Adverse SARS-CoV-2-associated outcomes among people experiencing social marginalisation and psychiatric vulnerability: A population-based cohort study among 4,4 million people

Nilsson, Sandra Feodor; Laursen, Thomas Munk; Osler, Merete; Hjorthøj, Carsten; Benros, Michael E.; Ethelberg, Steen; Mølbak, Kåre; Nordentoft, Merete

doi:10.1016/j.lanepe.2022.100421

Cited by 21 publications

(31 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the periods of lockdown delayed our study about 6 months, we continued to conduct assessments during the pandemic between lockdowns. It is very likely that more participants declined participation during this time because of the risk of infection, especially because this population was at higher risk of severe complications . With such high rates of missing data, we did not deem it feasible to impute missing data .…”

Section: Discussionmentioning

confidence: 99%

“…The following registers hold complete and updated data in real time on all participants (not deceased or emigrated) on a range of relevant outcomes: (1) addresses and vital status was drawn from the Danish Civil Registration System, 34 (2) information about psychiatric service use (days of psychiatric hospitalizations, number of psychiatric outpatient contacts) was extracted from the Danish Psychiatric Central Register, 35 (3) use of supported housing and homeless shelters at the previous year up to 20-year follow-up was obtained by linking information from the official Danish national website Tilbudsportalen with addresses of all supported housing facilities and homeless shelters in Denmark with individual-level address information in the Danish Civil Registration System register 34 as described in a previous publication, 36 (4) mortality and cause of death was drawn from the Cause of Death Registry, 37 and (5) vocational status was available from the DREAM database. 38 Registry data were collected for all individuals regardless of participation in the assessments and is thus free from attrition.…”

Section: The Danish Registry Datamentioning

confidence: 99%

“…It is very likely that more participants declined participation during this time because of the risk of infection, especially because this population was at higher risk of severe complications. 36 With such high rates of missing data, we did not deem it feasible to impute missing data. 49 To account for the high attrition rate, we used the Danish registers in some of the analyses in attempt to elucidate the skewed attrition at 20-year follow-up.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Recovery and Long-Term Association of Specialized Early Intervention Services vs Treatment as Usual Among Individuals With First-Episode Schizophrenia Spectrum Disorder

et al. 2023

Self Cite

View full text Add to dashboard Cite

ImportanceThe OPUS 20-year follow-up is the longest follow-up of a randomized clinical trial testing early intervention services (EIS) among individuals with first-episode schizophrenia spectrum disorder.ObjectiveTo report on long-term associations of EIS compared with treatment as usual (TAU) for first-episode schizophrenia spectrum disorder.Design, Setting, and ParticipantsA total of 547 individuals were included in this Danish multicenter randomized clinical trial between January 1998 and December 2000 and allocated to early intervention program group (OPUS) or TAU. Raters who were blinded to the original treatment performed the 20-year follow-up. A population-based sample aged 18 to 45 years with first-episode schizophrenia spectrum disorder were included. Individuals were excluded if they were treated with antipsychotics (&gt;12 weeks prior to randomization), had substance-induced psychosis, had mental disability, or had organic mental disorders. Analysis took place between December 2021 and August 2022.InterventionsEIS (OPUS) consisted of 2 years of assertive community treatment including social skill training, psychoeducation, and family involvement by a multidisciplinary team. TAU consisted of the available community mental health treatment.Main Outcomes and MeasuresPsychopathological and functional outcomes, mortality, days of psychiatric hospitalizations, number of psychiatric outpatient contacts, use of supported housing/homeless shelters, symptom remission, and clinical recovery.ResultsOf 547 participants, 164 (30%) were interviewed at 20-year follow-up (mean [SD] age, 45.9 [5.6] years; 85 [51.8%] female). No significant differences were found between the OPUS group compared with the TAU group on global functional levels (estimated mean difference, −3.72 [95% CI, −7.67 to 0.22]; P = .06), psychotic symptom dimensions (estimated mean difference, 0.14 [95% CI, −0.25 to 0.52]; P = .48), and negative symptom dimensions (estimated mean difference, 0.13 [95% CI, −0.18 to 0.44]; P = .41). The mortality rate was 13.1% (n = 36) in the OPUS group and 15.1% (n = 41) in the TAU group. Likewise, no differences were found 10 to 20 years after randomization between the OPUS and TAU groups on days of psychiatric hospitalizations (incidence rate ratio, 1.20 [95% CI, 0.73-1.20]; P = .46) or number of outpatient contacts (incidence rate ratio, 1.20 [95% CI, 0.89-1.61]; P = .24). Of the entire sample, 53 participants (40%) were in symptom remission and 23 (18%) were in clinical recovery.Conclusions and RelevanceIn this follow-up study of a randomized clinical trial, no differences between 2 years of EIS vs TAU among individuals with diagnosed schizophrenia spectrum disorders at 20 years were found. New initiatives are needed to maintain the positive outcomes achieved after 2 years of EIS and furthermore improve very long-term outcomes. While registry data was without attrition, interpretation of clinical assessments are limited by high attrition rate. However, this attrition bias most likely confirms the lack of an observed long-term association of OPUS with outcomes.Trial RegistrationClinicalTrials.gov Identifier: NCT00157313

show abstract

Section: Discussionmentioning

confidence: 99%

Section: The Danish Registry Datamentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Recovery and Long-Term Association of Specialized Early Intervention Services vs Treatment as Usual Among Individuals With First-Episode Schizophrenia Spectrum Disorder

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Noticeably, some of the factors linked with vaccine uptake we report here have been detailed for other vaccine types in PEH 8 – 11 , 15 and migrants 10 , 13 , 14 , and are summarized in two systematic reviews 38 , 39 .…”

Section: Discussionmentioning

confidence: 99%

“…Evidence from the early COVID-19 waves suggests that population subgroups, such as people experiencing homelessness (PEH) or precariously housed (PH), are disproportionately exposed to infection 1 – 3 and the severe forms of the disease 4 – 8 , as well as suffering from greater mental health and social impacts 7 , 8 . Transmission risk is worsened by factors specific to these groups, such as precarious living conditions, high population density, need to access food distribution services, poor access to sanitation and hygiene, and difficulties accessing care 1 – 3 , 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Estimating COVID-19 vaccine uptake and its drivers among migrants, homeless and precariously housed people in France

Roederer¹,

Mollo

Charline³

et al. 2023

Commun Med

View full text Add to dashboard Cite

Background Migrants, people experiencing homelessness (PEH), or precariously housed (PH) are at high risk for COVID-19 infection, hospitalization, and death from COVID-19. However, while data on COVID-19 vaccine uptake in these populations are available in the USA, Canada, and Denmark, we are lacking, to the best of our knowledge, data from France. Methods In late 2021, we carried out a cross-sectional survey to determine COVID-19 vaccine coverage in PEH/PH residing in Ile-de-France and Marseille, France, and to explore its drivers. Participants aged over 18 years were interviewed face-to-face where they slept the previous night, in their preferred language, and then stratified for analysis into three housing groups (Streets, Accommodated, and Precariously Housed). Standardized vaccination rates were computed and compared to the French population. Multilevel univariate and multivariable logistic regression models were built. Results We find that 76.2% (95% confidence interval [CI] 74.3–78.1) of the 3690 participants received at least one COVID-19 vaccine dose while 91.1% of the French population did so. Vaccine uptake varies by stratum, with the highest uptake (85.6%; reference) in PH, followed by Accommodated (75.4%; adjusted odds-ratio = 0.79; 95% CI 0.51–1.09 vs. PH) and lowest in Streets (42.0%; AOR = 0.38; 95%CI 0.25–0.57 vs. PH). Use for vaccine certificate, age, socioeconomic factors, and vaccine hesitancy is associated with vaccination coverage. Conclusions In France, PEH/PH, and especially the most excluded, are less likely than the general population to receive COVID-19 vaccines. While vaccine mandate has proved an effective strategy, targeted outreach, on-site vaccinations, and sensitization activities are strategies enhancing vaccine uptake that can easily be replicated in future campaigns and other settings.

show abstract

National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

et al. 2023

View full text Add to dashboard Cite

Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents, more adequate studies are needed to predict the trends of alcohol and substance use during recent periods, including the mid-pandemic period. This study investigated the changes in alcohol and substance use, except tobacco use, throughout the pre-, early-, and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South Korea. Methods Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention Agency. We evaluated adolescents’ alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend changes. We define the pre-COVID-19 period as consisting of four groups of consecutive years (2005–2008, 2009–2012, 2013–2015, and 2016–2019). The COVID-19 pandemic period is composed of 2020 (early-pandemic era) and 2021 (mid-pandemic era). Results More than a million adolescents successfully met the inclusion criteria. The weighted prevalence of current alcohol use was 26.8% [95% confidence interval (CI) 26.4–27.1] from 2005 to 2008 and 10.5% (95% CI 10.1–11.0) in 2020 and 2021. The weighted prevalence of substance use was 1.1% (95% CI 1.1–1.2) from 2005 to 2008 and 0.7% (95% CI 0.6–0.7) between 2020 and 2021. From 2005 to 2021, the overall trend of use of both alcohol and drugs was found to decrease, but the decline has slowed since COVID-19 epidemic (current alcohol use: β diff 0.167; 95% CI 0.150–0.184; substance use: β diff 0.152; 95% CI 0.110–0.194). The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex, grade, residence area, and smoking status from 2005 to 2021. Conclusion The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage (2020–2021) of the COVID-19 pandemic showed a slower decline than expected given the increase during the prepandemic period (2005–2019). Supplementary Information The online version contains supplementary material available at 10.1007/s12519-023-00715-9.

show abstract

Adverse SARS-CoV-2-associated outcomes among people experiencing social marginalisation and psychiatric vulnerability: A population-based cohort study among 4,4 million people

Cited by 21 publications

References 42 publications

Clinical Recovery and Long-Term Association of Specialized Early Intervention Services vs Treatment as Usual Among Individuals With First-Episode Schizophrenia Spectrum Disorder

Clinical Recovery and Long-Term Association of Specialized Early Intervention Services vs Treatment as Usual Among Individuals With First-Episode Schizophrenia Spectrum Disorder

Estimating COVID-19 vaccine uptake and its drivers among migrants, homeless and precariously housed people in France

National trends in alcohol and substance use among adolescents from 2005 to 2021: a Korean serial cross-sectional study of one million adolescents

Contact Info

Product

Resources

About