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Population-wide restrictions during the COVID-19 pandemic may create barriers to mental health diagnosis. This study aims to examine changes in the number of incident cases and the incidence rates of mental health diagnoses during the COVID-19 pandemic.
Methods
By using electronic health records from France, Germany, Italy, South Korea and the UK and claims data from the US, this study conducted interrupted time-series analyses to compare the monthly incident cases and the incidence of depressive disorders, anxiety disorders, alcohol misuse or dependence, substance misuse or dependence, bipolar disorders, personality disorders and psychoses diagnoses before (January 2017 to February 2020) and after (April 2020 to the latest available date of each database [up to November 2021]) the introduction of COVID-related restrictions.
Results
A total of 629,712,954 individuals were enrolled across nine databases. Following the introduction of restrictions, an immediate decline was observed in the number of incident cases of all mental health diagnoses in the US (rate ratios (RRs) ranged from 0.005 to 0.677) and in the incidence of all conditions in France, Germany, Italy and the US (RRs ranged from 0.002 to 0.422). In the UK, significant reductions were only observed in common mental illnesses. The number of incident cases and the incidence began to return to or exceed pre-pandemic levels in most countries from mid-2020 through 2021.
Conclusions
Healthcare providers should be prepared to deliver service adaptations to mitigate burdens directly or indirectly caused by delays in the diagnosis and treatment of mental health conditions.
The introduction situates the thirteen chapters of the volume in the field of discourse–pragmatic and change. It begins by explaining the history of the field, which was created from various strands of existing research in variationist sociolinguistics and pragmatics, and is now represented by the Discourse–Pragmatic Variation and Change (DiPVaC) Research Network, a group of scholars from a wide range of disciplines including sociolinguistics, pragmatics, conversation analysis, second language acquisition, corpus linguistics, and language contact. The introduction establishes the scope of the volume by identifying three major themes, including innovations in theory and method, innovative variables in English, and language contact, and explains how these themes fit together. It introduces the terminology used throughout the volume. Finally, it presents the structure of the volume and highlights the diverse perspectives, data sources, languages of analysis, and methodological and theoretical contributions of each chapter.
This study analyzes the use of general extenders in recorded conversations in English and Spanish between nine pairs of young adult Spanish–English bilingual friends from Southern Arizona. Building on previous studies in both languages, 325 tokens of general extenders were analyzed quantitatively according to frequency, length in words, and function (referential or non–referential), as well as the gender and language dominance of participants. It was expected that general extenders would be susceptible to borrowing in a language contact situation since discourse–pragmatic features often appear on the periphery of grammar and are detachable. However, in the speech of the same Spanish–English bilinguals, contact with English did not appear to influence the use of general extenders in Spanish. No English forms of general extenders were found in Spanish. Moreover, general extenders in Spanish were significantly longer and were used to fulfill referential functions more often than general extenders in English. As the first study to analyze the use of general extenders in English and Spanish in the speech of the same bilinguals, these results underline the ability of bilinguals to both understand and reproduce the subtleties of the use of these features in the two languages they speak.
After a brief overview of the advent of functional approaches to language in the mid– and late 1900s, stressing the importance of investigating pragmatic, i.e. implicit aspects of language use, and of simultaneously approaching language from different perspectives, this overview stresses the importance of understanding – rather than of finding some definite truth about language. The analysis of pragmatic particles (you know, like, well) in the mid–1960s showcased a plethora of challenges for investigations of language function and use that had previously not attracted scholars’ attention. This strand of research has fruitfully continued, especially so within the DiPVaC community, and constantly opens up new avenues of research. This overview lastly offers a reinterpretation of the author’s 1981 study of you know in terms of aspects of responsibility, suggesting that precisely responsibility – and its various facets – need to be given a more central task in future studies of language function and use, discourse, and pragmatics.