Impact of the COVID-19 Pandemic on Child and Adolescent Psychiatric Emergencies

Davico, Chiara; Marcotulli, Daniele; Lux, Caterina; Calderoni, Dario; Cammisa, Luca; Bondone, Claudia; Rosa-Brusin, Martina; Secci, Ilaria; Porro, Marzia; Campanile, Roberta; Bosia, Chiara; Santo, F. Di; Terrinoni, Arianna; Ricci, Federica; Amianto, Federico; Urbino, Antonio; Ferrara, Mauro; Vitiello, Benedetto

doi:10.4088/jcp.20m13467

Cited by 40 publications

(51 citation statements)

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“…PICUs are affected by changes in this field, since they are frequently involved in stabilizing patients' vital functions and surveillance after self-harm and suicide attempts. During the lockdown, psychiatric ED visits declined, as well as self-reported suicide plans or attempts [24][25][26]. Our study also found a decline in suicide attempts for adolescent girls, but an increase among adolescent boys.…”

Section: Discussionsupporting

confidence: 59%

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

et al. 2022

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Children’s and adolescents’ lives drastically changed during COVID lockdowns worldwide. To compare accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID lockdown with previous years, we conducted a retrospective multicenter study among 37 PICUs (21.5% of German PICU capacities). A total of 1444 admissions after accidents or injuries during the first lockdown period and matched periods of 2017–2019 were reported and standardized morbidity ratios (SMR) were calculated. Total PICU admissions due to accidents/injuries declined from an average of 366 to 346 (SMR 0.95 (CI 0.85–1.05)). Admissions with trauma increased from 196 to 212 (1.07 (0.93–1.23). Traffic accidents and school/kindergarten accidents decreased (0.77 (0.57–1.02 and 0.26 (0.05–0.75)), whereas household and leisure accidents increased (1.33 (1.06–1.66) and 1.34 (1.06–1.67)). Less neurosurgeries and more visceral surgeries were performed (0.69 (0.38–1.16) and 2.09 (1.19–3.39)). Non-accidental non-suicidal injuries declined (0.73 (0.42–1.17)). Suicide attempts increased in adolescent boys (1.38 (0.51–3.02)), but decreased in adolescent girls (0.56 (0.32–0.79)). In summary, changed trauma mechanisms entailed different surgeries compared to previous years. We found no evidence for an increase in child abuse cases requiring intensive care. The increase in suicide attempts among boys demands investigation.

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Section: Discussionsupporting

confidence: 59%

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

et al. 2022

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“…Reported number and proportion of MHR ED visits have not consistently followed the pattern of overall pediatric ED visits following the pandemic onset. While both MHR and overall ED visits first decreased during 2020 [ 7 – 12 , 14 – 17 , 21 – 25 ], some studies have reported increased MHR ED utilization during 2021 and early 2022 [ 13 , 26 ] During this time, overall pediatric ED utilization has remained lower than pre-COVID-19 levels [ 6 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…So far, the bulk of the evidence regarding changes in pediatric MHR ED utilization has originated from the United States [ 6 , 9 , 12 , 15 – 17 , 21 – 23 , 26 ], with few studies from other parts of the world [ 7 , 8 , 10 , 11 , 13 , 14 , 24 , 25 ], thereby limiting the generalizability of findings to other countries. Potential regional and national differences could stem from varying COVID-19 epidemiology, public health responses, healthcare systems, socio-economic and sociocultural factors, and availability of mental health services [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

A comparative analysis of pediatric mental health-related emergency department utilization in Montréal, Canada, before and during the COVID-19 pandemic

et al. 2022

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Background Reports on longitudinal trends in mental health-related (MHR) emergency department (ED) utilization spanning the pre- and post-pandemic periods are lacking, along with evidence comparing healthcare services utilization by sociodemographic subgroups. The aim of this study was to evaluate COVID-19-associated changes in MHR ED utilization among youth overall and by age, sex, and socio-economic status (SES). Methods This retrospective cross-sectional study analyzed MHR ED utilization before and during the COVID-19 pandemic at a large urban pediatric tertiary care hospital in Montréal, Canada. All ED visits for children (5–11 years) and adolescents (12–17 years) between April 1, 2016 and November 30, 2021 were included. The main outcome was the monthly count of MHR ED visits. Pre-pandemic and pandemic periods were compared using an interrupted time series design. The effect of seasonality (in months), age (in years), sex (male or female), and SES (low, average, high) were compared using a generalized additive model. Results There were a total of 437,147 ED visits (204,215 unique patients) during the 5-year study period of which 9748 (5.8%) were MHR visits (7,686 unique patients). We observed an increase of 69% (95% CI, + 53% to + 85%; p = 0.001) in the mean monthly count of MHR ED visits during the pandemic period, which remained significant after adjusting for seasonality (44% increase, 95% CI, + 38% to + 51%; p = 0.001). The chance of presenting for a MHR ED visit increased non-linearly with age. There were increased odds of presenting for a MHR ED visit among girls between the pre-pandemic and pandemic periods (OR 1.42, 95% CI 1.29–1.56). No difference by SES group during and before the COVID-19 pandemic was found [OR 1.01, 95% CI 0.89–1.15 (low); OR 1.09, 95% CI 0.96–1.25 (high)]. Conclusions Our study shows important increases in MHR ED utilization among youth, and especially among girls, during the first 20 months of the COVID-19 pandemic, highlighting the need for sustained, targeted and scalable mental health resources to support youth mental health during the current and future crises.

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“…[12][13][14][15][16] Recent studies have also begun to evaluate the pandemic's impact on pediatric MBH visits to the ED. [17][18][19][20][21][22] The overall objective of this study was to explore the impact of the COVID-19 pandemic on pediatric ED MBH visits, comparing 2019 (pre-COVID period) with 2020 (COVID period). We evaluated trends in MBH visits from 2017 to 2020 and specifically compared changes in visit pattern, patient demographics, diagnosis categories, and ED disposition between 2019 and 2020.…”

mentioning

confidence: 99%

“…As the pandemic has carried on, however, more recent literature has begun to objectively investigate the psychological impact of the pandemic and the associated social distancing on children and adolescents 12–16 . Recent studies have also begun to evaluate the pandemic's impact on pediatric MBH visits to the ED 17–22 . The overall objective of this study was to explore the impact of the COVID-19 pandemic on pediatric ED MBH visits, comparing 2019 (pre-COVID period) with 2020 (COVID period).…”

mentioning

confidence: 99%

Impact of COVID-19 on Pediatric Mental and Behavioral Health Visits to the Emergency Department

Bolt

Patel²,

Stone

et al. 2022

Pediatr Emer Care

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ObjectivesThis study aimed to describe changes in pediatric emergency department (ED) mental and behavioral health (MBH) visits before and during the early COVID-19 pandemic.MethodsWe retrospectively reviewed medical records of patients aged from 5 to 17 years presenting to the pediatric ED of a major tertiary care hospital with MBH-related concerns from March 2017 to September 2020. We evaluated trends in MBH ED visits over the study period, specifically comparing patient demographics, diagnosis categories, and ED disposition between the pre-COVID (2019) and COVID (2020) periods using pairwise Pearson χ2 analyses with reported odds ratios (ORs) in SAS statistical software version 9.4 (SAS Institute Inc, Cary, NC).ResultsOf 8093 MBH-related visits, 58.5% were females, 85.4% were adolescents, and 62.7% self-identified as non-Hispanic. The proportion of MBH-related ED visits increased from 3.8% to 7.5% over the study period (P < 0.0001). Although total MBH visits decreased by 17.3% from 2019 to 2020, there was a proportionate increase in MBH-to-total-ED visits, representing a 42.8% increase through 2019. Compared with 2019, there was a proportionate increase in MBH-related ED visits by females (10.6%, P < 0.0001), older adolescents (18.2%, P < 0.0001), and non-Hispanic patients (6.1%, P = 0.017) in 2020. The MBH visits in 2020 were more likely related to suicidality/self-harm (OR, 1.2; confidence interval [CI], 1.1–1.4) or substance use (OR, 1.4; CI, 1.1–1.9). Compared with 2019, there were significantly higher odds of admission (OR, 1.6; CI, 1.3–2.1) or transfer for inpatient psychiatric care (OR, 1.8; CI, 1.6–2.1) in 2020.ConclusionsOur data suggest that the early COVID-19 pandemic had a significant impact on MBH-related ED visits. Compared with 2019, we observed a significant increase in the proportion of MBH-to-total-ED visits primarily affecting older adolescent, non-Hispanic girls with suicidality/self-harm and substance-related disorders in 2020, despite an overall decrease in the number of MBH visits during this period. There was also an increase in the proportion of visits resulting in admission or transfer for inpatient psychiatric care in 2020.

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Impact of the COVID-19 Pandemic on Child and Adolescent Psychiatric Emergencies

Cited by 40 publications

References 0 publications

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

A comparative analysis of pediatric mental health-related emergency department utilization in Montréal, Canada, before and during the COVID-19 pandemic

Impact of COVID-19 on Pediatric Mental and Behavioral Health Visits to the Emergency Department

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