{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:52:00Z","timestamp":1793832720837,"version":"4.6.1"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"unspecified","delay-in-days":165,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01AI069924"],"award-info":[{"award-number":["U01AI069924"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["189498"],"award-info":[{"award-number":["189498"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["193381"],"award-info":[{"award-number":["193381"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol Psychiatr Sci"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2045796022000270_sec_a1\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The coronavirus disease 2019 (COVID-19) pandemic and ensuing restrictions have negatively affected the mental health and well-being of the general population, and there is increasing evidence suggesting that lockdowns have led to a disruption of health services. In March 2020, South Africa introduced a lockdown in response to the COVID-19 pandemic, entailing the suspension of all non-essential activities and a complete ban of tobacco and alcohol sales. We studied the effect of the lockdown on mental health care utilisation rates in private-sector care in South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796022000270_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an interrupted time-series analysis using insurance claims from 1 January 2017 to 1 June 2020 of beneficiaries 18 years or older from a large private sector medical insurance scheme. We calculated weekly outpatient consultation and hospital admission rates for organic mental disorders, substance use disorders, serious mental disorders, depression, anxiety, other mental disorders, any mental disorder and alcohol withdrawal syndrome. We calculated adjusted odds ratios (OR) for the effect of the lockdown on weekly outpatient consultation and hospital admission rates and the weekly change in rates during the lockdown until 1 June 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796022000270_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>710 367 persons were followed up for a median of 153 weeks. Hospital admission rates (OR 0.38; 95% confidence interval (CI) 0.33\u20130.44) and outpatient consultation rates (OR 0.74; 95% CI 0.63\u20130.87) for any mental disorder decreased substantially after the introduction of the lockdown and did not recover to pre-lockdown levels by 1 June 2020. Health care utilisation rates for alcohol withdrawal syndrome doubled after the introduction of the lockdown, but the statistical uncertainty around the estimates was large (OR 2.24; 95% CI 0.69\u20137.24).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2045796022000270_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mental health care utilisation rates for inpatient and outpatient services decreased substantially after the introduction of the lockdown. Hospital admissions and outpatient consultations for alcohol withdrawal syndrome increased after the introduction of the lockdown, but statistical uncertainty precludes strong conclusions about a potential unintended effect of the alcohol sales ban. Governments should integrate strategies for ensuring access and continuity of essential mental health services during lockdowns in pandemic preparedness planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s2045796022000270","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T04:51:09Z","timestamp":1655268669000},"source":"Crossref","is-referenced-by-count":21,"title":["The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time-series analysis"],"prefix":"10.1017","volume":"31","author":[{"given":"Anja","family":"Wettstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpho","family":"Tlali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Joska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morna","family":"Cornell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronika W.","family":"Skrivankova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soraya","family":"Seedat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes P.","family":"Mouton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh L.","family":"van den Heuvel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Maxwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary-Ann","family":"Davies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Maartens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Egger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4849-181X","authenticated-orcid":false,"given":"Andreas D.","family":"Haas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"S2045796022000270_ref33","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jad.2020.08.001","article-title":"Impact of COVID-19 pandemic on mental health in the general population: a systematic review","volume":"277","author":"Xiong","year":"2020","journal-title":"Journal of Affective Disorders"},{"key":"S2045796022000270_ref34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fpubh.2021.593307","article-title":"Utilization of inpatient mental health care in the Rhineland during the COVID-19 pandemic","volume":"9","author":"Zielasek","year":"2021","journal-title":"Frontiers in Public Health"},{"key":"S2045796022000270_ref9","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/PEC.0000000000002484","article-title":"Effect of the COVID-19 pandemic on patient volumes, acuity, and outcomes in pediatric emergency departments","volume":"37","author":"Finkelstein","year":"2021","journal-title":"Pediatric Emergency Care"},{"key":"S2045796022000270_ref29","doi-asserted-by":"crossref","first-page":"e543","DOI":"10.1016\/S2468-2667(20)30201-2","article-title":"Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study","volume":"5","author":"Williams","year":"2020","journal-title":"The Lancet Public Health"},{"key":"S2045796022000270_ref23","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1002\/(SICI)1099-1255(199611)11:6<619::AID-JAE418>3.0.CO;2-1","article-title":"Econometric methods for fractional response variables with an application to 401 (K) plan participation rates","volume":"11","author":"Papke","year":"1996","journal-title":"Journal of Applied Econometrics"},{"key":"S2045796022000270_ref15","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/S2215-0366(21)00242-X","article-title":"Hospital presentations for self-poisoning during COVID-19 in Sri Lanka: an interrupted time-series analysis","volume":"8","author":"Knipe","year":"2021","journal-title":"The Lancet Psychiatry"},{"key":"S2045796022000270_ref27","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/S0140-6736(21)02143-7","article-title":"Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic","volume":"398","author":"Santomauro","year":"2021","journal-title":"The Lancet"},{"key":"S2045796022000270_ref17","unstructured":"Kwinda, M (2020) Notice to amend Telemedicine Guidelines during COVID-19 \u2013 dated 3 April 2020. 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