COVID-19 testing and mental health service utilization in Ontario: a population-based cohort study.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

International Journal of Public Health Pub Date : 2026-06-02 eCollection Date: 2026-01-01 DOI:10.3389/ijph.2026.1609134

Kiran Saqib, Vivek Goel, Joel A Dubin, Jeremy VanderDoes, Zahid Ahmad Butt

{"title":"COVID-19 testing and mental health service utilization in Ontario: a population-based cohort study.","authors":"Kiran Saqib, Vivek Goel, Joel A Dubin, Jeremy VanderDoes, Zahid Ahmad Butt","doi":"10.3389/ijph.2026.1609134","DOIUrl":null,"url":null,"abstract":"Objective: To examine differences in mental health-related healthcare utilization for anxiety and depression between individuals who did and did not undergo COVID-19 PCR testing in Ontario. Background: The COVID-19 pandemic has been associated with changes in mental health and healthcare utilization.Methods: We conducted a population-based retrospective cohort study using linked ICES data, including 6,175,114 adults (January 2020-March 2021). Exposure was PCR-positive, PCR-negative, or untested. The outcome was time to first mental health-related healthcare use for anxiety and depression, identified using validated codes. Adjusted hazard ratios (aHRs) were estimated using Cox models with propensity score matching.Results: Individuals who underwent testing had higher mental health-related healthcare utilization than untested individuals. This was observed in PCR-positive (aHR 6.37; 95% CI 6.25-6.50) and PCR-negative groups (aHR 5.91; 95% CI 5.87-5.95). Higher utilization occurred among younger individuals, females, and socioeconomically disadvantaged groups. Results were consistent in matched analyses.Conclusion: Individuals underwent testing had higher mental health service utilization; similar estimates across PCR-positive and PCR-negative groups suggest testing reflects underlying vulnerability and healthcare-seeking behavior rather than a causal effect on mental health outcomes.","PeriodicalId":14322,"journal":{"name":"International Journal of Public Health","volume":"71 ","pages":"1609134"},"PeriodicalIF":3.2000,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220775/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/ijph.2026.1609134","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To examine differences in mental health-related healthcare utilization for anxiety and depression between individuals who did and did not undergo COVID-19 PCR testing in Ontario. Background: The COVID-19 pandemic has been associated with changes in mental health and healthcare utilization.

Methods: We conducted a population-based retrospective cohort study using linked ICES data, including 6,175,114 adults (January 2020-March 2021). Exposure was PCR-positive, PCR-negative, or untested. The outcome was time to first mental health-related healthcare use for anxiety and depression, identified using validated codes. Adjusted hazard ratios (aHRs) were estimated using Cox models with propensity score matching.

Results: Individuals who underwent testing had higher mental health-related healthcare utilization than untested individuals. This was observed in PCR-positive (aHR 6.37; 95% CI 6.25-6.50) and PCR-negative groups (aHR 5.91; 95% CI 5.87-5.95). Higher utilization occurred among younger individuals, females, and socioeconomically disadvantaged groups. Results were consistent in matched analyses.

Conclusion: Individuals underwent testing had higher mental health service utilization; similar estimates across PCR-positive and PCR-negative groups suggest testing reflects underlying vulnerability and healthcare-seeking behavior rather than a causal effect on mental health outcomes.

查看原文本刊更多论文

安大略省COVID-19检测和心理健康服务利用：一项基于人群的队列研究

目的：研究安大略省接受和未接受COVID-19 PCR检测的个体在焦虑和抑郁方面的心理健康保健利用差异。背景：COVID-19大流行与心理健康和医疗保健利用的变化有关。方法：我们使用相关ICES数据进行了一项基于人群的回顾性队列研究，包括6,175,114名成年人（2020年1月至2021年3月）。暴露为聚合酶链反应阳性、聚合酶链反应阴性或未经检测。结果是第一次使用心理健康相关的医疗保健来治疗焦虑和抑郁，使用经过验证的代码进行识别。采用倾向评分匹配的Cox模型估计校正风险比（aHRs）。结果：接受测试的个体比未接受测试的个体有更高的心理健康相关的医疗保健利用。这在pcr阳性组（aHR 6.37; 95% CI 6.25-6.50）和pcr阴性组（aHR 5.91; 95% CI 5.87-5.95）中观察到。较高的利用率发生在年轻人、女性和社会经济弱势群体。配对分析的结果是一致的。结论：接受心理测试的个体心理健康服务利用率较高；对pcr阳性和pcr阴性人群的类似估计表明，检测反映了潜在的脆弱性和寻求医疗保健的行为，而不是对心理健康结果的因果影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

4.20

自引率

2.20%

发文量

269

审稿时长

12 months

期刊介绍： The International Journal of Public Health publishes scientific articles relevant to global public health, from different countries and cultures, and assembles them into issues that raise awareness and understanding of public health problems and solutions. The Journal welcomes submissions of original research, critical and relevant reviews, methodological papers and manuscripts that emphasize theoretical content. IJPH sometimes publishes commentaries and opinions. Special issues highlight key areas of current research. The Editorial Board''s mission is to provide a thoughtful forum for contemporary issues and challenges in global public health research and practice.