Impact of the COVID-19 Pandemic on the General Mental Health in Sweden: No Observed Changes in the Dispensed Amount of Common Psychotropic Medications in the Region of Scania

Abstract

Some first investigations have focused on the consequences of the COVID-19 pandemic for the general mental health after its outbreak in 2020. According to multiple self-reporting surveys, symptoms of stress, anxiety, and depression have risen worldwide. Even some studies based on health care records start to be published, providing more objective and statistically reliable results. Additionally, concerns have been raised, to what extend the access to mental health care has been compromised by the COVID-19 outbreak. The aim of this study was to detect changes in prescription trends of common psychotropic medications in the Swedish region of Scania. The monthly dispensed amounts of selected pharmaceuticals were compared from January 2018 until January 2021, regarding the prescription trends before and after the outbreak of COVID-19. Using an interrupted time series analysis for each medication, no general trend changes were observed. On the one hand, a possible deterioration of the general mental health could not be confirmed by these results. On the other hand, the access to mental health care did not seem to be impaired by the pandemic. When interpreting findings related to the COVID-19 pandemic, regional differences and country-specific approaches for coping with the pandemic should be considered. The Swedish population, for instance, never experienced a full “lock-down” and within Sweden the time point of the outbreak waves differed regionally. In general, the effects of the COVID-19 outbreak on mental health are still unclear and need to be investigated further in an international comparison.

Antidepressants Drug Use during COVID-19 Waves in the Tuscan General Population: An Interrupted Time-Series Analysis

“…On the contrary, other studies found an initial reduction of AD use during the peak of the first wave followed by an increased use in the subsequent periods [21]. Finally, some authors reported a non-significant change in psychotropic medication dispensing, including ADs, during the outbreak [22]. To the best of our knowledge, evidence on the impact of lockdowns on AD use in Italy is still scant and deserves careful evaluation.…”

Effect of the COVID-19 pandemic on the psychotropic drug consumption

“…Despite two studies showing an increase in the delivery of psychotropic drugs during the COVID-19 pandemic, our study had an exhaustive sample size ( 24 ) and a long-term follow-up ( 25 ). On the opposite, some studies did not find significant variation in the prescription of psychotropic drugs following the pandemic ( 26 – 30 ) that may be explained by specificities of the lockdown in each country. For example, Sweden, ( 30 ) Poland, ( 26 ) or Northern California ( 29 ) showed only an isolated peak in March 2020.…”

“…On the opposite, some studies did not find significant variation in the prescription of psychotropic drugs following the pandemic ( 26 – 30 ) that may be explained by specificities of the lockdown in each country. For example, Sweden, ( 30 ) Poland, ( 26 ) or Northern California ( 29 ) showed only an isolated peak in March 2020. The discordance of results between countries may be explained by difference in the severity of lockdown restrictions, with a variable impact on daily life.…”

Regional clozapine, ECT and lithium usage inversely associated with excess suicide rates in male adolescents

“…The lack of significance in the combined sex group (albeit exhibiting a non-significant trend in the same direction) reduce confidence in this association. Furthermore, downstream effects from the 2020 onset of the Covid-19 pandemic 24 has been hypothesized to increase mental health problems in youth, potentially influencing suicide death rates. The present study evinced no such effects in males or females for the year 2020 compared to 2016-2019.…”

“…Variables not satisfying requirements for normal distribution were subjected to transformation by Blom's method 29 for the subsequent robust linear regression analyses (but not for nonparametric tests, i.e., the Wilcoxon rank sum exact test). To examine potential confound conferred from the 2020 onset of the Covid-19 pandemic 24 , we implemented the Wilcoxon Rank Sum Exact test to compare the mean of min-max normalized values for excess adolescents suicide death rates over 2016-2019 with values in the year 2020 across the 21 regionsevincing no significant difference in any sex group (combined sexes: p-value = 0.811, females: p-value = 0.613, males: p-value = 0.358). Multiple ordinary least squares regression was implemented to examine the relative contribution of each treatment modality to the mean clozapine/ECT/lithium proxy variable.…”