Impact of the early COVID‐19 pandemic on adult mental health‐related dispensed medications, hospitalizations and specialist outpatient visits in Norway and Sweden: Interrupted time series analysis
Aims Norway and Sweden had different early pandemic responses that may have impacted mental health management. The aim was to assess the impact of the early COVID‐19 pandemic on mental health‐related care. Methods We used national registries in Norway and Sweden (1 January 2018–31 December 2020) to...
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| Published in: | British journal of clinical pharmacology Vol. 90; no. 7; pp. 1627 - 1636 |
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| Main Authors: | , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
01-07-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Aims
Norway and Sweden had different early pandemic responses that may have impacted mental health management. The aim was to assess the impact of the early COVID‐19 pandemic on mental health‐related care.
Methods
We used national registries in Norway and Sweden (1 January 2018–31 December 2020) to define 2 cohorts: (i) general adult population; and (ii) mental health adult population. Interrupted times series regression analyses evaluated step and slope changes compared to prepandemic levels for monthly rates of medications (antidepressants, antipsychotics, anxiolytics, hypnotics/sedatives, lithium, opioid analgesics, psychostimulants), hospitalizations (for anxiety, bipolar, depressive/mood, eating and schizophrenia/delusional disorders) and specialist outpatient visits.
Results
In Norway, immediate reductions occurred in the general population for medications (−12% antidepressants to −7% hypnotics/sedatives) except for antipsychotics; and hospitalizations (−33% anxiety disorders to −17% bipolar disorders). Increasing slope change occurred for all medications except psychostimulants (+1.1%/month hypnotics/sedatives to +1.7%/month antidepressants); and hospitalization for anxiety disorders (+5.5%/month), depressive/mood disorders (+1.7%/month) and schizophrenia/delusional disorders (+2%/month). In Sweden, immediate reductions occurred for antidepressants (−7%) and opioids (−10%) and depressive/mood disorder hospitalizations (−11%) only with increasing slope change in psychostimulant prescribing of (0.9%/month). In contrast to Norway, increasing slope changes occurred in specialist outpatient visits for depressive/mood disorders, eating disorders and schizophrenia/delusional disorders (+1.5, +1.9 and +2.3%/month, respectively). Similar changes occurred in the pre‐existing mental health cohorts.
Conclusion
Differences in early COVID‐19 policy response may have contributed to differences in adult mental healthcare provision in Norway and Sweden. |
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| Bibliography: | Funding information David Moreno‐Martos and Jing Zhao are joint first author. Hedvig Nordeng and Daniel R. Morales are joint last author. This work was performed as part of the Nordic COHERENCE project, project no. 105670 funded by NordForsk under the Nordic Council of Ministers, the EU‐COVID‐19 project, project no. 312707 funded by the Norwegian Research Council's COVID‐19 Emergency Call and by a grant from the Novo Nordisk Foundation to the University of Copenhagen (NNF15SA0018404). The SCIFI‐PEARL project, which supplies the data for the Swedish part of this analysis, has basic funding based on grants from the Swedish state under the agreement between the Swedish government and the county councils, the ALF‐agreement (Avtal om Läkarutbildning och Forskning/Medical Training and Research Agreement) grants ALFGBG‐938453, ALFGBG‐971130, ALFGBG‐978954 and previously from a joint grant from Forte (Swedish Research Council for Health, Working Life and Welfare) and FORMAS (Forskningsrådet för miljö, areella näringar och samhällsbyggande), grant 2020‐02828. Dr Morales was supported by a Wellcome Trust Clinical Research Development Fellowship (Grant 214588/Z/18/Z). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0306-5251 1365-2125 1365-2125 |
| DOI: | 10.1111/bcp.16044 |