LATEBREAKER
COVID-19 Pandemic
Changes in psychological disease incidence patterns during the COVID-19 pandemic: A study using the nationwide health insurance data of Korea Changwoo Han* Changwoo Han
Background
The psychological impact of the coronavirus disease (COVID-19) pandemic on a comprehensive set of psychological conditions has rarely been examined. Here, we aimed to use Korea’s universal health insurance data to evaluate changes in psychological disease incidence patterns during the pandemic.
Methods
Hospital visit data related to psychological diseases (January 2013–February 2023) were retrieved from the National Health Insurance Database. Using primary diagnostic codes, first-ever hospital visits for specific psychological diseases were identified, and monthly age-standardized incidence rates were calculated. An interrupted time-series analysis, adjusted for seasonality and long-term trends, was used to estimate counterfactual disease incidence rates. Observed and counterfactual rates were compared to estimate the disease incidence pattern changes during the pandemic.
Results
Compared to pre-pandemic rates, there was a decrease in the incidence [percentage changes in monthly age-standardized rate (95% confidence intervals)] of organic mental disorders (F00-F09) [-14.6% (-18.4, -10.9)] and psychoactive substance use-related disorders (F10-F19) [-12.9% (-17.5, -8.3)]. However, there was increase in anxiety-related disorders (F40-F48) [8.8% (3.1, 14.6)] and behavioural syndromes associated with physiological disturbances (F50-F59) [8.1% (4.2, 11.9)]. Additionally, the incidence of mental retardation (F70-F79) [8.6% (3.0, 14.2)], psychological developmental disorders (F80-F89) [19.6% (11.5, 27.7)], childhood- and adolescent-onset behavioural and emotional disorders (F90-F98) [45.1% (28.4, 61.8)], and unspecified mental diseases (F99) [51.8% (39.8, 63.8)] increased.
Conclusions
Psychological disease incidence patterns changed substantially during the pandemic in South Korea with important heterogeneity across specific conditions. Various pandemic-related stressors, such as disrupted lifestyles, social isolation and primary care accessibility, may explain these changes. The causes and public health consequences of these changes require further evaluation.