{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:33:44Z","timestamp":1784957624769,"version":"3.55.0"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Otsuka Pharmaceutical Development & Commercialization, Inc"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research and Managerial Epidemiology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p> To estimate the impact COVID-19 pandemic on healthcare resource utilization (HCRU) among individuals with major depressive disorder (MDD). <\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p> A retrospective cohort study was conducted to compare HCRU in the twelve months prior to and six months following pandemic onset among 1,318,709 individuals with MDD and propensity-score matched controls. Outcomes were monthly rates of all-cause and MDD-specific outpatient, inpatient, and prescription medication HCRU. Piecewise random effects models were used to adjust for patient-level clustering, trends over time, and pre-pandemic factors. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> In the first month following onset, outpatient HCRU declined with primary care visits down 25.1%. Following this initial decline, outpatient HCRU increased, exceeding pre-pandemic rates within three months. By April 2020, three quarters of all psychotherapy sessions were delivered by telehealth, followed by psychiatry (62.3%), and primary care visits (30.1%). The use of telehealth remained highest for psychotherapy and psychiatry (representing 67.6% and 54.2% of visits, respectively, in September 2020). All-cause partial-day hospitalizations declined 50.5% and remained depressed through July 2020 (down 18.3%). Beginning in the first month post-onset, prescription medication HCRU increased for all antidepressant and antipsychotic medication classes: serotonin modulators (\u2009+\u200911.8%), bupropion (\u2009+\u200910.4%), SSRIs (\u2009+\u20099.0%), SNRIs (\u2009+\u20098.6%), and atypical antipsychotics (\u2009+\u20097.5%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Following pandemic onset, individuals with MDD realized an immediate, but short-lived, reduction in primary care HCRU. Telehealth use remained elevated through the first six months. The most significant and sustained reduction in HCRU was noted for partial-day hospitalizations and all-cause ED visits. <\/jats:p><\/jats:sec>","DOI":"10.1177\/23333928221111864","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T06:50:21Z","timestamp":1657176621000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of the COVID-19 Pandemic on Healthcare Resource Utilization in Individuals with Major Depressive Disorder"],"prefix":"10.1177","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4907-812X","authenticated-orcid":false,"given":"Joshua N.","family":"Liberman","sequence":"first","affiliation":[{"name":"Health Analytics, LLC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandipan","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Otsuka Pharmaceutical Development & Commercialization, Inc, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinyao","family":"Rui","sequence":"additional","affiliation":[{"name":"Health Analytics, LLC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Ruetsch","sequence":"additional","affiliation":[{"name":"Health Analytics, LLC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Rothman","sequence":"additional","affiliation":[{"name":"Otsuka Pharmaceutical Development & Commercialization, Inc, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Otsuka Pharmaceutical Development & Commercialization, Inc, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Forma","sequence":"additional","affiliation":[{"name":"Former employee of Otsuka Pharmaceutical Development & Commercialization, Inc"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"key":"bibr1-23333928221111864","unstructured":"Mehrotra A, Chernew ME, Linetsky D, Hatch H, Cutler DA. The impact of the COVID-19 pandemic on outpatient visits: A rebound emerges. To the Point (blog), Commonwealth Fund, updated May 19, 2020. doi:10.26099\/ds9e-jm36."},{"key":"bibr2-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-020-01044-z"},{"key":"bibr3-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.24984"},{"key":"bibr4-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.21476"},{"key":"bibr5-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113069"},{"key":"bibr6-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2020.04.013"},{"key":"bibr7-23333928221111864","unstructured":"Panchal N, Kamal R, Cox C, Garfield R. The implications of COVID-19 for mental health and substance use. Kaiser Family Foundation Issue Brief 2021. Available at https:\/\/www.kff.org\/coronavirus-covid-19\/issue-brief\/the-implications-of-covid-19-for-mental-health-and-substance-use\/. Accessed August 5, 2021."},{"key":"bibr8-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.19686"},{"key":"bibr9-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchp.2020.07.007"},{"key":"bibr10-23333928221111864","author":"Gobbi S","journal-title":"Front Psychiatry"},{"key":"bibr11-23333928221111864","author":"Lebel C","journal-title":"J Affect Dis"},{"key":"bibr12-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-021-01019-4"},{"key":"bibr13-23333928221111864","doi-asserted-by":"publisher","DOI":"10.1002\/da.20580"},{"key":"bibr14-23333928221111864","unstructured":"Nytimes. 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