TY - JOUR
T1 - Increased incident rates of antidepressant use during the COVID-19 pandemic
T2 - interrupted time-series analysis of a nationally representative sample
AU - Frangou, Sophia
AU - Travis-Lumer, Yael
AU - Kodesh, Arad
AU - Goldberg, Yair
AU - New, Faye
AU - Reichenberg, Abraham
AU - Levine, Stephen Z.
N1 - Publisher Copyright:
Copyright © The Author(s), 2022. Published by Cambridge University Press.
PY - 2023/8/10
Y1 - 2023/8/10
N2 - Background The COVID-19 pandemic has been associated with increased levels of depression and anxiety with implications for the use of antidepressant medications. Methods The 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. Results The 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. Conclusion These 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.
AB - Background The COVID-19 pandemic has been associated with increased levels of depression and anxiety with implications for the use of antidepressant medications. Methods The 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. Results The 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. Conclusion These 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.
KW - Coronavirus
KW - disaster
KW - epidemiology
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=85132727583&partnerID=8YFLogxK
U2 - 10.1017/S0033291722001891
DO - 10.1017/S0033291722001891
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 35680620
AN - SCOPUS:85132727583
SN - 0033-2917
VL - 53
SP - 4943
EP - 4951
JO - Psychological Medicine
JF - Psychological Medicine
IS - 11
ER -