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Substantial Mental Health Impact From COVID-19 Measures Found in New Research

Findings from new University of Texas Medical Branch research suggest a substantial mental health impact of COVID-related mitigation measures such as stay-at-home orders.

The study, which was published today in the JAMA Network Open, found an increase in the use of psychiatric medications coinciding with the COVID-19 pandemic among both men and women, with a substantially higher increase among women.

“We hope that this study highlights the disproportionate effect of the ongoing COVID-19 pandemic, sex as a priority in research on the COVID-19 pandemic and the need for interventions to address these sex disparities in the consequences of the pandemic,” said Dr. Sadaf Milani, Department of Internal Medicine assistant professor and one of the study’s authors.

Using data from Clinformatics Data Mart, one of the largest commercial health insurance databases in the United States, researchers identified qualified enrollees and their prescribed medicine from Jan. 1, 2018 to March 31, 2021. The study focused on prescriptions of benzodiazepines, Z-hypnotics and serotonergic drugs, which are commonly used to treat insomnia, anxiety and depressive disorders.

Benzodiazepine prescriptions decreased from Jan. 2018 to March 2021, except for a slight increase from January 2020 to April 2020 among women; Z-hypnotic prescriptions increased from Jan. 2020 for women and from February 2020 for men through October 2020; and serotonergic prescriptions increased from January 2018 to April 2020 for men and to October 2020 for women. The study noted that the decrease in benzodiazepine may be explained by current efforts to reduce its prescriptions.

Women had a higher rate of prescription use for all three psychiatric drug classes and larger changes in prescription rates over time compared to men, the data showed.

“The substantially higher impact of the ongoing pandemic on women underscores the need for all providers across all settings of medical contact with women to incorporate a screening process for mental health conditions in their routine practice,” Milani said. “This is especially critical in moments of natural disasters, which our study suggests disproportionately impact women than men – vis-à-vis psychological toll.”

The study discusses several factors that may explain why women are disproportionately affected, including having higher rates of mental health conditions, comprising more than 75% of health care workers and serving as primary caregivers with an increased burden of childcare due to closures of schools and childcare centers during the pandemic.

“Providers and patients should have heightened awareness of the substantially higher rates of occurrence of anxiety, depressive symptoms and sleep disorders – both short- and long-term – in women compared to men, especially during periods of natural disasters, social disruptions and economic upheavals leading to school closure and social isolation with heavier load of childcare falling on women,” Milani said.

The study also indicated that as additional data is accumulated, studying the long-term consequences of these prescribing trends and how they relate to mental health outcomes may be necessary.

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