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Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study

Laura Cowley, Karen Hodgson, Jiao Song, Tony Whiffen, Jacinta Tan Orcid Logo, Ann John Orcid Logo, Amrita Bandyopadhyay Orcid Logo, Alisha R Davies Orcid Logo

BMJ Open, Volume: 13, Issue: 6, Start page: e067882

Swansea University Authors: Laura Cowley, Jacinta Tan Orcid Logo, Ann John Orcid Logo

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DOI (Published version): 10.1136/bmjopen-2022-067882

Abstract

Objectives: To determine whether clinically extremely vulnerable (CEV) children or children living with a CEV person in Wales were at greater risk of presenting with anxiety or depression in primary or secondary care during the COVID-19 pandemic compared with children in the general population and t...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2023
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Design: Population-based cross-sectional cohort study using anonymised, linked, routinely collected health and administrative data held in the Secure Anonymised Information Linkage Databank. CEV individuals were identified using the COVID-19 shielded patient list. Setting: Primary and secondary healthcare settings covering 80% of the population of Wales. Participants: Children aged 2–17 in Wales: CEV (3769); living with a CEV person (20 033); or neither (415 009). Primary outcome measure: First record of anxiety or depression in primary or secondary healthcare in 2019/2020 and 2020/2021, identified using Read and International Classification of Diseases V.10 codes. Results: A Cox regression model adjusted for demographics and history of anxiety or depression revealed that only CEV children were at greater risk of presenting with anxiety or depression during the pandemic compared with the general population (HR=2.27, 95% CI=1.94 to 2.66, p&lt;0.001). Compared with the general population, the risk among CEV children was higher in 2020/2021 (risk ratio 3.04) compared with 2019/2020 (risk ratio 1.90). In 2020/2021, the period prevalence of anxiety or depression increased slightly among CEV children, but declined among the general population. 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The views expressed are entirely those of the authors and should not be assumed to be the same as those of ADP or MQ Mental Health Research Charity. This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. 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spelling v2 63661 2023-06-19 Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study a80501f280e89fee276510b25fc68e77 Laura Cowley Laura Cowley true false 7e34bcfc492efffababfc1d4b6477c30 0000-0002-8879-441X Jacinta Tan Jacinta Tan true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2023-06-19 HDAT Objectives: To determine whether clinically extremely vulnerable (CEV) children or children living with a CEV person in Wales were at greater risk of presenting with anxiety or depression in primary or secondary care during the COVID-19 pandemic compared with children in the general population and to compare patterns of anxiety and depression during the pandemic (23 March 2020–31 January 2021, referred to as 2020/2021) and before the pandemic (23 March 2019–31 January 2020, referred to as 2019/2020), between CEV children and the general population. Design: Population-based cross-sectional cohort study using anonymised, linked, routinely collected health and administrative data held in the Secure Anonymised Information Linkage Databank. CEV individuals were identified using the COVID-19 shielded patient list. Setting: Primary and secondary healthcare settings covering 80% of the population of Wales. Participants: Children aged 2–17 in Wales: CEV (3769); living with a CEV person (20 033); or neither (415 009). Primary outcome measure: First record of anxiety or depression in primary or secondary healthcare in 2019/2020 and 2020/2021, identified using Read and International Classification of Diseases V.10 codes. Results: A Cox regression model adjusted for demographics and history of anxiety or depression revealed that only CEV children were at greater risk of presenting with anxiety or depression during the pandemic compared with the general population (HR=2.27, 95% CI=1.94 to 2.66, p<0.001). Compared with the general population, the risk among CEV children was higher in 2020/2021 (risk ratio 3.04) compared with 2019/2020 (risk ratio 1.90). In 2020/2021, the period prevalence of anxiety or depression increased slightly among CEV children, but declined among the general population. Conclusions: Differences in the period prevalence of recorded anxiety or depression in healthcare between CEV children and the general population were largely driven by a reduction in presentations to healthcare services by children in the general population during the pandemic. Journal Article BMJ Open 13 6 e067882 BMJ 2044-6055 2044-6055 16 6 2023 2023-06-16 10.1136/bmjopen-2022-067882 http://dx.doi.org/10.1136/bmjopen-2022-067882 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University SU Library paid the OA fee (TA Institutional Deal) Adolescent Mental Health Data Platform (ADP) and the authors would like to acknowledge the data providers who supplied the datasets enabling this research study. The views expressed are entirely those of the authors and should not be assumed to be the same as those of ADP or MQ Mental Health Research Charity. This study makes use of anonymised data held in the Secure Anonymised Information Linkage (SAIL) Databank. We would like to acknowledge all the data providers who make anonymised data available for research. 2023-07-12T17:19:51.9453616 2023-06-19T10:38:14.4967153 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Laura Cowley 1 Karen Hodgson 2 Jiao Song 3 Tony Whiffen 4 Jacinta Tan 0000-0002-8879-441X 5 Ann John 0000-0002-5657-6995 6 Amrita Bandyopadhyay 0000-0003-2798-4030 7 Alisha R Davies 0000-0002-8066-7264 8 63661__27875__d675eeff49214f1194bd4c43e524c7bc.pdf 63661.VOR.pdf 2023-06-19T10:45:43.1824592 Output 1748487 application/pdf Version of Record true This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. true eng http://creativecommons.org/licenses/by-nc/4.0/
title Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
spellingShingle Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
Laura Cowley
Jacinta Tan
Ann John
title_short Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
title_full Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
title_fullStr Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
title_full_unstemmed Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
title_sort Effects of the COVID-19 pandemic on the mental health of clinically extremely vulnerable children and children living with clinically extremely vulnerable people in Wales: a data linkage study
author_id_str_mv a80501f280e89fee276510b25fc68e77
7e34bcfc492efffababfc1d4b6477c30
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv a80501f280e89fee276510b25fc68e77_***_Laura Cowley
7e34bcfc492efffababfc1d4b6477c30_***_Jacinta Tan
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Laura Cowley
Jacinta Tan
Ann John
author2 Laura Cowley
Karen Hodgson
Jiao Song
Tony Whiffen
Jacinta Tan
Ann John
Amrita Bandyopadhyay
Alisha R Davies
format Journal article
container_title BMJ Open
container_volume 13
container_issue 6
container_start_page e067882
publishDate 2023
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2022-067882
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1136/bmjopen-2022-067882
document_store_str 1
active_str 0
description Objectives: To determine whether clinically extremely vulnerable (CEV) children or children living with a CEV person in Wales were at greater risk of presenting with anxiety or depression in primary or secondary care during the COVID-19 pandemic compared with children in the general population and to compare patterns of anxiety and depression during the pandemic (23 March 2020–31 January 2021, referred to as 2020/2021) and before the pandemic (23 March 2019–31 January 2020, referred to as 2019/2020), between CEV children and the general population. Design: Population-based cross-sectional cohort study using anonymised, linked, routinely collected health and administrative data held in the Secure Anonymised Information Linkage Databank. CEV individuals were identified using the COVID-19 shielded patient list. Setting: Primary and secondary healthcare settings covering 80% of the population of Wales. Participants: Children aged 2–17 in Wales: CEV (3769); living with a CEV person (20 033); or neither (415 009). Primary outcome measure: First record of anxiety or depression in primary or secondary healthcare in 2019/2020 and 2020/2021, identified using Read and International Classification of Diseases V.10 codes. Results: A Cox regression model adjusted for demographics and history of anxiety or depression revealed that only CEV children were at greater risk of presenting with anxiety or depression during the pandemic compared with the general population (HR=2.27, 95% CI=1.94 to 2.66, p<0.001). Compared with the general population, the risk among CEV children was higher in 2020/2021 (risk ratio 3.04) compared with 2019/2020 (risk ratio 1.90). In 2020/2021, the period prevalence of anxiety or depression increased slightly among CEV children, but declined among the general population. Conclusions: Differences in the period prevalence of recorded anxiety or depression in healthcare between CEV children and the general population were largely driven by a reduction in presentations to healthcare services by children in the general population during the pandemic.
published_date 2023-06-16T17:19:47Z
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