Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan
Abstract Background The COVID-19 pandemic has significantly affected global health, leading to an increased incidence of mental health disorders, particularly depression. Methods This matched cohort study aimed to assess the impact of COVID-19 on antidepressant prescriptions using data from Japan’s...
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BMC
2025-07-01
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| Series: | BMC Psychiatry |
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| Online Access: | https://doi.org/10.1186/s12888-025-07172-w |
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| author | Daisuke Miyamori Shuhei Yoshida Wataru Omori Saori Kashima Masanori Ito |
| author_facet | Daisuke Miyamori Shuhei Yoshida Wataru Omori Saori Kashima Masanori Ito |
| author_sort | Daisuke Miyamori |
| collection | DOAJ |
| description | Abstract Background The COVID-19 pandemic has significantly affected global health, leading to an increased incidence of mental health disorders, particularly depression. Methods This matched cohort study aimed to assess the impact of COVID-19 on antidepressant prescriptions using data from Japan’s National Insurance Claims Database. The primary outcome was new antidepressant prescriptions, with SARS-CoV-2 infection as exposure. Data were matched by age, sex, Charlson comorbidity index (CCI), and insurance enrollment date to compare SARS-CoV-2 infected individuals with matched uninfected controls. Follow-up was terminated upon new antidepressant prescriptions or at the end of the study. The incidence rate ratios (IRR) and differences were calculated and compared using survival analysis. Results In this study, 16 million participants were analyzed, forming approximately 2.5 million pairs. Over 34 months (median follow-up: 7 months, interquartile range 4–13), there were 54,352 and 33,101 antidepressant prescriptions in the COVID-19 and control groups, respectively, with a cumulative incidence difference of 841 events (95% confidence interval [CI]: 815–860) per 1,000,000 person-months and an IRR of 1.56 (95%CI 1.54–1.58). The largest increase was observed with serotonin antagonists and reuptake inhibitors (IRR:2.18, 95%CI 2.11–2.25). Subgroup analyses revealed higher prescription rates among older adults (65 + years; IRR:2.02, 95%CI 1.98–2.07) and those with higher CCI scores (4+; IRR:1.82, 95%CI 1.77–1.88). Sensitivity analysis confirmed a persistent increase in risk 1-year post-exposure, with IRR of 1.65 (95%CI 1.63–1.68) and 1.23 (95%CI 1.19–1.27) before and after 1 year, respectively. Conclusion COVID-19 is significantly associated with an increased risk of antidepressant prescriptions, underscoring the need for enhanced mental health support and resources. Addressing stigma and ensuring timely interventions are essential for managing mental health in this context. |
| format | Article |
| id | doaj-art-0be6b754fb8f4c7b9a3be68016286aef |
| institution | Kabale University |
| issn | 1471-244X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj-art-0be6b754fb8f4c7b9a3be68016286aef2025-08-20T03:46:11ZengBMCBMC Psychiatry1471-244X2025-07-0125111210.1186/s12888-025-07172-wImpact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in JapanDaisuke Miyamori0Shuhei Yoshida1Wataru Omori2Saori Kashima3Masanori Ito4Department of General Internal Medicine, Hiroshima University HospitalDepartment of General Internal Medicine, Hiroshima University HospitalDepartment of Psychiatry and Neurosciences, Graduate School of Biomedical Sciences, Hiroshima UniversityCenter for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima UniversityDepartment of General Internal Medicine, Hiroshima University HospitalAbstract Background The COVID-19 pandemic has significantly affected global health, leading to an increased incidence of mental health disorders, particularly depression. Methods This matched cohort study aimed to assess the impact of COVID-19 on antidepressant prescriptions using data from Japan’s National Insurance Claims Database. The primary outcome was new antidepressant prescriptions, with SARS-CoV-2 infection as exposure. Data were matched by age, sex, Charlson comorbidity index (CCI), and insurance enrollment date to compare SARS-CoV-2 infected individuals with matched uninfected controls. Follow-up was terminated upon new antidepressant prescriptions or at the end of the study. The incidence rate ratios (IRR) and differences were calculated and compared using survival analysis. Results In this study, 16 million participants were analyzed, forming approximately 2.5 million pairs. Over 34 months (median follow-up: 7 months, interquartile range 4–13), there were 54,352 and 33,101 antidepressant prescriptions in the COVID-19 and control groups, respectively, with a cumulative incidence difference of 841 events (95% confidence interval [CI]: 815–860) per 1,000,000 person-months and an IRR of 1.56 (95%CI 1.54–1.58). The largest increase was observed with serotonin antagonists and reuptake inhibitors (IRR:2.18, 95%CI 2.11–2.25). Subgroup analyses revealed higher prescription rates among older adults (65 + years; IRR:2.02, 95%CI 1.98–2.07) and those with higher CCI scores (4+; IRR:1.82, 95%CI 1.77–1.88). Sensitivity analysis confirmed a persistent increase in risk 1-year post-exposure, with IRR of 1.65 (95%CI 1.63–1.68) and 1.23 (95%CI 1.19–1.27) before and after 1 year, respectively. Conclusion COVID-19 is significantly associated with an increased risk of antidepressant prescriptions, underscoring the need for enhanced mental health support and resources. Addressing stigma and ensuring timely interventions are essential for managing mental health in this context.https://doi.org/10.1186/s12888-025-07172-wCOVID-19AntidepressantsNational insurance claims databaseMatched cohort studyDepressionSARS-CoV-2 |
| spellingShingle | Daisuke Miyamori Shuhei Yoshida Wataru Omori Saori Kashima Masanori Ito Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan BMC Psychiatry COVID-19 Antidepressants National insurance claims database Matched cohort study Depression SARS-CoV-2 |
| title | Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan |
| title_full | Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan |
| title_fullStr | Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan |
| title_full_unstemmed | Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan |
| title_short | Impact of COVID-19 on antidepressant prescription: a matched cohort study using the National insurance claims database in Japan |
| title_sort | impact of covid 19 on antidepressant prescription a matched cohort study using the national insurance claims database in japan |
| topic | COVID-19 Antidepressants National insurance claims database Matched cohort study Depression SARS-CoV-2 |
| url | https://doi.org/10.1186/s12888-025-07172-w |
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