Impact of COVID‐19 social distancing measures on routine mental health care provision and treatment outcome for common mental disorders in the Netherlands

Beurs, Edwin de; Blankers, Matthijs; Peen, Jaap; Rademacher, Clara; Podgorski, Alicja; Dekker, Jack

doi:10.1002/cpp.2713

Cited by 10 publications

(12 citation statements)

References 58 publications

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“…Using a similar approach as de Beurs et al (2022) who studied a sample of adults, we did not find differences between the three groups of children in the overall reduction in internalizing or externalizing problems over time. All groups did show diminished problems after treatment compared to before treatment.…”

Section: Discussionmentioning

confidence: 60%

Changes in internalizing and externalizing problems in Dutch children and adolescents receiving youth care before and during the COVID-19 pandemic

Broek,

De Meyer,

van der Rijken

et al. 2023

Preprint

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BackgroundThe COVID-19 pandemic had serious effects on the mental health of children and adolescents. However, it is unclear how the pandemic may have affected treatment effects and outcomes in youth care. We investigated if treatment effects and externalizing and internalizing problems of children and adolescents receiving youth care were affected by the COVID-19 pandemic.MethodsWe used data from children and adolescents in youth care (N= 1,090,Mage= 12.85 (SD= 2.83; range = 8-18 years)). Internalizing and externalizing problems were assessed at the start and end of treatment using the Child Behavior Checklist. We inspected change in internalizing and externalizing problems and clinical status at the end of treatment to investigate treatment effects, and the level of problems at the start and end of treatment. Outcomes were compared between three groups: children treated entirely before the COVID-19 pandemic, children who experienced the transition into COVID-19 measures during treatment, and children treated entirely during the pandemic.ResultsWe did not find evidence that the pandemic affected treatment effectiveness. However, fewer children who were treated during the pandemic recovered from externalizing problems compared to children treated before the pandemic. Children who received treatment entirely during the pandemic also showed more internalizing and externalizing problems at both the start and end of their treatment, and children who experienced the transition into the pandemic showed elevated externalizing problems at both timepoints.ConclusionsAlthough the change in internalizing and externalizing problems from start to end of treatment was not affected by the pandemic, our findings that children are entering and leaving care with more problems suggest that child mental health has deteriorated since the pandemic.

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Section: Discussionmentioning

confidence: 60%

Changes in internalizing and externalizing problems in Dutch children and adolescents receiving youth care before and during the COVID-19 pandemic

Broek,

De Meyer,

van der Rijken

et al. 2023

Preprint

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“…Similar to the existing research on the comparison between video conferencing treatment and in‐person treatment, there is convincing evidence for the effectiveness of video conferencing treatment in general (de Beurs et al, 2022) and for AUD in particular: Tarp et al (2017) found no differences in treatment outcome for AUD between regular in‐person treatment and in‐person treatment with some of the sessions conducted in video conferencing format (so called “blended treatment”). A systematic review supports these findings, by demonstrating that there is no difference in treatment outcome of alcohol consumption between in‐person treatment and video conferencing treatment (Byaruhanga et al, 2020).…”

Section: Introductionmentioning

confidence: 62%

“…An observational study can show whether video-conferencing treatment is non-inferior to in-person therapy in everyday clinical practice. In a previous Dutch observational study of the effectiveness of video conferencing treatment for common mental disorders, such as depression and anxiety disorders, no differences in outcomes were found (de Beurs et al, 2022). It is important to investigate whether this holds as well for the treatment of AUD.…”

Section: Introductionmentioning

confidence: 96%

Alcohol use disorder treatment via video conferencing compared with in‐person therapy during COVID‐19 social distancing : A non‐inferiority comparison of three cohorts

de Beurs,

Rademacher,

Blankers

et al. 2023

Alcohol: Clinical and Experimental Research

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BackgroundSocial distancing measures during the COVID‐19 pandemic forced an abrupt transformation of treatment delivery for mental health care. In mid‐March 2020, nearly all in‐person contact was replaced with video conferencing. The pandemic thus offered a natural experiment and a unique opportunity to conduct an observational study of whether alcohol use disorder treatment through video conferencing is non‐inferior to in‐person treatment.MethodsIn a large urban substance use disorder treatment center in the Netherlands, treatment evaluation is routine practice. Outcome data are regularly collected to support shared decision making and monitor patient progress. For this study, pre‐test and post‐test data on alcohol use (Measurements in the Addictions for Triage and Evaluation), psychopathology (Depression Anxiety Stress Scales), and quality of life (Manchester Short Assessment of Quality of Life) were used to compare outcomes of cognitive behavioral therapy treatment for three cohorts: patients who received treatment for a primary alcohol use disorder performed prior to (n = 628), partially during (n = 557), and entirely during (n = 653) the COVID‐19 lockdown.ResultsOutcome was similar across the three cohorts: No inferior outcomes were found for treatments that were conducted predominantly through video conferencing during lockdown or treatments that started in‐person, but were continued through video conferencing, compared to in‐person treatments that were conducted prior to COVID‐19. The number of drop‐outs were also similar between cohorts. However, there was a difference in average treatment intensity between cohorts, with treatment partially or fully conducted during the COVID‐19 pandemic lasting longer.ConclusionsTreatment for a primary alcohol use disorder, provided partially or predominantly through video conferencing during the COVID‐19 pandemic resulted in abstinence rates and secondary outcomes similar to traditional in‐person care, in spite of the potentially negative effects of the COVID‐related lockdown measures themselves. These results from everyday clinical practice corroborate findings of randomized controlled studies and meta‐analyses in which video conferencing appeared non‐inferior to in‐person care in clinical effectiveness.

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“…Although data availability and the organization of healthcare systems varied across countries, we aimed to collect as comparable measures of care utilization as possible. Previous studies suggest that among all mental disorders, CMD would belong to the most affected ( 11 , 16 , 17 ). Since, at least in Sweden and the UK, most individuals seeking care for CMD meet general practitioners rather than specialists [Flodin et al, n.d., ( 9 , 10 )], CMD counts in primary care would likely be among the most sensitive measures for changes in population mental health.…”

Section: Introductionmentioning

confidence: 99%

Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study

Flodin

Wallin²,

Tarantino³

et al. 2023

Front. Psychiatry

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BackgroundThe COVID-19 pandemic is commonly believed to have increased common mental disorders (CMD, i.e., depression and anxiety), either directly due to COVID-19 contractions (death of near ones or residual conditions), or indirectly by increasing stress, economic uncertainty, and disruptions in daily life resulting from containment measure. Whereas studies reporting on initial changes in self-reported data frequently have reported increases in CMD, pandemic related changes in CMD related to primary care utilization are less well known. Analyzing time series of routinely and continuously sampled primary healthcare data from Sweden, Norway, Netherlands, and Latvia, we aimed to characterize the impact of the pandemic on CMD recorded prevalence in primary care. Furthermore, by relating these changes to country specific time-trajectories of two classes of containment measures, we evaluated the differential impact of containment strategies on CMD rates. Specifically, we wanted to test whether school restrictions would preferentially affect age groups corresponding to those of school children or their parents.MethodsFor the four investigated countries, we collected time-series of monthly counts of unique CMD patients in primary healthcare from the year 2015 (or 2017) until 2021. Using pre-pandemic timepoints to train seasonal Auto Regressive Integrated Moving Average (ARIMA) models, we predicted healthcare utilization during the pandemic. Discrepancies between observed and expected time series were quantified to infer pandemic related changes. To evaluate the effects of COVID-19 measures on CMD related primary care utilization, the predicted time series were related to country specific time series of levels of social distancing and school restrictions.ResultsIn all countries except Latvia there was an initial (April 2020) decrease in CMD care prevalence, where largest drops were found in Sweden (Prevalence Ratio, PR = 0.85; 95% CI 0.81–0.90), followed by Netherlands (0.86; 95% CI 0.76–1.02) and Norway (0.90; 95% CI 0.83–0.98). Latvia on the other hand experienced increased rates (1.25; 95% CI 1.08–1.49). Whereas PRs in Norway and Netherlands normalized during the latter half of 2020, PRs stayed low in Sweden and elevated in Latvia. The overall changes in PR during the pandemic year 2020 was significantly changed only for Sweden (0.91; 95% CI 0.90–0.93) and Latvia (1.20; 95% CI 1.14–1.26). Overall, the relationship between containment measures and CMD care prevalence were weak and non-significant. In particular, we could not observe any relationship of school restriction to CMD care prevalence for the age groups best corresponding to school children or their parents.ConclusionCommon mental disorders prevalence in primary care decreased during the initial phase of the COVID-19 pandemic in all countries except from Latvia, but normalized in Norway and Netherlands by the latter half of 2020. The onset of the pandemic and the containment strategies were highly correlated within each country, limiting strong conclusions on whether restriction policy had any effects on mental health. Specifically, we found no evidence of associations between school restrictions and CMD care prevalence. Overall, current results lend no support to the common belief that the pandemic severely impacted the mental health of the general population as indicated by healthcare utilization, apart from in Latvia. However, since healthcare utilization is affected by multiple factors in addition to actual need, future studies should combine complementary types of data to better understand the mental health impacts of the pandemic.

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Impact of COVID‐19 social distancing measures on routine mental health care provision and treatment outcome for common mental disorders in the Netherlands

Cited by 10 publications

References 58 publications

Changes in internalizing and externalizing problems in Dutch children and adolescents receiving youth care before and during the COVID-19 pandemic

Changes in internalizing and externalizing problems in Dutch children and adolescents receiving youth care before and during the COVID-19 pandemic

Alcohol use disorder treatment via video conferencing compared with in‐person therapy during COVID‐19 social distancing : A non‐inferiority comparison of three cohorts

Differential impact of the COVID-19 pandemic on primary care utilization related to common mental disorders in four European countries: A retrospective observational study

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