Increase in Referrals of Children and Adolescents to the Psychiatric Emergency Room Is Evident Only in the Second Year of the COVID-19 Pandemic—Evaluating 9156 Visits from 2010 through 2021 in a Single Psychiatric Emergency Room

Dror, Chen; Hertz‐Palmor, Nimrod; Yadan-Barzilai, Yael; Talia, Saker; Maya, Kritchmann-Lupo; Bloch, Yuval

doi:10.3390/ijerph19158924

Cited by 12 publications

(11 citation statements)

References 30 publications

(48 reference statements)

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“…However, if this had been the case, then a larger proportion of the ER visits would have resulted in hospitalization rather than in discharge. The current findings are in accord with a study that covered most of the psychiatric hospital beds for adolescents in Israel and showed a decline in 2020, probably at least partly related to inpatient services and mental health policies [ 24 ]. In the present study, there was no rise in the proportion of hospitalizations from ER visits; as such, the severity of the emergency seems not to have been the central reason for the decline.in ER referrals during the pandemic.…”

Section: Discussionsupporting

confidence: 91%

Pediatric psychiatric emergency rooms during COVID-19: a multi-center study

et al. 2022

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Background The COVID-19 (SARS-CoV-2) pandemic has been a major stressor for the mental health and well-being of children and adolescents. Surveys and reports from hotlines indicate a significant rise in mental health problems. As the psychiatric emergency room (ER) is a first-line free-of-charge facility for psychiatric emergencies, we expected to see a significant increase in visits, specifically of new patients suffering from anxiety, depression, or stress-related disorders. Methods Data from two psychiatric hospital ERs and one general hospital were included. All visits of children and adolescents from the computerized files between March and December of 2019 were analyzed anonymously and compared to the same months in 2020, using multilevel linear modeling. Results There was a significant decline in the total number of visits (p = .017), specifically among those diagnosed as suffering from stress-related, anxiety, and mood disorder groups (p = .017), and an incline in the proportion of visits of severe mental disorders (p = .029). Discussion The limited use of child and adolescent psychiatric emergency facilities during the pandemic highlights the importance of tele-psychiatry as part of emergency services. It also suggests the importance of the timeline of the emergence of clinically relevant new psychiatric diagnoses related to the pandemic. Future studies are needed to establish the long-term effects of the pandemic and the expeditious use of tele-psychiatry.

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Section: Discussionsupporting

confidence: 91%

Pediatric psychiatric emergency rooms during COVID-19: a multi-center study

et al. 2022

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“…Additionally, there was a decline in children’s and adolescents’ visits to psychiatric ERs during the early stages of the pandemic [ 7 , 8 ]. Conversely, in a recent study we showed that the first year of the COVID-19 pandemic was no different from the continuous decade long rise of referrals to the children and adolescents’ psychiatric ER and the second year showed an additional incline beyond the general trend [ 9 ]. There has been also a rise in visits of patients with severe mental disorders such as psychotic spectrum disorders and bipolar disorder [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Youth Psychiatric Hospitalization in Israel during COVID-19: A Multi-Center Study

Dror

Hertz‐Palmor

Barzilai

et al. 2022

IJERPH

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During the COVID-19 pandemic there have been numerous reports of increases in psychiatric morbidity and a deterioration of status among existing patients. There is little information about how this increase has affected youth and rates of adolescent psychiatric hospitalization. Our study was aimed at examining trends in youth psychiatric hospitalization during the first year of the COVID-19 pandemic. Method: We used medical records to compare trends in hospitalization rates from 2019 to 2020, among psychiatric youth wards from five different centers in Israel. Results: The number of patients that were hospitalized in youth psychiatric wards decreased significantly from 2019 (Mean ± SD=52.2 ± 28.6 per month) to 2020 (M ± SD = 40.8 ± 22.0; unstandardized B = −11.4, 95% CI = −14.4 to −8.3, p < 0.0001). There was a significant decrease in the number of patients that were hospitalized due to internalizing disorders from 2019 (M ± SD = 22.3 ± 9.3 per month) to 2020 (M ± SD = 16.8 ± 7.7; B = −5.5, 95% CI = −8.0 to −3.0, p = 0.0002) and a marginally significant increase in the number of restraints per month (2019: M ± SD = 2.8 ± 6.8, 2020: M ± SD = 9.0 ± 14.5; Z = −1.96, Rosenthal’s r= 0.36, p = 0.07).Conclusions: There was a significant decline in psychiatric hospitalizations during the pandemic, specifically among patients suffering from internalizing disorders. The reasons for this decline, and the future impact these changes had on hospitalizations during the pandemic demand further research. Study limitations: This is a retrospective multicenter study from five medical centers in Israel, therefore generalizability of our findings is limited.

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“…It has been reported that self-rated psychological problems, functional impairment, depression, and referral to psychiatric emergency services, appeared higher among young people after school re-openings ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Suicide attempts and eating disorders in adolescents, the mental health wave of the second year of the COVID-19 pandemic: A paediatric emergency department perspective

et al. 2023

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AimWe compared adolescents’ visits to a tertiary-level paediatric emergency department (PED) in Italy during the pre-pandemic year and the first and second years of the COVID-19 pandemic, focusing on mental health presentations.MethodsThis was a retrospective study. We collected the number of visits, the demographical features, triage codes, discharge diagnoses, and outcomes of adolescents 13–17 years old who accessed the PED from 1 March 2019 to 28 February 2022.ResultsDuring the study period, 13,410 adolescents accessed the PED. The number of visits related to mental health problems was 304 (6.4%) in the second year of the pandemic and 306 (5.6%) in the pre-pandemic year, p = 0.07. In the same periods, females’ prevalence was higher, 220 (72.4%) vs. 197 (64.4%), p = 0.03. The absolute number of subjects needing admission increased, 44 vs. 34, p = 0.21, and more urgent psychiatric consultations were needed, 161 vs. 114, p < 0.0001. The number of suicide attempts was 23 vs. 8, +188%, p = 0.01. The number of adolescents with eating disorders was 21 vs. 5, +320%, p = 0.001.ConclusionPED visits for suicide attempts and eating disorders in adolescents sharply increased in the second year of the pandemic.

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Increase in Referrals of Children and Adolescents to the Psychiatric Emergency Room Is Evident Only in the Second Year of the COVID-19 Pandemic—Evaluating 9156 Visits from 2010 through 2021 in a Single Psychiatric Emergency Room

Cited by 12 publications

References 30 publications

Pediatric psychiatric emergency rooms during COVID-19: a multi-center study

Pediatric psychiatric emergency rooms during COVID-19: a multi-center study

Youth Psychiatric Hospitalization in Israel during COVID-19: A Multi-Center Study

Suicide attempts and eating disorders in adolescents, the mental health wave of the second year of the COVID-19 pandemic: A paediatric emergency department perspective

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