Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study

Wong, Ben Hoi-Ching; Cross, Samantha; Zavaleta-Ramírez, Patricia; Bauda, Ines; Hoffman, Pamela; Ibeziako, Patricia; Nussbaum, Laura Alexandra; Berger, Gregor; Hassanian‐Moghaddam, Hossein; Kapornai, Krisztina; Mehdi, Tauseef; Tolmac, Jovanka; Barrett, Elizabeth; Romaniuk, Liana; Davico, Chiara; Moghraby, Omer S; Ostrauskaite, Giedra; Chakrabarti, Sulagna; Carucci, Sara; Sófi, Gyula; Hussain, Haseena; Lloyd, Alexandra; McNicholas, Fiona; Meadowcroft, Ben; Rao, Manish; Csábí, Györgyi; Gatica-Bahamonde, Gabriel; Öğütlü, Hakan; Skouta, Eirini; Elvins, Rachel; Boege, Isabel; Dahanayake, Dulangi M.A.; Anderluh, Marija; Chandradasa, Miyuru; Girela-Serrano, Braulio M.; Uccella, Sarà; Stevanović, Dejan; Lamberti, Marco; Piercey, Amy; Nagy, Péter; Mehta, Varun; Rohanachandra, Yasodha Maheshi; Li, Jie; Tufan, Ali Evren; Mirza, Hassan; Rozali, Farah; Baig, Benjamin; Noor, Isa M.; Fujita, Saori; Gholami, Narges; Hangül, Zehra; Vasileva, A. V.; Salucci, Katie; Bilaç, Öznur; Yektaş, Çiğdem; Cansız, Mehmet Akif; Aksu, Gülen Güler; Suleiman, Babatunde; Youssef, Fatima; Al‐Huseini, Salim; Kılıçaslan, Fethiye; Kütük, Özgür; Pilecka, Izabela; Bakolis, Ioannis; Ougrin, Dennis

doi:10.1016/j.jaac.2022.11.016

Cited by 25 publications

(14 citation statements)

References 47 publications

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“…There was a big surplus of referrals provided in 2021, both for existing patients (follow-ups) and new patients ( rst referrals) and for both urgent and very fast referral types. These congruent trends, together with similar trends of substantial increase in urgent referrals reported in emergency departments globally [13], support the hypothesis of a deteriorating mental health in this population in that period. The spike in very fast referrals after the rst wave (and not for urgent referrals) may also re ect a deterioration, but fasttracking patients with the use of more urgent referral types and compensating for missed referrals might also play a role.…”

Section: Urgencysupporting

confidence: 80%

“…The striking difference between adult and child and adolescent psychiatry services is notable for rst referrals in 2021, when the total number of referrals exceeded those of 2019 by 42%. A recent large international observational study reported a twofold increase in the number of emergency presentations between March-April 2020 and March-April 2021 observed in 62 emergency child & adolescent psychiatry units in 24 countries [13]. Disruption in everyday routine during the COVID-19 pandemic with prolonged period of school closure, massive sudden increase in screen time with disruptions in social interactions, as well as a great amount of stress some young people have experienced, when schools started to gradually reopen in the beginning of 2021, might all have contributed to the observed dynamic [14].…”

Section: Child and Adolescent Psychiatry Servicesmentioning

confidence: 99%

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Referrals to outpatient specialist child and adolescent psychiatry services during the COVID-19 pandemic in Slovenia

Havaši¹,

Vinko²,

Anderluh

et al. 2023

Preprint

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Introduction: The COVID-19 pandemic and the efforts to curb the spread of the disease have exposed people to significant distress on one hand and limited the resources to deal with it on the other. In this article, we compare the data on referrals to child and adolescent psychiatry specialist outpatient services before and during the pandemic.Methods We collected data about the number of provided e-referrals for child and adolescent psychiatric services for the years 2019, 2020, and 2021. In the same way, data was also gathered for child and adolescent hematology/oncology and endocrinology services in the same period to serve as controls. The data was analyzed using descriptive statistics and gross trends were observed on data charts.Results There were marked reductions in the number of referrals provided in the first two epidemic waves. Follow-up referrals were generally reduced more than first referrals. For the third and fourth epidemic wave, there was no general trend of reduction – on the contrary, there was an increase in first referrals for child and adolescent psychiatry referrals, which was larger than in control fields. Females aged 10–19 contributed disproportionately to that increase. Referrals for neurotic, stress-related and somatoform disorders and especially affective disorders and behavioral syndromes, associated with physiological disturbances and physical factors, were important contributors to this trend.

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Section: Urgencysupporting

confidence: 80%

Section: Child and Adolescent Psychiatry Servicesmentioning

confidence: 99%

Referrals to outpatient specialist child and adolescent psychiatry services during the COVID-19 pandemic in Slovenia

Havaši¹,

Vinko²,

Anderluh

et al. 2023

Preprint

Self Cite

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“…Theoretically, such a condition, associated with the threat represented by the pandemic itself, may represent a significant risk factor for physical and mental health in adolescents. Consistently, adverse mental health symptoms have been frequently reported in adolescents during the pandemic, mainly in terms of depressive (and therefore suicidal) behaviors, self-harm, anxiety, and post-traumatic stress symptoms [ 123 , 124 , 125 , 126 , 127 , 128 ]. Around the world, high levels of uncertainty and psychological distress in adolescents during the pandemic have been consistently reported [ 129 , 130 , 131 ].…”

Section: The Impact Of Covid-19 Outbreak On Sleep and Mental Health I...mentioning

confidence: 99%

Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health

et al. 2023

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Sleep changes significantly throughout the human lifespan. Physiological modifications in sleep regulation, in common with many mammals (especially in the circadian rhythms), predispose adolescents to sleep loss until early adulthood. Adolescents are one-sixth of all human beings and are at high risk for mental diseases (particularly mood disorders) and self-injury. This has been attributed to the incredible number of changes occurring in a limited time window that encompasses rapid biological and psychosocial modifications, which predispose teens to at-risk behaviors. Adolescents’ sleep patterns have been investigated as a biunivocal cause for potential damaging conditions, in which insufficient sleep may be both a cause and a consequence of mental health problems. The recent COVID-19 pandemic in particular has made a detrimental contribution to many adolescents’ mental health and sleep quality. In this review, we aim to summarize the knowledge in the field and to explore implications for adolescents’ (and future adults’) mental and physical health, as well as to outline potential strategies of prevention.

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“…11 Since the COVID-19 pandemic, a global increase has been reported in young people presenting at accident and emergency departments (A&E) for self-harm and other psychiatric emergencies. 12 Post-discharge mental health follow-up for these young people is crucial. Previous research corroborated the elevated risks in completed suicide, hospital readmissions, and preventable adverse events, within the rst week following hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation

Wong,

Chu,

Calaminus

et al. 2023

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Background The number of accident and emergency (A&E) hospital attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition more than tripled between 2010 and 2022. After discharge from the hospital, attendance at follow-up appointments in the community is critical to ensure the safety of young people and optimise the use of clinical resources Aims To evaluate the association between follow-up attendance and the continuity of clinicians and clinical teams. Method A retrospective cohort study was conducted using electronic clinical record data from East London NHS Foundation Trust (ELFT), between April 2019 and March 2022. Multi-level mixed effects logistic regression was performed to model the follow-up attendance odds based on whether the same or different clinician and clinical team offered the initial A&E and the community follow-up appointment or whether a crisis team was involved. Results 3134 A&E presentations by 2368 young people were identified within the study period. Following these presentations, 2091 follow-up appointments in the community were offered. The attendance rate increased by more than three times if the follow-up appointment was offered by the same clinician who saw the young person in A&E (odds ratio (OR) = 3.66; 95% CI 1.65–8.13). Whether the same clin ical team provided the community follow-up appointment, or whether a crisis team was involved before discharge made no difference to the likelihood of follow-up attendance. Conclusions The findings support the importance of the continuity of clinicians in the care of young people in crisis. Crisis service planners and policymakers should prioritise the continuity of clinicians in mental health service models and rota planning.

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Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study

Cited by 25 publications

References 47 publications

Referrals to outpatient specialist child and adolescent psychiatry services during the COVID-19 pandemic in Slovenia

Referrals to outpatient specialist child and adolescent psychiatry services during the COVID-19 pandemic in Slovenia

Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health

Association between continuity of care and attendance of post-discharge follow-up after psychiatric emergency presentation

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