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Characteristics of mental health emergency visits among adolescents before and during the COVID-19 pandemic.
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We described changes caused by the COVID-19 pandemic in the frequency of Emergency Department (ED) visits for mental health disorders (MHDs) in adolescents on a wider temporal range—that is, not just “the waves” of the pandemic—and characterized the profile of the adolescent seeking emergency psychiatric care. We conducted a retrospective longitudi...
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Context 1
... ED visits for MHDs increased by 45.08% in the COVID-19 period than the prior period (Table 1). The demographic and clinical characteristics and the medical history and disposition of the total population and the two study groups are reported in Table 2. Referring to the demographic features, the median age at ED admission was 15.75 years (14.5-16.83 ...Similar publications
Introduction: The number of emergency department observation units (EDOU) and observation stays has continued to increase. Despite this, there is limited data on the characteristics of patients who return unexpectedly to the ED after EDOU discharge.
Methods: We identified the charts of all patients who were admitted to the EDOU of an academic medi...
Citations
... This study found that ER visits for symptoms of depression, post-traumatic stress, psychosis, and self-harm in children and adolescents increased from 2019 to 2021. Subsequent studies conducted in other Italian hospitals confirmed these data [27], leading to the hypothesis that the persistence in time of the COVID-19 pandemic had a detrimental effect on youth psychological well-being, with plausible long-term implications. ...
... Regardless of the reasons that could explain the significant increase in the symptoms of anxiety, depression, eating disorders, self-harm, and somatization motivating presentations to the ER, we could support the hypothesis that the time trends of APSs could reflect the trend over the last century in the worsening of the mental health of children and adolescents, with an overlapping effect of the pandemic, which could have created a new social and health scenario and worsened the state of the mental health of the young population [27]. Certainly, at present, greater clinical severity and etiopathogenic complexities require less immediate and more complicated treatments than in the past. ...
Recent studies have revealed increasingly worse and more complex mental health conditions in young people, which is reflected in a growing trend in emergency room (ER) visits for acute psychopathological symptoms (APSs). This phenomenon has become exacerbated in recent decades, with a peak in the post-pandemic period. To better characterize the phenomenon, we investigated the change in the rate and type of ER counseling requests provided at the Child Neuropsychiatry Unit of the University Hospital of Bari, Italy over the period between 2019 and 2023 for subjects younger than 18 years old. For this purpose, we retrospectively analyzed a total number of 1073 urgent consultation reports retrieved through the reporting computerized operating system of our hospital. The distribution of the counseling requests provided for APSs and, among these, the distribution of the numbers of APSs and of the male: female ratio were significantly different over the years, with an increasing linear trend identified for APSs (p = 3.095 × 10−7), the average number of APSs (p = 3.598 × 10−7), and female gender prevalence (p = 0.03908), as well as for the patients with a history of psychotropic drug assumption (p = 0.0006319). A significant change in the number of urgent counseling requests received for eating disorders (p = 0.0007408), depression (p = 7.92 × 10−8), somatization (p = 4.03 × 10−6), self-harm (SA) (p = 1.358 × 10−6), and non-suicidal self-injury (NSSI) (p = 8.965 × 10−6) was found, with a significant increasing trend for anxiety (p = 0.0444), depression (p = 8.06 × 10−6), somatization (p = 0.004616), SA (p = 3.998 × 10−8), and NSSI (p = 5.074 × 10−7). The findings of our study support the hypothesis of an alarming progressive worsening of the mental health of children and adolescents, with an overlapping effect of the pandemic exacerbating the process.
... For the change in emergencies in CAPs for affective disorders during the pandemic, results have been heterogenous, ranging from no differences in comparison with prepandemic times in an earlier study [33] to a significant increase in a rather new study [34]. For expansive disorders, results have again been heterogenous, with studies finding a decrease in aggressive behavior [34] and a consistent appearance of agitation [33]. ...
... For the change in emergencies in CAPs for affective disorders during the pandemic, results have been heterogenous, ranging from no differences in comparison with prepandemic times in an earlier study [33] to a significant increase in a rather new study [34]. For expansive disorders, results have again been heterogenous, with studies finding a decrease in aggressive behavior [34] and a consistent appearance of agitation [33]. For disruptive, impulse control, and conduct disorders, Ferro et al. [34] did not find any differences over time, whereas Shankar et al. [35] found an increase. ...
... For expansive disorders, results have again been heterogenous, with studies finding a decrease in aggressive behavior [34] and a consistent appearance of agitation [33]. For disruptive, impulse control, and conduct disorders, Ferro et al. [34] did not find any differences over time, whereas Shankar et al. [35] found an increase. Anxiety disorders could cautiously be concluded to have declined in emergency presentations [34,35]. ...
Psychiatric emergencies have increased in recent decades, particularly with the onset of the SARS-CoV-2 pandemic, and far too little is known about the backgrounds of these emergencies. In this study, we investigated the extent to which the number of psychiatric emergencies changed during and in the aftermath of the SARS-CoV-2 pandemic at the Child and Adolescent Psychiatry (CAP) Tübingen. We considered age and psychiatric diagnoses. Additionally, we evaluated the backgrounds of the emergencies. We applied a mixed- (quantitative and qualitative) methods approach to data on emergency presentations at the CAP Tübingen from the pre-SARS-CoV-2 pandemic period (October 2019–January 2020) to Restriction Phase 1 (October 2020–January 2021), Restriction Phase 2 (October 2021–January 2022), and endemic phase (October 2022–January 2023). The total number of emergencies and those with eating disorders and affective disorders increased, while obsessive–compulsive disorders, expansive disorders and anxiety disorders decreased. The patients presenting in the pre-SARS-CoV-2 pandemic period were younger than those in the subsequent periods. We content-coded the reasons behind the emergency presentations. We also identified four areas of stressors and personality characteristics associated with the emergency presentations. In light of the increasing number of psychiatric emergencies, the long-term aim should be to meet the growing demands and create options for prevention.
... Limitatamente al pe-riodo analizzato, si è osservato anche un aumento dei disturbi internalizzanti quali autolesionismo, disturbi d'ansia, disturbi dell'umore con ideazione suicidaria e tentativi di suicidio -oltre che disturbi della condotta alimentare e i disturbi dello spettro somatoforme [Figura 3]. Questo risultato è confermato da un altro studio italiano condotto presso l'Unità di Psichiatria dell'Ospedale Bambino Gesù nello stesso periodo [6]. Nota, liberamente tradotta dal manoscritto citato. ...
The Covid-19 pandemic has acted as a detrimental trigger for the malaise of pre-adolescents and adolescents, who, in a context of continuous and rapid social changes, are going through difficult times, featured by an epidemiological wideranging increase in accesses to mental health services, so high that it is likely to become a ‘new normality’. This article reviews the last three years of Italian medical history and shows the epidemiological data collected at national level and at the Giannina Gaslini tertiary care children’s hospital in the metropolitan city of Genoa.
Adolescence is a period of elevated risk for suicide, and mental health professionals expressed concerns that suicidal behaviours and suicide rates may increase among this age group during the COVID-19 pandemic. Adolescent suicide rates, attempts, and ideation during the pandemic varied depending on the country, data collection methodology, and population (e.g., general population vs. emergency department). Many pre-pandemic risk factors for suicidal behaviour or ideation were identified as risk factors during the pandemic; however, there was also some evidence that certain groups were disproportionately at risk, such as girls, and adolescents identifying as Black, Asian, American Indian/Alaska Native, or Asian/Pacific Islander. Given the trend of increased adolescent suicide in many countries over the past two decades, there is an ongoing need to direct resources toward prevention programs, screening, and evidence-based interventions for suicide risk.
