a mental disorder (57.2%) and ED admissions (25.1%) were the main reasons for enrollment. Compared to the general population, people with mental health conditions were older and more often female. The distribution of the incident users by deprivation index overlapped that of the population. Immigrants were younger, socioeconomically more deprived, and more often entered the study for an ED admission.Conclusion We will focus on the impact of the pandemic through the evaluation of accesses to hospitalization, emergency, outpatient visits, residential and day care services, and drug prescriptions. We will also evaluate socioeconomic inequalities through the use of census-based deprivation index and migration status. Finally, we will also analyze the impact of COVID-19 infection and outcome on the study cohort.
Subject(s)
COVID-19 , Mental DisordersABSTRACT
Background The CoMeH cohort was established to assess the impact of the COVID-19 pandemic on the use of mental health services in Italy in the short and long term, with a particular focus on socioeconomic and/or citizenship inequalities.Methods All residents subjects for at least 2 years, aged ≥ 10 years, and assisted by an NHS general practitioner (GP) of the area of residence, in three vast catchment areas (N = 5,167,043). Primary outcomes of interest are the following indicators of mental health care services’ use: first access to any mental health care service, total number of accesses to mental health care services, the consumption of psychiatric drugs, the number of psychiatric or psychological outpatient visits, the number of residential or day care days spent in psychiatric facilities, the number of emergency and/or inpatient admissions to hospitals.Results Incident users were 3.2% of the population for Bergamo LHA, 3.5% for Rome2 LHA, and 4.4% for the Tuscany Region. The overall crude incidence rate of access to mental health care was 3.3% in the pre-COVID-19 period and 2.6% during the pandemic. Prescriptions for a mental disorder (57.2%) and ED admissions (25.1%) were the main reasons for enrollment. Compared to the general population, people with mental health conditions were older and more often female. The distribution of the incident users by deprivation index overlapped that of the population. Immigrants were younger, socioeconomically more deprived, and more often entered the study for an ED admission.Discussion We will focus on the impact of the pandemic through the evaluation of accesses to hospitalization, emergency, outpatient visits, residential and day care services, and drug prescriptions. We will also evaluate socioeconomic inequalities through the use of census-based deprivation index and migration status. Finally, we will also analyze the impact of COVID-19 infection and outcome on the study cohort.
Subject(s)
COVID-19 , Mental DisordersABSTRACT
Objective: To compare the estimates of preterm birth (PTB; 22-36 weeks gestational age, GA) and stillbirth rates during COVID-19 pandemic in Italy with those recorded in the three previous years. Design. A population-based cohort study of liveborn and stillborn infants was conducted using data from Regional Health Systems and comparing the pandemic period (March 1st, 2020-March 31st, 2021, N= 362,129) to an historical period (January 2017- February 2020, N=1,117,172). The cohort covered 84.3% of the births in Italy. Methods. Logistic regressions were run in each Region and meta-analyses were performed centrally. We used an interrupted time series regression analysis to study the trend of preterm births from 2017 to 2021. Main Outcome Measures. The primary outcomes were PTB and stillbirths. Secondary outcomes were late PTB (32-36 weeks’ GA), very PTB (<32 weeks’ GA), and extreme PTB (<28 weeks’ GA), overall and stratified into singleton and multiples. Results. The pandemic period compared with the historical one was associated with a reduced risk for PTB (Odds Ratio: 0.90; 95% Confidence Interval, CI: 0.87, 0.93), late PTB (0.91; 0.87, 0.94), very PTB (0.87; 0.84, 0.91), and extreme PTB (0.88; 0.82, 0.94). In multiples, point estimates were not very different, but had wider CIs. No association was found for stillbirths (1.01; 0.90, 1.13). A linear decreasing trend in PTB rate was present in the historical period, with a further reduction after the lockdown. Conclusions We demonstrated a decrease in PTB rate after the introduction of COVID-19 restriction measures, without an increase in stillbirths.