Pre-existing and new users of psychotherapy and pharmacotherapy for common mental disorders during the COVID-19 pandemic: a population-based study

BackgroundThe COVID-19 pandemic increased mental health service use. The extent of treatment for common mental disorders (CMD) and the profile of new users remain poorly understood. This study aimed to assess the prevalence of psychotherapy and pharmacotherapy use for CMD in the French general population, and to compare the characteristics of new users during the pandemic with those of pre-existing users with respects to need, predisposing and enabling factors of healthcare use. MethodsWe conducted a cross-sectional study within the French Grippenet/Covidnet cohort in April 2022. Data were collected through a voluntary online questionnaire. Within the overall sample (n=4,159), weighted analyses estimated the prevalence for psychotherapy or pharmacotherapy use for CMD. Among users of these treatments (n=1,092), logistic regression models compared characteristics of new users during the pandemic versus pre-existing users. ResultsOverall, 26.1% (95%CI [24.4-27.8]) of participants reported receiving treatment for CMD: 16.0% [14.5-17.5] psychotherapy, and 18.0% [16.6-19.5] pharmacotherapy (anxiolytics: 12.2%, [11.0-13.4], antidepressants: 8.0%, [7.0-9.0], and hypnotics: 3.6%, [3.1-4.0]). Compared with pre-existing users (n=862), new users (n=230) were more likely to receive psychotherapy alone (45.8% vs. 25.9%, p < 0.0001), and less likely to use pharmacotherapy (54.2% vs. 74.1%, p < 0.0001). Compared with pre-existing users, new users of psychotherapy were more likely to report a decline in mental health during the pandemic (adjusted odd ratio [aOR]=2.63, 1.70-4.12), a history of symptomatic COVID-19 (aOR=1.54, 1.02-2.32), and to use pharmacotherapy (aOR=2.83, 1.68-4.84), but less likely to report financial difficulties (aOR=0.45, 0.23-0.87), or to have used pharmacotherapy before the pandemic (aOR=0.15, 0.08-0.27). New users of pharmacotherapy were more likely to report a decline in mental health during the pandemic (aOR=1.87, 1.28-2.74), to be a female (aOR=1.54, 1.02-2.39), to use psychotherapy (aOR=4.79, 2.87-8.08), but less likely to use psychoactive substances (aOR=0.59, 0.36-0.94) and to have used psychotherapy before the pandemic (aOR=0.14, 0.08-0.25). ConclusionsOne in four French adults was receiving treatment for CMD, with new users showing distinct treatment patterns and characteristics, highlighting the importance of addressing pandemic-related mental health needs and reducing financial barriers to psychotherapy.