Dataset Information

Biopsychosocial exposure to the COVID-19 pandemic and the relative risk of schizophrenia: Interrupted time-series analysis of a nationally representative sample.

ABSTRACT:

Background

Studies of COVID-19 pandemic biopsychosocial exposure and schizophrenia risk showed contradictory results, were undertaken early in the pandemic, and did not consider lockdowns or COVID-19 infection. Hence, we examined the association between COVID-19 biopsychosocial exposure and incident schizophrenia.

Methods

An interrupted time-series study design was implemented based on Israeli electronic health records from 2013 to 2021 with national coverage. The period coinciding with the COVID-19 pandemic biopsychosocial exposures from March 2020 to February 2021 was classified as exposed, otherwise unexposed. The effect of the COVID-19 pandemic on incident schizophrenia was quantified by fitting a Poisson regression and modeling the relative risk (RR) and corresponding 95% confidence intervals (CI). Three scenarios were projected from the third lockdown to 10 months to forecast incident schizophrenia rates and their associated 95% prediction intervals (PI).

Results

The total population (N = 736,356) yielded 4,310 cases of incident schizophrenia over time. The primary analysis showed that the period exposed to the COVID-19 pandemic was associated with a reduced RR (RR = 0.81, 95% CI = 0.73, 0.91, p < 0.001). This conclusion was supported in 12 sensitivity analyses, including scrutinizing lockdowns and COVID-19 infection status. Two of three forecast scenarios projected an incident increase (6.74, 95% PI = 5.80, 7.84; 7.40, 95% PI = 6.36, 8.60).

Conclusions

The reduced risk of schizophrenia during the pandemic suggests no immediate triggering of new onsets either by the virus or the pandemic-induced psychosocial adversities. Once restrictions are lifted, the increased projected presentations have implications for clinicians and healthcare policy.

SUBMITTER: Travis-Lumer Y

PROVIDER: S-EPMC8853851 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

Biopsychosocial exposure to the COVID-19 pandemic and the relative risk of schizophrenia: Interrupted time-series analysis of a nationally representative sample.

Travis-Lumer Yael Y Kodesh Arad A Goldberg Yair Y Reichenberg Abraham A Frangou Sophia S Levine Stephen Z SZ

European psychiatry : the journal of the Association of European Psychiatrists 20220124 1

<h4>Background</h4>Studies of COVID-19 pandemic biopsychosocial exposure and schizophrenia risk showed contradictory results, were undertaken early in the pandemic, and did not consider lockdowns or COVID-19 infection. Hence, we examined the association between COVID-19 biopsychosocial exposure and incident schizophrenia.<h4>Methods</h4>An interrupted time-series study design was implemented based on Israeli electronic health records from 2013 to 2021 with national coverage. The period coincidin ...[more]

PMID: 35067255

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Project description:BackgroundThe COVID-19 pandemic has been associated with increased levels of depression and anxiety with implications for the use of antidepressant medications.MethodsThe incident rate of antidepressant fills before and during the COVID-19 pandemic were compared using interrupted time-series analysis followed by comprehensive sensitivity analyses on data derived from electronic medical records from a large health management organization providing nationwide services to 14% of the Israeli population. The dataset covered the period from 1 January 2013 to 1 February 2021, with 1 March 2020 onwards defined as the period of the COVID-19 pandemic. Forecasting analysis was implemented to test the effect of the vaccine roll-out and easing of social restrictions on antidepressant use.ResultsThe sample consisted of 852 233 persons with a total antidepressant incident fill count of 139 535.4 (total cumulative rate per 100 000 = 16 372.91, 95% CI 16 287.19-16 459.01). We calculated the proportion of antidepressant prescription fills for the COVID-19 period, and the counterfactual proportion for the same period, assuming COVID-19 had not occurred. The difference in these proportions was significant [Cohen's h = 10-3 (0.16), 95% CI 10-3 ( - 0.71 to 1.03)]. The pandemic was associated with a significant increase in the slope of the incident rate of antidepressant fills (slope change = 0.01, 95% CI 0.00-0.03; p = 0.04) and a monthly increase of 2% compared to the counterfactual (the estimated rate assuming no pandemic occurred). The increased rate was more pronounced in women, and was not modified by lockdown on/off periods, socioeconomic or SARS-CoV-2 status. The rate of observed antidepressant fills was similar to that forecasted under the assumption of ongoing COVID-19 distress.ConclusionThese findings underscore the toll of the pandemic on mental health and inform mental health policy and service delivery during and after implementing COVID-19 attenuation strategies.

Dataset Information

Biopsychosocial exposure to the COVID-19 pandemic and the relative risk of schizophrenia: Interrupted time-series analysis of a nationally representative sample.

Background

Methods

Results

Conclusions

Publications

Biopsychosocial exposure to the COVID-19 pandemic and the relative risk of schizophrenia: Interrupted time-series analysis of a nationally representative sample.

Similar Datasets

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