{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T06:43:41Z","timestamp":1770705821681,"version":"3.49.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T00:00:00Z","timestamp":1606348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p>To date, there is a paucity of information regarding the effect of COVID-19 or lockdown on mental disorders. We aimed to quantify the medium-term impact of lockdown on referrals to secondary care mental health clinical services. We conducted a controlled interrupted time series study using data from Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment population ~0.86 million). The UK lockdown resulted in an instantaneous drop in mental health referrals but then a longer-term acceleration in the referral rate (by 1.21 referrals per day per day, 95% confidence interval [CI] 0.41\u20132.02). This acceleration was primarily for urgent or emergency referrals (acceleration 0.96, CI 0.39\u20131.54), including referrals to liaison psychiatry (0.68, CI 0.35\u20131.02) and mental health crisis teams (0.61, CI 0.20\u20131.02). The acceleration was significant for females (0.56, CI 0.04\u20131.08), males (0.64, CI 0.05\u20131.22), working-age adults (0.93, CI 0.42\u20131.43), people of White ethnicity (0.98, CI 0.32\u20131.65), those living alone (1.26, CI 0.52\u20132.00), and those who had pre-existing depression (0.78, CI 0.19\u20131.38), severe mental illness (0.67, CI 0.19\u20131.15), hypertension\/cardiovascular\/cerebrovascular disease (0.56, CI 0.24\u20130.89), personality disorders (0.32, CI 0.12\u20130.51), asthma\/chronic obstructive pulmonary disease (0.28, CI 0.08\u20130.49), dyslipidemia (0.26, CI 0.04\u20130.47), anxiety (0.21, CI 0.08\u20130.34), substance misuse (0.21, CI 0.08\u20130.34), or reactions to severe stress (0.17, CI 0.01\u20130.32). No significant post-lockdown acceleration was observed for children\/adolescents, older adults, people of ethnic minorities, married\/cohabiting people, and those who had previous\/pre-existing dementia, diabetes, cancer, eating disorder, a history of self-harm, or intellectual disability. This evidence may help service planning and policy-making, including preparation for any future lockdown in response to outbreaks.<\/jats:p>","DOI":"10.3389\/fpsyt.2020.585915","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T07:28:21Z","timestamp":1606375701000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":48,"title":["The Medium-Term Impact of COVID-19 Lockdown on Referrals to Secondary Care Mental Health Services: A Controlled Interrupted Time Series Study"],"prefix":"10.3389","volume":"11","author":[{"given":"Shanquan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"She","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Kershenbaum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Fernandez-Egea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny R.","family":"Nelder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuoxin","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaoqun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolf N.","family":"Cardinal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2020,11,26]]},"reference":[{"key":"B1","unstructured":"Timeline of WHO's Response to COVID-192020"},{"key":"B2","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1002\/wps.20758","article-title":"Anxiety and depression among general population in China at the peak of the COVID-19 epidemic","volume":"19","author":"Li","year":"2020","journal-title":"World Psychiatry"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e19009","DOI":"10.2196\/19009","article-title":"Mental health, risk factors, and social media use during the COVID-19 epidemic and cordon sanitaire among the community and health professionals in Wuhan, China: cross-sectional survey","volume":"7","author":"Ni","year":"2020","journal-title":"JMIR Ment Health"},{"key":"B4","doi-asserted-by":"publisher","first-page":"102076","DOI":"10.1016\/j.ajp.2020.102076","article-title":"Assessing the anxiety level of Iranian general population during COVID-19 outbreak","volume":"51","author":"Moghanibashi-Mansourieh","year":"2020","journal-title":"Asian J Psychiatr"},{"key":"B5","unstructured":"Survey Results: Understanding People's Concerns About the Mental Health Impacts of the COVID-19 Pandemic2020"},{"key":"B6","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1016\/S2215-0366(20)30168-1","article-title":"Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science","volume":"7","author":"Holmes","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2020.03.009","article-title":"Mental health care for pregnant women in the COVID-19 outbreak is urgently needed","author":"Zeng","year":"2020","journal-title":"Women Birth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1056\/NEJMp2008017","article-title":"Mental health and the Covid-19 pandemic","volume":"383","author":"Pfefferbaum","year":"2020","journal-title":"N Engl J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e19","DOI":"10.1016\/S2215-0366(20)30079-1","article-title":"Mental health services for older adults in China during the COVID-19 outbreak","volume":"7","author":"Yang","year":"2020","journal-title":"Lancet Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/S2352-4642(20)30109-7","article-title":"Mental health effects of school closures during COVID-19","volume":"4","author":"Lee","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"key":"B11","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1001\/jamapsychiatry.2020.0894","article-title":"Addressing the COVID-19 pandemic in populations with serious mental illness","volume":"77","author":"Druss","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1001\/jamapediatrics.2020.1456","article-title":"Coronavirus disease 2019. 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