Changes in mental health diagnosis and healthcare use in seven European countries before and during the COVID-19 pandemic (2017-21)

Abstract

In the framework of the European Population Health Information Research Infrastructure (PHIRI) project, we analysed the healthcare use for depression and/or anxiety during the coronavirus disease 2019 (COVID-19) pandemic. Aggregated monthly number of diagnoses were obtained from electronic health records and databases in Austria, Estonia, Finland, Latvia, Romania, Wales (UK), and Aragon (Spain) and analysed using the PHIRI federated research infrastructure. Rates of diagnosis, prescriptions and visits to primary care, hospital or emergency department were calculated by 10 000 population. Segmented Poisson regression to estimate changes in outcomes after the COVID-19 pandemic declaration was produced controlling for baseline levels and trends for the period January 2017 to December 2021. Following pandemic declaration, level change of incident diagnoses fell in Romania, Aragon (Spain), and Wales (UK) [log rate -0.853 (95% confidence interval -1.045 to -0.661), -0.338 (-0.434 to -0.242), and -0274 (-0.365 to -0.183), respectively]; level change of visits to primary care decreased in Romania and Wales (UK) [-0.347 (-0.555 to -0.138) and -0.272 (-0.368 to -0.177), respectively], and increased in Latvia [0.065 (0.004-0.126)]; level change for hospital admissions diminished in Latvia, Romania and Wales (UK) [-0.206 (-0.393 to -0.019), -0.947 (-1.143 to -0.752) and -0.116 (-0.202 to -0.030), respectively]; and level change of visits to emergency units fell in Latvia and Romania [-0.290 (-0.429 to -0.151) and -0.865 (-1.040 to -0.690), respectively] and increased in Aragon (Spain) [0.880 (0.259 to 1.502)]. COVID-19 pandemic declaration altered the use of mental health resources. This study highlights the potential use of harmonized data for providing evidence for future pandemic preparedness.

Figure 1.

Effect of the pandemic declaration of COVID-19 in March 2020 on trends of rates of diagnoses of depression or anxiety by country, 2017–21.

Figure 2.

Effect of the pandemic declaration of COVID-19 in March 2020 on trends of rates of visits to primary care due to diagnoses of depression or anxiety by country, 2017–21.

Figure 3.

Effect of the pandemic declaration of COVID-19 in March 2020 on trends of rates of visits to specialized care or hospital or hospital admissions due to diagnoses of depression or anxiety by country, 2017–21.

Figure 4.

Effect of the pandemic declaration of COVID-19 in March 2020 on trends of rates of visits to emergency departments due to diagnoses of depression or anxiety by country, 2017–21.