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Koet LBM, Velek P, Bindels PJE, Bohnen AM, de Schepper EIT, Gerger H. Children and young people's consultation rates for psychosocial problems between 2016 and 2021 in the Netherlands. Eur J Gen Pract 2024; 30:2357780. [PMID: 38832626 DOI: 10.1080/13814788.2024.2357780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/14/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Worldwide, there are concerns about declining mental health of children and young people (CYP). OBJECTIVES To examine trends in GP consultation rates for psychosocial problems and the impact of the COVID-19 pandemic. METHODS We performed a population-based cohort study using electronic GP records of CYP (0-24 years) living in the Rotterdam metropolitan area between 2016 and 2021. We calculated monthly consultation rates for psychosocial problems, stratified by age group and sex. We used negative binomial models to model the pre-COVID-19 trend, and estimate expected rates post-COVID-19 onset. We modelled the effect of COVID-19 infection rate and school closure on consultation rates per sex and age group. RESULTS The cohort increased from 64801 to 92093 CYP between January 2016 and December 2021. Median age was 12.5 years and 49.3% was female. Monthly consultation rates increased from 2,443 to 4,542 consultations per 100,000 patient months over the six years. This trend (RR 1.009, 95%CI 1.008-1.011) started well before the COVID-19 pandemic. Consultation rates of adolescent girls and young women increased most strongly. Between March and May 2020, there was a temporary reduction in consultation rates, whereupon these returned to expected levels. COVID-19 infection rate and school closures showed small but significant associations with consultation rates for psychosocial problems but this did not affect the overall trend. Although consultation rates for psychosocial problems increased, this increment was stable over the entire study period. CONCLUSION The COVID-19 pandemic did not significantly increase consultation rates for psychosocial problems in CYP. The consultation rates increased, especially in adolescent girls and young women.
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Affiliation(s)
- Lukas B M Koet
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Premysl Velek
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Patrick J E Bindels
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Arthur M Bohnen
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Evelien I T de Schepper
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Heike Gerger
- Department of General Practice, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Clinical Psychology, Open University, Heerlen, The Netherlands
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Bond L, Rooney L, Healy D, McNicholas F. A qualitative study exploring the challenges for a national police force as first responders to children and young people presenting with mental health crises: perspectives of emergency department professionals. Ir J Psychol Med 2024:1-7. [PMID: 38831731 DOI: 10.1017/ipm.2024.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
INTRODUCTION The difficulties in accessing Child and Adolescent Mental Health Services (CAMHS) and the lack of out-of-hours and crises services have resulted in Ireland's national police force, An Garda Síochána (GS), becoming increasingly involved as first responders to children and young people (CYP) who are experiencing potential mental health crises. AIMS To outline challenges faced by members of GS and emergency department (ED) professionals in such cases. METHOD Qualitative study design with semi-structured interviews conducted with a convenience sample of medical and mental health professionals (n = 11) from a paediatric ED who are frequently involved with the interface between GS and CYP experiencing potential mental health crises. Thematic analysis was conducted on transcribed interviews using the software package MaxQDA to systematically organise and code transcriptions. RESULTS Participants highlighted a lack of appropriate clinical settings within the ED for CYP who attend with a mental health crisis through GS. Whilst participants described positive rapport between GS and ED staff, interactions between GS and patients were identified as challenging. Knowledge gaps amongst members of GS in Mental Health Act (MHA) legislation and restraint were also identified as contributory stressors for GS and emergency department professionals. CONCLUSION The increased prevalence of CYP mental health issues and psychosocial stressors in conjunction with difficulty in accessing CAMHS means that challenges faced by GS as first responders are likely to continue. Research is needed to quantify the adverse personal impacts on GS along with the potential negative impact on youth. Access to emergency mental health review for youth is essential to optimise the experience of both groups.
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Affiliation(s)
- L Bond
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Psychiatry, Children's Hospital Ireland at Crumlin, Dublin, Ireland
| | - L Rooney
- School of Medicine, University College Dublin, Dublin, Ireland
| | - D Healy
- University College Dublin, UCD Institute of Criminology and Criminal Justice, Dublin, Ireland
| | - F McNicholas
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Psychiatry, Children's Hospital Ireland at Crumlin, Dublin, Ireland
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Maciá-Casas A, de la Iglesia-Larrad J, García-Ullán L, Refoyo-Matellán B, Munaiz-Cossío C, Díaz-Trejo S, Berdión-Marcos V, Calama-Martín J, Roncero C, Pérez J. Post-Pandemic Evolution of Suicide Risk in Children and Adolescents Attending a General Hospital Accident and Emergency Department. Healthcare (Basel) 2024; 12:977. [PMID: 38786388 PMCID: PMC11121140 DOI: 10.3390/healthcare12100977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Lockdowns and other health protective measures, such as social distancing, imposed during the COVID-19 pandemic nurtured unprecedented levels of stress and social isolation around the world. This scenario triggered an increase in suicide thoughts and self-harm behaviours among children and young people. However, the longer-term impact of the pandemic on children's and adolescents' mental health, especially with regard to self-harm, is still to be fully discovered. METHODS We carried out a retrospective study where we collected data related to suicide ideation and self-harm behaviours in all patients aged under 18 that required on-call psychiatric services at the General Hospital Accident and Emergency (A&E) department in Salamanca, Spain, during 2019 (pre-pandemic) and in both 2021 and 2022 to capture possible variation at different time points during the post-pandemic period. RESULTS A total of 316 patients aged under 18 were seen by on-call psychiatric services at the A&E department during the three time periods: 78 in 2019, 98 in 2021 and 140 in 2022. The mean age was 15.12 (SD 2.25) and females represented more than twice the number of males each year. More than half of all patients assessed during 2022 disclosed suicide thoughts, whilst in 2019, it was near 25%. This increase in suicide ideation rates was more marked among females (X2 = 15.127; p = 0.001), those aged over 15 (X2 = 16.437; p < 0.001) and/or those with a previous history of mental health problems (X2 = 17.823; p < 0.001). We identified an increase in the proportion of males with suicide ideas, especially between 2021 and 2022 (X2 = 8.396; p = 0.015). CONCLUSIONS Our study suggests that children's and adolescents' demand for urgent mental healthcare and their clinical presentations in A&E departments with suicide thoughts and/or self-injuries do not seem to be declining after the pandemic but increasing over time. More research is warranted to understand possible factors involved in this sustained upward trend.
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Affiliation(s)
- Ana Maciá-Casas
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Javier de la Iglesia-Larrad
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Department of Psychiatry, Faculty of Medicine, University of Salamanca, 37001 Salamanca, Spain
| | - Llanyra García-Ullán
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Department of Psychiatry, Faculty of Medicine, University of Salamanca, 37001 Salamanca, Spain
| | - Belén Refoyo-Matellán
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Clara Munaiz-Cossío
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
| | - Sara Díaz-Trejo
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Vanesa Berdión-Marcos
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Julia Calama-Martín
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
| | - Carlos Roncero
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Department of Psychiatry, Faculty of Medicine, University of Salamanca, 37001 Salamanca, Spain
| | - Jesús Pérez
- Psychiatry Service, Salamanca Healthcare Complex (CAUSA), 37007 Salamanca, Spain; (A.M.-C.); (J.d.l.I.-L.); (L.G.-U.); (B.R.-M.); (C.M.-C.); (S.D.-T.); (V.B.-M.); (J.C.-M.); (C.R.)
- Neuroscience Division, Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
- Department of Psychiatry, Faculty of Medicine, University of Salamanca, 37001 Salamanca, Spain
- Department of Psychiatry, University of Cambridge, Cambridge CB2 3EG, UK
- Norwich Medical School, University of East Anglia, Norwich NR4 7UQ, UK
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Zinchuk M, Kustov G, Beghi M, Bryzgalova Y, Sviatskaia E, Popova S, Voinova N, Terentieva M, Yakovlev A, Guekht A. Suicide risk in patients with a current depressive episode during the COVID-19 pandemic. Front Psychiatry 2024; 15:1343323. [PMID: 38726385 PMCID: PMC11079814 DOI: 10.3389/fpsyt.2024.1343323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction The prevalence of major depressive disorder (MDD) increased during the COVID-19 pandemic. Data on suicidality in these patients during the pandemic period remain scarce. The aim of the study was to determine the prevalence and variables associated with serious suicide risk in Russian inpatients with MDD during the COVID-19 pandemic. Methods A cross-sectional cohort study with consecutive sampling was conducted from January 1, 2021 to December 31, 2021. All patients completed the Mini International Neuropsychiatric Interview (M.I.N.I.) (including the suicidality module), the Beck Depression Inventory, and the State-Trait Anxiety Inventory, and underwent a semi-structured interview to collect relevant demographic and clinical data. Effect sizes for all independent variables and covariates were calculated using partial eta-squared (ηp2). Results Of the 6757 patients with non-psychotic mental disorders assessed, 1605 (23.7%) had MDD confirmed by the M.I.N.I., of whom 17.8% were at serious risk for suicide according to the M.I.N.I. suicidality module. Factors independently associated with serious suicide risk in Russian inpatients with MDD during the pandemic were younger age (ηp2 = 0.021), greater severity of depression (0.038), higher state anxiety (0.003), and nonsuicidal self-injury (NSSI) (0.066). The same variables, except for state anxiety, were independently associated with suicide risk in the subgroup of MDD patients previously infected with SARS-CoV2. Conclusion In the COVID-19 pandemic, the proportion of patients with MDD at serious risk of suicide was similar to pre-pandemic data. No associations were found between suicidality in patients with MDD and COVID-related factors. Younger age, greater severity of depression, and especially NSSI were the most significant risk factors for suicide in patients with MDD during the COVID-19 pandemic.
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Affiliation(s)
- Mikhail Zinchuk
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Georgii Kustov
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Massimiliano Beghi
- Department of Mental Health, azienda unità sanitaria locale (AUSL) Romagna, Cesena, Italy
| | - Yulia Bryzgalova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | | | - Sofya Popova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Nadezhda Voinova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Marina Terentieva
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Alexander Yakovlev
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, Moscow, Russia
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Newberry-Dupé J, Chu W, Craig S, Borschmann R, O'Reilly G, Yates P, Melvin G, King K, Hiscock H. Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions. Psychiatr Q 2024; 95:33-52. [PMID: 37938493 PMCID: PMC10901934 DOI: 10.1007/s11126-023-10057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/09/2023]
Abstract
The COVID-19 pandemic and associated public health measures altered patterns of help-seeking for mental health, with increases in emergency department utilisation reported. We examined the association between COVID-19 restrictions and adult emergency department (ED) mental health presentations in Victoria, Australia, through secondary analysis of data from 39 public EDs across the state. Participants were all patients (18+ years) presenting between 1 January 2018 and 31 October 2020 with mental health or intentional self-harm. The main outcome was number of presentations for each mental health condition, by patient age, socioeconomic status (SES), location, and ED triage category. We used a Poisson regression model to compare predicted monthly ED presentations based on trends from 2018, 2019 and 2020 (up to 31 March), with observed presentations during the initial months of the COVID-19 pandemic (1 April to 31 October 2020). There was an average of 4,967 adult mental health presentations per month pre-COVID-19 (1 January-31 March 2020) and 5,054 per month during the COVID-19 period (1 April-31 October 2020). Compared to predicted incidence, eating disorder presentations increased 24.0% in the COVID-19 period, primarily among higher SES females aged 18-24 years. Developmental/behavioural disorder presentations decreased by 19.7% for all age groups. Pandemic restrictions were associated with overall increases in monthly adult ED presentations for mental health, with some disorders increasing and others decreasing. Accessibility of acute mental health services needs to be addressed to meet changing demand and ensure services are responsive to changes in presentations resulting from future public health challenges.
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Affiliation(s)
- Jackson Newberry-Dupé
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia.
| | - Wanyu Chu
- Centre for Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Simon Craig
- Paediatric Emergency Department, Monash Medical Centre, Emergency Service, Monash Health, Clayton, VIC, Australia
- Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
- Emergency Research Group, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rohan Borschmann
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
| | - Gerard O'Reilly
- Emergency and Trauma Centre, The Alfred, Melbourne, Australia
- National Trauma Research Institute, The Alfred, Melbourne, Australia
- School of Public Health and Preventive Medicine, Alfred Campus, Monash University, Melbourne, Australia
| | - Paul Yates
- Department of Geriatric Medicine, Continuing Care Clinical Service Unit, Austin Health, Heidelberg, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Kylie King
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Harriet Hiscock
- Centre for Health Services, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
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Park JL, Clark CA, Bagshawe M, Kuntz J, Perri A, Deegan A, Marriott B, Rahman A, Graham S, McMorris CA. A comparison of psychiatric inpatient admissions in youth before and during the COVID-19 pandemic. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2024; 33:3-17. [PMID: 38449720 PMCID: PMC10914150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 10/10/2023] [Indexed: 03/08/2024]
Abstract
Background The current understanding of the effect of COVID-19 on child and youth admissions to psychiatric inpatient units over time is limited, with conflicting findings and many studies focusing on the initial wave of the pandemic. Objectives This study identified changes in psychiatric inpatient admissions, and reasons for admission, including suicidality and self-harm, before and during the COVID-19 pandemic. Method This time series study analyzed 3,723 admissions of youth (ages 0-18.88 years) admitted to four major psychiatry inpatient units in a large Canadian city between January 1st, 2016 and December 31st, 2021. Pre-pandemic (before March 11, 2020) and during-pandemic (after March 11, 2020) trends of admissions were explored using a Bayesian structural time series model (BSTS). Results The model revealed that overall admissions during the pandemic period exceeded what would have been predicted in the absence of a pandemic, a relative increase of 29%. Additionally, a rise in the total number of admissions due to self-harm and suicidality (29% increase), externalizing/behavioral issues (69% increase), and internalizing/emotional issues (28% increase) provided strong evidence of increased admissions compared to what might have been expected from pre-pandemic numbers. Conclusions There was strong evidence of increases in psychiatric inpatient admissions during the COVID-19 pandemic compared to expected trends based on pre-pandemic data. To ensure accessible and continuous mental health supports and services for youth and their families during future pandemics, these findings highlight the need for rapid expanse of inpatient mental health services, similar to what occurred in many intensive care units across Canada.
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Affiliation(s)
- Joanne L Park
- Department of Psychology, University of Calgary, Calgary, Alberta
- Alberta Children's Hospital Research Institute, Calgary, Alberta
| | - Chris A Clark
- Werklund School of Education, University of Calgary, Calgary, Alberta
| | - Mercedes Bagshawe
- Werklund School of Education, University of Calgary, Calgary, Alberta
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Alberta
| | - Jennifer Kuntz
- Child and Adolescent Addiction, Mental Health and Psychiatry Program, Alberta Health Services (AHS), Calgary, Alberta
| | - Andrea Perri
- Child and Adolescent Addiction, Mental Health and Psychiatry Program, Alberta Health Services (AHS), Calgary, Alberta
| | - Avril Deegan
- Child and Adolescent Addiction, Mental Health and Psychiatry Program, Alberta Health Services (AHS), Calgary, Alberta
| | - Brian Marriott
- Child and Adolescent Addiction, Mental Health and Psychiatry Program, Alberta Health Services (AHS), Calgary, Alberta
| | - Abdul Rahman
- Child and Adolescent Addiction, Mental Health and Psychiatry Program, Alberta Health Services (AHS), Calgary, Alberta
| | - Susan Graham
- Department of Psychology, University of Calgary, Calgary, Alberta
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, Alberta
| | - Carly A McMorris
- Werklund School of Education, University of Calgary, Calgary, Alberta
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Wüllner S, Hermenau K, Krutkova M, Petras IK, Hecker T, Siniatchkin M. Mobile applications in adolescent psychotherapy during the COVID-19 pandemic: a systematic review. Front Public Health 2024; 12:1345808. [PMID: 38420028 PMCID: PMC10899334 DOI: 10.3389/fpubh.2024.1345808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Background To bridge the gap in adolescent psychotherapy created by the increasing need for mental health interventions and the limited possibilities of in-person treatment during the pandemic, many health care providers opted to offer online mental health care programs. As a result, the number of mental health apps available in app stores experienced a sharp increase during the COVID-19 pandemic. Objective The aim of the current review is to provide an overview of feasibility and effectiveness studies testing mobile applications in adolescent psychotherapy during the peak phase of the COVID-19 pandemic. Methods We conducted a literature search in Pubmed, PsychInfo, Google Scholar, OpenSIGLE and OpenGREY for papers published from June 2020 to June 2023. Studies were included if they evaluated app-based interventions intended for psychotherapeutic treatment and targeted adolescents between 12 and 27 years of age with symptoms of psychological disorders. The quality of each study was assessed using the Systematic Assessment of Quality in Observational Research (SAQOR). Effectiveness outcomes were analyzed by vote counting and calculating a binomial probability test. Results The search yielded 31 relevant studies that examined 27 different apps with a total of 1,578 adolescent participants. Nine articles were primary effectiveness studies and 22 focused on feasibility measures as primary outcome. There was evidence that mental health apps influenced adolescents' psychotherapy, with 83% of the studies with effectiveness outcomes favoring the intervention (p = 0.002). Sixty-one percent of the included studies were rated at low or very low quality. Conclusions The pandemic has given apps a firm and important role in healthcare that will probably continue to expand in the future. To ensure that mental health apps are truly effective and beneficial for adolescents' psychotherapy, we need a standardized measurement of quality features of mental health apps and higher quality app evaluation studies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=406455, PROSPERO International Prospective Register of Systematic Reviews [CRD42023406455].
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Affiliation(s)
- Sarah Wüllner
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
| | - Katharin Hermenau
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
| | - Mariya Krutkova
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
| | - Ira-Katharina Petras
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of Children and Adolescents, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Tobias Hecker
- Institute for Interdisciplinary Conflict and Violence Research, Bielefeld University, Bielefeld, Germany
- Department of Psychology, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Michael Siniatchkin
- University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, Bielefeld University, Medical School East Westphalia, Bielefeld, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics of Children and Adolescents, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
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Mrożek-Gąsiorowska M, Tambor M. How COVID-19 has changed the utilization of different health care services in Poland. BMC Health Serv Res 2024; 24:105. [PMID: 38238694 PMCID: PMC10797947 DOI: 10.1186/s12913-024-10554-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected health care systems in many ways, including access to and the use of non-COVID services. The aim of the study was to assess the impact of the pandemic on the utilization of different public health care services in Poland. METHODS The aggregated data on health care users and provided services for the years 2015/2016-2021 were used to analyse the changes in health care utilization during the pandemic and deviations from pre-pandemic utilization trends. Quantitative analysis was complemented with qualitative descriptions of the changes in principles of health care provision during the pandemic. RESULTS The results show a considerable drop in the provision of most health care services in 2020 that in some cases disturbed pre-pandemic utilization trends and was not made up for in 2021. The most significant decrease has been observed in the field of preventive and public health services, as well as rehabilitation. The provision of these services was put on hold during the pandemic. CONCLUSIONS The accumulated COVID-19-related "health debt" urgently calls for government actions to strengthen disease prevention and health promotion in Poland.
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Affiliation(s)
- Magdalena Mrożek-Gąsiorowska
- Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawinska Street, 31-066, Krakow, Poland.
| | - Marzena Tambor
- Department of Health Economics and Social Security, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 8 Skawinska Street, 31-066, Krakow, Poland
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Orban E, Li LY, Gilbert M, Napp AK, Kaman A, Topf S, Boecker M, Devine J, Reiß F, Wendel F, Jung-Sievers C, Ernst VS, Franze M, Möhler E, Breitinger E, Bender S, Ravens-Sieberer U. Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies. Front Public Health 2024; 11:1275917. [PMID: 38259801 PMCID: PMC10800626 DOI: 10.3389/fpubh.2023.1275917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Background The COVID-19 pandemic has significantly impacted the mental health of children and families, i.e., due to measures like social distancing and remote schooling. While previous research has shown negative effects on mental health and health-related quality of life (HRQoL), most studies have focused on pre-post comparisons in the early pandemic stages. This systematic review aims to examine longitudinal studies to understand the long-term impacts of the pandemic on children and adolescents. Methods This systematic review adhered to the PRISMA guidelines and was preregistered in the international prospective register of systematic reviews (Record ID: CRD42022336930). We systematically searched PubMed/MEDLINE, Web of Science, PsycINFO, PSYNDEX, and the WHO-COVID-19 database and included studies published up to August 30, 2022. Based on pre-defined eligibility criteria, longitudinal and prospective studies that assessed the mental health or quality of life of children or adolescents (0-19 years) in the general population over a longer time span (at two or more measurement points) during the COVID-19 pandemic were included in the review. The methodological quality of the included studies was assessed using an adapted version of the Effective Public Health Practice Project (EPHPP) checklist. Narrative data synthesis was used to summarize the findings. Results A total of 5,099 results were obtained from literature searches, with 4,935 excluded during title/abstract screening. After reviewing 163 full-text articles, 24 publications were included in the review. Sample sizes ranged between n = 86 and n = 34,038. The length of the investigated time periods and the number of assessment points, as well as outcomes, varied. The majority of studies were of moderate methodological quality. Mental health outcomes were more frequently studied compared to measures of HRQoL. The findings from these studies mostly suggest that children and adolescents experienced heightened mental health problems, specifically internalizing symptoms like anxiety and depression. Further, there was a decline in their overall HRQoL over the course of the COVID-19 pandemic that did not necessarily subside when lockdowns ended. Conclusion It is crucial to continue monitoring the mental health and well-being of children and adolescents following the pandemic to identify groups at risks and plan interventions. This should ideally be conducted by large systematic studies, using validated instruments, and encompassing representative samples to obtain reliable and comprehensive insights with the aim of improving youth mental health care.
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Affiliation(s)
- Ester Orban
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Li
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martha Gilbert
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Napp
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Kaman
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sabine Topf
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maren Boecker
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Child and Adolescent Psychiatry, Child Neuropsychology Section, University Hospital RWTH Aachen, Aachen, Germany
| | - Janine Devine
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Reiß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Flora Wendel
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Faculty of Medicine, Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Vanessa Sophie Ernst
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Marco Franze
- Institute for Community Medicine, Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Eva Möhler
- Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Eva Breitinger
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Singh P, Nawaz S, Seiber EE, Bryant I, Moon K, Wastler H, Breitborde NJ. ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems. JAMA Netw Open 2023; 6:e2349305. [PMID: 38150255 PMCID: PMC10753394 DOI: 10.1001/jamanetworkopen.2023.49305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/10/2023] [Indexed: 12/28/2023] Open
Abstract
Importance Although substantial research has reported grave population-level psychiatric sequelae of the COVID-19 pandemic, evidence pertaining to temporal changes in schizophrenia spectrum disorders in the US following the pandemic remains limited. Objective To examine the monthly patterns of emergency department (ED) visits for schizophrenia spectrum disorders after the onset of the COVID-19 pandemic. Design, Setting, and Participants This observational cohort study used time-series analyses to examine whether monthly counts of ED visits for schizophrenia spectrum disorders across 5 University of California (UC) campus health systems increased beyond expected levels during the COVID-19 pandemic. Data included ED visits reported by the 5 UC campuses from 2016 to 2021. Participants included persons who accessed UC Health System EDs had a diagnosis of a psychiatric condition. Data analysis was performed from March to June 2023. Exposures The exposures were binary indicators of initial (March to May 2020) and extended (March to December 2020) phases of the COVID-19 pandemic. Main Outcomes and Measures The primary outcome was monthly counts of ED visits for schizophrenia spectrum disorders. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes, categorized within Clinical Classification Software groups, were used to identify ED visits for schizophrenia spectrum disorders and all other psychiatric ED visits, from the University of California Health Data Warehouse database, from January 2016 to December 2021. Time-series analyses controlled for autocorrelation, seasonality, and concurrent trends in ED visits for all other psychiatric conditions. Results The study data comprised a total of 377 872 psychiatric ED visits, with 37 815 visits for schizophrenia spectrum disorders. The prepandemic monthly mean (SD) number of ED visits for schizophrenia spectrum disorders was 519.9 (38.1), which increased to 558.4 (47.6) following the onset of the COVID-19 pandemic. Results from time series analyses, controlling for monthly counts of ED visits for all other psychiatric conditions, indicated 70.5 additional ED visits (95% CI, 11.7-129.3 additional visits; P = .02) for schizophrenia spectrum disorders at 1 month and 74.9 additional visits (95% CI, 24.0-126.0 visits; P = .005) at 3 months following the initial phase of the COVID-19 pandemic in California. Conclusions and Relevance This study found a 15% increase in ED visits for schizophrenia spectrum disorders within 3 months after the initial phase of the pandemic in California across 5 UC campus health systems, underscoring the importance of social policies related to future emergency preparedness and the need to strengthen mental health care systems.
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Affiliation(s)
- Parvati Singh
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus
| | - Saira Nawaz
- Center for Health Outcomes and Policy Evaluation Studies, College of Public Health, The Ohio State University, Columbus
| | - Eric E. Seiber
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus
| | - Ian Bryant
- Department of Economics, University of Cincinnati, Cincinnati, Ohio
| | - Kyle Moon
- Center for Health Outcomes and Policy Evaluation Studies, College of Public Health, The Ohio State University, Columbus
| | - Heather Wastler
- Early Psychosis Intervention Center, Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus
| | - Nicholas J. Breitborde
- Early Psychosis Intervention Center, Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus
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11
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Mitchell RHB, Toulany A, Chung H, Cohen E, Fu L, Strauss R, Vigod SN, Stukel TA, Moran K, Guttmann A, Kurdyak P, Artani A, Kopec M, Saunders NR. Self-harm among youth during the first 28 months of the COVID-19 pandemic in Ontario, Canada: a population-based study. CMAJ 2023; 195:E1210-E1220. [PMID: 37722745 PMCID: PMC10506509 DOI: 10.1503/cmaj.230127] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Youth have reported worsening mental health during the COVID-19 pandemic. We sought to evaluate rates of pediatric acute care visits for self-harm during the pandemic according to age, sex and mental health service use. METHODS We conducted a population-based, repeated cross-sectional study using linked health administrative data sets to measure monthly rates of emergency department visits and hospital admissions for self-harm among youth aged 10-17 years between Jan. 1, 2017, and June 30, 2022, in Ontario, Canada. We modelled expected rates of acute care visits for self-harm after the pandemic onset based on prepandemic rates. We reported relative differences between observed and expected monthly rates overall and by age group (10-13 yr and 14-17 yr), sex and mental health service use (new and continuing). RESULTS In this population of about 1.3 million children and adolescents, rates of acute care visits for self-harm during the pandemic were higher than expected for emergency department visits (0.27/1000 population v. 0.21/1000 population; adjusted rate ratio [RR] 1.29, 95% confidence interval [CI] 1.19-1.39) and hospital admissions (0.74/10 000 population v. 0.43/10 000 population, adjusted RR 1.72, 95% CI 1.46-2.03). This increase was primarily observed among females. Rates of emergency department visits and hospital admissions for self-harm were higher than expected for both those aged 10-13 years and those aged 14-17 years, as well as for both those new to the mental health system and those already engaged in care. INTERPRETATION Rates of acute care visits for self-harm among children and adolescents were higher than expected during the first 2 and a half years of the COVID-19 pandemic, particularly among females. These findings support the need for accessible and intensive prevention efforts and mental health supports in this population.
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Affiliation(s)
- Rachel H B Mitchell
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Alene Toulany
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Hannah Chung
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Eyal Cohen
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Longdi Fu
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Rachel Strauss
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Simone N Vigod
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Therese A Stukel
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Kimberly Moran
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Astrid Guttmann
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Paul Kurdyak
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Azmina Artani
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Monica Kopec
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont
| | - Natasha R Saunders
- Sunnybrook Health Sciences Centre (Mitchell); Evaluative Clinical Sciences, Sunnybrook Research Institute (Mitchell); Department of Psychiatry (Mitchell, Vigod, Kurdyak), University of Toronto; The Hospital for Sick Children (Toulany, Cohen, Guttmann, Saunders); Department of Pediatrics (Toulany, Cohen, Guttmann, Saunders), University of Toronto; ICES Central (Toulany, Chung, Cohen, Fu, Strauss, Vigod, Stukel, Guttmann, Kurdyak, Artani, Saunders); Institute of Health Policy, Management and Evaluation (Toulany, Cohen, Vigod, Stukel, Guttmann, Kurdyak, Saunders), University of Toronto; Child Health Evaluative Sciences (Toulany, Cohen, Guttmann, Kopec, Saunders), SickKids Research Institute; Edwin S.H. Leong Centre for Healthy Children (Toulany, Cohen, Guttmann, Saunders), University of Toronto; Women's College Hospital (Vigod); Women's College Research Institute (Vigod); Women's College Hospital Institute for Health System Solutions and Virtual Care (Vigod); Ontario College of Family Physicians (Moran); Centre for Addiction and Mental Health (Kurdyak), Toronto, Ont.
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Tan Dat N, Mitsui N, Asakura S, Fujii Y, Toyoshima K, Kusumi I. Relationship between self-esteem and suicidal ideation before and during COVID-19 in a non-clinical sample: mediating effects of psychological distress and hopelessness. Front Psychiatry 2023; 14:1240715. [PMID: 37743986 PMCID: PMC10512949 DOI: 10.3389/fpsyt.2023.1240715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Several studies have highlighted the impact of the novel coronavirus disease (COVID-19) pandemic on suicide. Accordingly, investigating the risk factors of suicide during this crisis is important. Based on the escape theory of suicide, the current study examined the serial mediating roles of psychological distress and hopelessness in the relationship between self-esteem and suicidal ideation. It also aimed to explore whether or not the COVID-19 pandemic changed the mediation effect in any way. Methods Data were collected from 645 university students before and during the pandemic. The study employed mediation and multi-group analyses to test the hypotheses. Results The results demonstrated that individuals with low self-esteem reported high psychological distress, which further lead to hopelessness and eventually heightened suicidal ideation. Multi-group analysis revealed that psychological distress exerted a greater impact on suicidal ideation during COVID-19. Discussion The finding suggested that self-esteem, hopelessness, and psychological distress could help elucidate the development of suicidal ideation. Clinicians may target these factors in suicide prevention programs, particularly in the settings of the COVID-19 pandemic or future crisis.
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Affiliation(s)
- Nguyen Tan Dat
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nobuyuki Mitsui
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoshi Asakura
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Health Care Center of Hokkaido University, Sapporo, Japan
| | - Yutaka Fujii
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Health Care Center of Hokkaido University, Sapporo, Japan
| | - Kuniyoshi Toyoshima
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Ahmed N, Barnett P, Greenburgh A, Pemovska T, Stefanidou T, Lyons N, Ikhtabi S, Talwar S, Francis ER, Harris SM, Shah P, Machin K, Jeffreys S, Mitchell L, Lynch C, Foye U, Schlief M, Appleton R, Saunders KRK, Baldwin H, Allan SM, Sheridan-Rains L, Kharboutly O, Kular A, Goldblatt P, Stewart R, Kirkbride JB, Lloyd-Evans B, Johnson S. Mental health in Europe during the COVID-19 pandemic: a systematic review. Lancet Psychiatry 2023; 10:537-556. [PMID: 37321240 PMCID: PMC10259832 DOI: 10.1016/s2215-0366(23)00113-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic caused immediate and far-reaching disruption to society, the economy, and health-care services. We synthesised evidence on the effect of the pandemic on mental health and mental health care in high-income European countries. We included 177 longitudinal and repeated cross-sectional studies comparing prevalence or incidence of mental health problems, mental health symptom severity in people with pre-existing mental health conditions, or mental health service use before versus during the pandemic, or between different timepoints of the pandemic. We found that epidemiological studies reported higher prevalence of some mental health problems during the pandemic compared with before it, but that in most cases this increase reduced over time. Conversely, studies of health records showed reduced incidence of new diagnoses at the start of the pandemic, which further declined during 2020. Mental health service use also declined at the onset of the pandemic but increased later in 2020 and through 2021, although rates of use did not return to pre-pandemic levels for some services. We found mixed patterns of effects of the pandemic on mental health and social outcome for adults already living with mental health conditions.
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Affiliation(s)
- Nafiso Ahmed
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK.
| | - Phoebe Barnett
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK; Centre for Outcomes Research and Effectiveness, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
| | - Anna Greenburgh
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Tamara Pemovska
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Theodora Stefanidou
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Natasha Lyons
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sarah Ikhtabi
- Division of Psychiatry, University College London, London, UK
| | - Shivangi Talwar
- Division of Psychiatry, University College London, London, UK
| | - Emma R Francis
- Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Samantha M Harris
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Prisha Shah
- Lived Experience Working Group, University College London, London, UK
| | - Karen Machin
- Lived Experience Working Group, University College London, London, UK
| | - Stephen Jeffreys
- Lived Experience Working Group, University College London, London, UK
| | - Lizzie Mitchell
- Lived Experience Working Group, University College London, London, UK
| | - Chris Lynch
- Lived Experience Working Group, University College London, London, UK
| | - Una Foye
- National Institute of Health and Care Research Mental Health Policy Research Unit, King's College London, London, UK
| | - Merle Schlief
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Rebecca Appleton
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Katherine R K Saunders
- National Institute of Health and Care Research Mental Health Policy Research Unit, King's College London, London, UK
| | - Helen Baldwin
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sophie M Allan
- Cambridgeshire and Peterborough National Health Service Foundation Trust, South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Luke Sheridan-Rains
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | | | - Ariana Kular
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Peter Goldblatt
- Institute of Health Equity, University College London, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, London, UK
| | | | - Brynmor Lloyd-Evans
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK
| | - Sonia Johnson
- National Institute of Health and Care Research Mental Health Policy Research Unit, University College London, London, UK; Camden and Islington National Health Service Foundation Trust, London, UK
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14
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Adrados-Pérez M, Llorca-Bofí V, Laín MM, Porcar CA, Nicolau-Subires E, Ibarra-Pertusa L, Jiménez-Mayoral A, Buil-Reiné E, Budny F, Resa-Pérez B, Velásquez-Acebey VG, Arenas-Pijoan L, Irigoyen-Otiñano M, López-Castroman J. Trajectories of children and adolescents attending a psychiatric emergency unit during the COVID-19 confinements: 2020-2022 longitudinal study. Child Adolesc Psychiatry Ment Health 2023; 17:66. [PMID: 37291582 PMCID: PMC10248990 DOI: 10.1186/s13034-023-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION The prevalence of psychiatric disorders has not shifted widely through the COVID pandemic, except for some specific groups such as young people or women. Our objective is to examine prospectively the evolution of children and adolescents who consulted in a psychiatric emergency service during the COVID-19 confinements. METHOD We collected prospective clinical information about 296 young people under 18 who visited a tertiary hospital for psychiatric reasons during the confinement periods in Spain. Clinical diagnoses, suicide attempts, hospital admissions, and pharmacological prescriptions were extracted from electronic health records through 2020, 2021, and 2022. Features of those who maintained psychiatric care and those who did not were compared. RESULTS Three out of four children and adolescents who visited the psychiatric emergency department during the confinements continued psychiatric care at the end of 2022. Those who did not showed better premorbid adjustment at baseline. During follow-up, diagnoses of neurodevelopmental disorders and eating disorders, as well as the dosage of psychotropic drug prescriptions, increased. The diagnoses of major depressive disorder and eating disorder at baseline were associated with attempting suicide during follow-up. Patients with internalizing symptoms were admitted earlier than those with externalizing symptoms but no differences were found in terms of suicide attempts. CONCLUSIONS The continuity of psychiatric care after an initial emergency visit during the confinements implied greater clinical severity, as reflected by changes in clinical diagnoses and pharmacological regimens. Emergent symptoms of depression or eating disorders after social distancing or isolation could predict subsequent suicidal behavior in young populations.
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Affiliation(s)
- Marina Adrados-Pérez
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | - Vicent Llorca-Bofí
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
- Department of Medicine, University of Barcelona School of Medicine, Barcelona, Spain
| | - María Mur Laín
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
- University of Lleida, Lérida, Spain
| | - Carla Albert Porcar
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | - Eugènia Nicolau-Subires
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | - Lucía Ibarra-Pertusa
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain
| | | | - Esther Buil-Reiné
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
| | - Filip Budny
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
| | - Belén Resa-Pérez
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain
| | | | | | - María Irigoyen-Otiñano
- Department of Psychiatry, Santa Maria University Hospital, Lleida, Spain.
- Institut de Recerca Biomèdica Lleida, Biological Foundations of Mental Disorders, Lérida, Spain.
- CIBERSAM, Madrid, Spain.
| | - Jorge López-Castroman
- University of Montpellier, IGF, CNRS-INSERM, Montpellier, France
- Department of Psychiatry, Nimes University Hospital, Nimes, France
- CIBERSAM, Madrid, Spain
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15
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Kauhanen L, Wan Mohd Yunus WMA, Lempinen L, Peltonen K, Gyllenberg D, Mishina K, Gilbert S, Bastola K, Brown JSL, Sourander A. A systematic review of the mental health changes of children and young people before and during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2023; 32:995-1013. [PMID: 35962147 PMCID: PMC9373888 DOI: 10.1007/s00787-022-02060-0] [Citation(s) in RCA: 99] [Impact Index Per Article: 99.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
There is increasing knowledge that the COVID-19 pandemic has had an impact on mental health of children and young people. However, the global evidence of mental health changes before compared to during the COVID-19 pandemic focusing on children and young people has not been systematically reviewed. This systematic review examined longitudinal and repeated cross-sectional studies comparing before and during COVID-19 pandemic data to determine whether the mental health of children and young people had changed before and during the COVID-19 pandemic. The Web of Science, PubMed, Embase and PsycINFO databases were searched to identify peer-reviewed studies that had been published in English and focused on children and young people between 0 and 24 years of age. This identified 21 studies from 11 countries, covering more than 96,000 subjects from 3 to 24 years of age. Pre-pandemic and pandemic data were compared. Most studies reported longitudinal deterioration in the mental health of adolescents and young people, with increased depression, anxiety and psychological distress after the pandemic started. Other findings included deteriorated negative affect, mental well-being and increased loneliness. Comparing data for pandemic and pre-pandemic periods showed that the COVID-19 pandemic may negatively impact the mental health of children and young people. There is an urgent need for high-quality research to address the impact, risks and protective factors of the pandemic on their mental health, as this will provide a good foundation for dealing with future health emergencies and other crises.
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Affiliation(s)
- Laura Kauhanen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
| | - Wan Mohd Azam Wan Mohd Yunus
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- Department of Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Johor, Malaysia
| | - Lotta Lempinen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kirsi Peltonen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - David Gyllenberg
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Kaisa Mishina
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Sonja Gilbert
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- INVEST Research Flagship, University of Turku, Turku, Finland
| | - Kalpana Bastola
- National Institute for Health and Welfare, Helsinki, Finland
| | - June S L Brown
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, England, London, UK
| | - Andre Sourander
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland.
- INVEST Research Flagship, University of Turku, Turku, Finland.
- Department of Child Psychiatry, Turku University Hospital, Turku, Finland.
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Uccella S, Cordani R, Salfi F, Gorgoni M, Scarpelli S, Gemignani A, Geoffroy PA, De Gennaro L, Palagini L, Ferrara M, Nobili L. Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health. Brain Sci 2023; 13:brainsci13040569. [PMID: 37190534 DOI: 10.3390/brainsci13040569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
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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17
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Chitty KM, Sawyer MG, Carter G, Lawrence D. Use of Medicare Benefit Scheme mental health services in young people who experienced self-harm and/or suicidal behaviours: Data from the Young Minds Matter survey. Australas Psychiatry 2023:10398562231163415. [PMID: 36935217 DOI: 10.1177/10398562231163415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
OBJECTIVES To examine healthcare utilisation patterns in a sample of young people with self-reported experiences of self-harm and/or suicidal behaviours. METHODS A national survey examining mental health in a nationally representative sample of young Australians aged 12-17 years, linked to routinely collected healthcare and dispensing data. For respondents that self-reported experience of self-harm, suicidal ideation, suicidal plan and/or suicide attempt, we assessed attendance at a Medicare Benefits Scheme (MBS) subsidised MH service or non-MH general practitioner (GP) attendance at three time periods: 1) ever, 2) in the 12 months prior to completing the survey and 3) after completing the survey until 31 Dec 2015. We also assessed correlates associated with attendance and non-attendance at a MH service. RESULTS The study included 311 young people. MH services were attended in the 12 months before the survey by 38.3% with attempted suicide, 28.7% with a suicidal plan, 28.9% with suicidal ideation and 29.4% with self-harm. MH treatment administered by a GP was the most common MH service (25%); followed treatment by psychologist (15%) and psychiatrist (5%). Attendance at a MH service was observed highest alongside more severe self-reported depression. CONCLUSIONS Potential underutilisation of MBS MH services by young people with self-harm and/or suicidal behaviours.
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Affiliation(s)
- Kate M Chitty
- Biomedical Informatics and Digital Health, Faculty of Medicine and Health, 4334The University of Sydney, Sydney, NSW, Australia
| | - Michael Gifford Sawyer
- Professor of Child and Adolescent Psychiatry, School of Paediatrics and Child Health, 1066University of Adelaide, Stirling, WA, Australia
| | - Gregory Carter
- Conjoint Professor in Psychiatry in the Faculty of Health Sciences, 5982University of Newcastle, Callaghan, NSW, Australia
| | - David Lawrence
- Professor of Mental Health, School of Population Health, 1649Curtin University, Perth, WA, Australia
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18
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Bower M, Smout S, Donohoe-Bales A, O’Dean S, Teesson L, Boyle J, Lim D, Nguyen A, Calear AL, Batterham PJ, Gournay K, Teesson M. A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19. Front Psychiatry 2023; 14:1107560. [PMID: 36970258 PMCID: PMC10032377 DOI: 10.3389/fpsyt.2023.1107560] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/17/2023] [Indexed: 03/11/2023] Open
Abstract
BackgroundThe mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes.MethodsWe conducted a rigorous umbrella review with meta-review and present (a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, (b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and (c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic.FindingsThree hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-analyses. Meta-review prevalence of anxiety symptoms ranged from 24.4% (95%CI: 18–31%, I2: 99.98%) for general populations to 41.1% (95%CI: 23–61%, I2: 99.65%) in vulnerable populations. Prevalence of depressive symptoms ranged from 22.9% (95%CI: 17–30%, I2: 99.99%) for general populations to 32.5% (95%CI: 17–52%, I2: 99.35) in vulnerable populations. Prevalence of stress, psychological distress and PTSD/PTSS symptoms were 39.1% (95%CI: 34–44%; I2: 99.91%), 44.2% (95%CI: 32–58%; I2: 99.95%), and 18.8% (95%CI: 15–23%; I2: 99.87%), respectively. Meta-review comparing pre-COVID-19 to during COVID-19 prevalence of probable depression and probable anxiety revealed standard mean differences of 0.20 (95%CI = 0.07–0.33) and 0.29 (95%CI = 0.12–0.45), respectively.ConclusionThis is the first meta-review to synthesise the longitudinal mental health impacts of the pandemic. Findings show that probable depression and anxiety were significantly higher than pre-COVID-19, and provide some evidence that that adolescents, pregnant and postpartum people, and those hospitalised with COVID-19 experienced heightened adverse mental health. Policymakers can modify future pandemic responses accordingly to mitigate the impact of such measures on public mental health.
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Affiliation(s)
- Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- *Correspondence: Marlee Bower,
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Scarlett Smout,
| | - Amarina Donohoe-Bales
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Siobhan O’Dean
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Julia Boyle
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Denise Lim
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Andre Nguyen
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Alison L. Calear
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Philip J. Batterham
- Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia
| | - Kevin Gournay
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Rice T, Reliford A, Calov C, Rodriguez J. The Behavioral Health Needs of Youth With Preexisting Psychiatric Disorders in the Aftermath of COVID-19. J Pediatr Health Care 2023; 37:137-141. [PMID: 36347759 PMCID: PMC9579186 DOI: 10.1016/j.pedhc.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/19/2022]
Abstract
Children and adolescents with psychiatric disorders are a sizable population of children and youth with special health care needs. While the capabilities of behavioral health resources to meet these youth's needs were already strained, the Coronavirus Disease 2019 (COVID-19) pandemic extended resource limitations just as this subgroup of children and youth with special health care needs faced new stressors and potential exacerbations of their underlying psychiatric illnesses. In this article, we provide a brief narrative review of the factors' manifestations with an emphasis upon their disproportionate impact upon children of color and their families and particularly those from disadvantaged communities. We proceed to provide policy proposals for addressing these disparities. These include raising reimbursement for behavioral health services, increasing telehealth care delivery, reducing inter-state licensing requirements, increasing community-based services, and addressing social determinants of health. Conclusions and directions for strengthening behavioral health service delivery capabilities and addressing systemic injustices are made.
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Affiliation(s)
- Timothy Rice
- Timothy Rice, Associate Professor, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Aaron Reliford
- Aaron Reliford, Clinical Associate Professor, Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY
| | - Chiara Calov
- Chiara Calov, Program Coordinator, McSilver Institute for Poverty Policy and Research, New York University Grossman School of Medicine, New York, NY
| | - James Rodriguez
- James Rodriguez, Senior Director, Clinical Initiatives, McSilver Institute for Poverty Policy and Research, New York University Grossman School of Medicine, New York, NY
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20
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Gyllenberg D, Bastola K, Wan Mohd Yunus WMA, Mishina K, Liukko E, Kääriälä A, Sourander A. Comparison of new psychiatric diagnoses among Finnish children and adolescents before and during the COVID-19 pandemic: A nationwide register-based study. PLoS Med 2023; 20:e1004072. [PMID: 36848384 PMCID: PMC10089356 DOI: 10.1371/journal.pmed.1004072] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 04/11/2023] [Accepted: 07/11/2022] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) restrictions decreased the use of specialist psychiatric services for children and adolescents in spring 2020. However, little is known about the pattern once restrictions eased. We compared new psychiatric diagnoses by specialist services during pandemic and pre-pandemic periods. METHODS AND FINDINGS This national register study focused on all Finnish residents aged 0 to 17 years from January 2017 to September 2021 (approximately 1 million a year). The outcomes were new monthly diagnoses for psychiatric or neurodevelopmental disorders in specialist services. These were analyzed by sex, age, home location, and diagnostic groups. The numbers of new diagnoses from March 2020 were compared to predictive models based on previous years. The predicted and observed levels in March to May 2020 showed no significant differences, but the overall difference was 18.5% (95% confidence interval 12.0 to 25.9) higher than predicted in June 2020 to September 2021, with 3,821 more patients diagnosed than anticipated. During this period, the largest increases were among females (33.4%, 23.4 to 45.2), adolescents (34.4%, 25.0 to 45.3), and those living in areas with the highest COVID-19 morbidity (29.9%, 21.2 to 39.8). The largest increases by diagnostic groups were found for eating disorders (27.4%, 8.0 to 55.3), depression and anxiety (21.0%, 12.1 to 51.9), and neurodevelopmental disorders (9.6%, 3.0 to 17.0), but psychotic and bipolar disorders and conduct and oppositional disorders showed no significant differences and self-harm (-28.6, -41.5 to -8.2) and substance use disorders (-15.5, -26.4 to -0.7) decreased in this period. The main limitation is that data from specialist services do not allow to draw conclusions about those not seeking help. CONCLUSIONS Following the first pandemic phase, new psychiatric diagnoses in children and adolescents increased by nearly a fifth in Finnish specialist services. Possible explanations to our findings include changes in help-seeking, referrals and psychiatric problems, and delayed service access.
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Affiliation(s)
- David Gyllenberg
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- * E-mail:
| | - Kalpana Bastola
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Wan Mohd Azam Wan Mohd Yunus
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Malaysia
| | - Kaisa Mishina
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Emmi Liukko
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Antti Kääriälä
- Finnish Institute of Health and Welfare, Helsinki, Finland
| | - Andre Sourander
- Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland
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21
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Waller G, Newbury-Birch D, Simpson D, Armstrong E, James B, Chapman L, Ahmed F, Ferguson J. The barriers and facilitators to the reporting and recording of self-harm in young people aged 18 and under: a systematic review. BMC Public Health 2023; 23:158. [PMID: 36694149 PMCID: PMC9871435 DOI: 10.1186/s12889-023-15046-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND AND AIMS This systematic review sought to identify, explain and interpret the prominent or recurring themes relating to the barriers and facilitators of reporting and recording of self-harm in young people across different settings, such as the healthcare setting, schools and the criminal justice setting. METHODS A search strategy was developed to ensure all relevant literature around the reporting and recording of self-harm in young people was obtained. Literature searches were conducted in six databases and a grey literature search of policy documents and relevant material was also conducted. Due to the range of available literature, both quantitative and qualitative methodologies were considered for inclusion. RESULTS Following the completion of the literature searches and sifting, nineteen papers were eligible for inclusion. Facilitators to reporting self-harm across the different settings were found to be recognising self-harm behaviours, using passive screening, training and experience, positive communication, and safe, private information sharing. Barriers to reporting self-harm included confidentiality concerns, negative perceptions of young people, communication difficulties, stigma, staff lacking knowledge around self-harm, and a lack of time, money and resources. Facilitators to recording self-harm across the different settings included being open to discussing what is recorded, services working together and co-ordinated help. Barriers to recording self-harm were mainly around stigma, the information being recorded and the ability of staff being able to do so, and their length of professional experience. CONCLUSION Following the review of the current evidence, it was apparent that there was still progress to be made to improve the reporting and recording of self-harm in young people, across the different settings. Future work should concentrate on better understanding the facilitators, whilst aiming to ameliorate the barriers.
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Affiliation(s)
- Gillian Waller
- NHS Business Services Authority, Stella House, Newburn, Newcastle, NE15 8NY, UK.
| | - Dorothy Newbury-Birch
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Diane Simpson
- grid.7110.70000000105559901Faculty of Education and Society, University of Sunderland, Sunderland, SR6 0DD UK
| | - Emma Armstrong
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Becky James
- Department of Health and Social Care, Office for Health Improvement & Disparities, Newburn, Newcastle, NE15 8NY UK
| | - Lucy Chapman
- grid.433912.e0000 0001 0150 9675Durham County Council, County Hall, Durham, DH1 5UJ UK
| | - Farhin Ahmed
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
| | - Jennifer Ferguson
- grid.26597.3f0000 0001 2325 1783School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, TS1 3BA UK
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22
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Koper N, Creemers HE, van Dam L, Stams GJJM, Branje S. Resilience, well-being and informal and formal support in multi-problem families during the Covid-19 pandemic. Child Adolesc Psychiatry Ment Health 2022; 16:103. [PMID: 36536396 PMCID: PMC9762621 DOI: 10.1186/s13034-022-00542-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The Covid-19 pandemic may have had negative effects on youth and parental mental health, especially in high-risk populations such as multi-problem families (i.e., families that experience problems in multiple domains, such as mental health and social network problems). Using one to four assessments during all phases of the Covid-19 pandemic up until January 2022, we examined the associations between pandemic-related stress and mental health (resilience and well-being) of youth and parents from multi-problem families. We also investigated whether experienced informal (i.e., youth informal mentoring) and formal support (i.e., therapist support) served as protective factors in this association. METHODS A total of 92 youth aged 10-19 years (46.7% girls; mean age 16.00 years) and 78 parents (79.5% female; mean age 47.17 years) filled in one to four questionnaires between March 2020 and January 2022. Multi-level analyses were conducted to account for the nested structure of the data. RESULTS For youth, pandemic-related stress was associated with lower well-being, but not with resilience. Perceived support from both mentors and therapists was positively associated with youth mental health. Furthermore, high perceived therapist support protected youth from the negative effect of pandemic-related stress on resilience. For parents, pandemic-related stress was not related to mental health, irrespective of therapist support. Yet, therapist support was directly and positively associated with parental mental health. CONCLUSIONS Youth from multi-problem families who experience pandemic-related stress are at risk of (elevated) mental health problems during the pandemic, specifically if they have no or weak therapist support. The mental health of parents, however, was minimally affected by pandemic-related stress, indicating strength and flexibility. Youth and parents who experienced support during the pandemic reported higher levels of resilience and well-being, demonstrating the importance of support for individuals' mental health during stressful times such as a pandemic.
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Affiliation(s)
- Natasha Koper
- Department of Youth and Family, Utrecht University, PO box 80140, 3508TC, Utrecht, The Netherlands. .,Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands. .,YIM Foundation, Amersfoort, The Netherlands.
| | - Hanneke E. Creemers
- grid.7177.60000000084992262Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Levi van Dam
- grid.7177.60000000084992262Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands ,YIM Foundation, Amersfoort, The Netherlands ,grid.491096.3Levvel Youth and Family Care, Amsterdam, The Netherlands
| | - Geert Jan J. M. Stams
- grid.7177.60000000084992262Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Susan Branje
- grid.5477.10000000120346234Department of Youth and Family, Utrecht University, PO box 80140, 3508TC Utrecht, The Netherlands
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23
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Pouquet M, Launay T, Rivière M, Chan-Chee C, Urbain F, Coulombel N, Bardoulat I, Pons R, Guerrisi C, Blanchon T, Hanslik T, Younes N. Trends and characteristics of attempted and completed suicides reported to general practitioners before vs during the COVID-19 pandemic in France: Data from a nationwide monitoring system, 2010-2022. PLoS One 2022; 17:e0278266. [PMID: 36520827 PMCID: PMC9754243 DOI: 10.1371/journal.pone.0278266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Most studies published to date have investigated the impact of the COVID-19 pandemic on suicidal acts using hospital data. Trends from primary care in a country such as France are crucial, as individuals may not consult hospital services after suicide attempts (SAs) but rather see their general practitioner (GP). OBJECTIVES We aimed to evaluate whether the incidence and characteristics of SAs and completed suicides (CSs) reported to French GPs were different during the COVID-19 pandemic than those of before. METHODS AND FINDINGS We conducted a retrospective observational study using data from a nationwide monitoring system, the French Sentinel Network (FSN). All SAs and CSs reported by GPs to the FSN from January 1, 2010, to March 10, 2022 were included. The annual incidence rates (IRs) and the characteristics of SAs and CSs during the pandemic (March 11, 2020, to March 10, 2022) were compared to those of before. In total, 687 SAs and 169 CSs were included. The IRs remained stable for SAs and CSs before and during the pandemic (overlap in confidence intervals). The mean IRs were 52 (95%CI = 44; 57) per 100,000 inhabitants for SAs during the pandemic versus 47 [36; 57] during the pre-pandemic period (p = 0.49), and 5 (95%CI = 2; 9) for CSs versus 11 [6; 16] (p = 0.30). During the pandemic, SA were slightly different from those before in terms of age and occupational status (young/students and older/retirees over-represented), history of consultation and expression of suicidal ideas to GP (more frequent), and CS in terms of occupational status (students over-represented) (p<0.05). CONCLUSION The COVID-19 pandemic had no major effect on the overall incidence of SAs and CSs reported to French GPs. However, more suicidal acts were reported among younger and older individuals. Suicidal patients and GPs have adapted by improving the expression of suicidal ideas.
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Affiliation(s)
- Marie Pouquet
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- * E-mail:
| | - Titouan Launay
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Mathieu Rivière
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | | | - Frédéric Urbain
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | | | | | - Romain Pons
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Caroline Guerrisi
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thierry Blanchon
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
| | - Thomas Hanslik
- INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Service de Médecine Interne, Hôpital Ambroise-Paré, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France
| | - Nadia Younes
- Unité de Formation et de Recherche des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Université Versailles Saint Quentin, Université Paris Saclay, Team DevPsy, Villejuif, France
- Centre Hospitalier Versailles, Service Hospitalo-Universitaire de Psychiatrie de l’Adulte et d’Addictologie, Le Chesnay, France
- Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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24
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Sourander S, Sourander A, Hinkka-Yli-Salomäki S, Ristkari T, Kurki M. An Internet-Based Parent Training With Telephone Coaching on Managing Disruptive Behavior in Children at Special Family Counseling Centers During the COVID-19 Pandemic: Feasibility Study. JMIR Pediatr Parent 2022; 5:e40614. [PMID: 36194895 PMCID: PMC9635457 DOI: 10.2196/40614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/15/2022] [Accepted: 10/04/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND There is growing concern about the short- and long-term impacts that the COVID-19 pandemic will have on the mental health and psychosocial well-being of children and families. There are no existing studies about feasibility and outcomes using internet-based parent training programs with telephone coaching for disruptive behavioral problems in childhood during the COVID-19 pandemic in clinical settings. OBJECTIVE This study explored how the Strongest Families Smart Website (SFSW) parent training program, with telephone coaching, provided support during the COVID-19 pandemic at specialist family counseling centers in Helsinki, Finland, when restrictions made face-to-face counseling impossible. This study followed the success of a randomized controlled trial (RCT) and its implementation study of the SFSW parent training program by primary care child health clinics. The aim was to improve parenting skills, so that parents could tackle disruptive behavior by developing positive parent-child relationships. It started in May 2020, when the COVID-19 pandemic was at its height in Finland. METHODS In total, 8 family counseling centers in Helsinki identified 50 referrals aged 3-8 years with high levels of parent-reported disruptive behavioral problems. Child psychopathology and functioning and parental skills and well-being were measured at baseline, posttreatment, and 6 months later using a range of tools. The data were extracted from questionnaires completed by the parents. RESULTS We found that 44 (88%) of the 50 families completed the whole 11-session parent training program. Most of the children (n=48, 96%) had definitive or severe behavioral problems when they were initially screened by the centers, but with those assessed at the 6-month follow-up (n=45, 90%), this dropped to 58% (n=26). There were significant changes from baseline to 6-month follow-up in most of the child psychopathology measures, including the Child Behavior Checklist-Parent Report Form (CBCL) total score (mean change 16.3, SE 3.0, 95% CI 10.2-22.3; P<.001) and externalizing score (mean change 7.0, SE 1.0, 95% CI 4.9-9.0; P<.001). When parenting skills were measured with the Parenting Scale (PS), they showed significant changes from baseline to 6-month follow-up in total scores (mean change 0.5, SE 0.1, 95% CI 0.4-0.7; P<.001). Parents showed significant change in the stress subscore (mean change 3.9, SE 0.8, 95% CI 2.2-5.6; P<.001). Of the parents who filled in the satisfaction questionnaire (n=45, 90%), 42 (93%) reported high satisfaction in the skills and 44 (98%) in the professionalism of the family coaches. CONCLUSIONS The program proved to be an effective method for improving parenting skills and child psychopathology and functioning. The parents were satisfied with the program, and the dropout rate was exceptionally low. The study shows that the training program could be implemented in specialist clinical settings and during crisis conditions, such as the COVID-19 pandemic.
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Affiliation(s)
- Saana Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland.,Unit of Digital Education and Master Programmes, Laurea University of Applied Sciences, Vantaa, Finland.,INVEST Research Flagship, University of Turku, Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland.,INVEST Research Flagship, University of Turku, Turku, Finland.,Department of Child Psychiatry, Turku University Hospital, Turku, Finland
| | - Susanna Hinkka-Yli-Salomäki
- Department of Child Psychiatry, University of Turku, Turku, Finland.,INVEST Research Flagship, University of Turku, Turku, Finland
| | - Terja Ristkari
- Department of Child Psychiatry, University of Turku, Turku, Finland.,INVEST Research Flagship, University of Turku, Turku, Finland
| | - Marjo Kurki
- Department of Child Psychiatry, University of Turku, Turku, Finland.,INVEST Research Flagship, University of Turku, Turku, Finland.,ITLA Children´s Foundation, Helsinki, Finland
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25
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Hossain MM, Nesa F, Das J, Aggad R, Tasnim S, Bairwa M, Ma P, Ramirez G. Global burden of mental health problems among children and adolescents during COVID-19 pandemic: An umbrella review. Psychiatry Res 2022; 317:114814. [PMID: 36055064 PMCID: PMC9420079 DOI: 10.1016/j.psychres.2022.114814] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/30/2022]
Abstract
Mental health problems among children and adolescents are increasingly reported amidst the coronavirus disease (COVID-19) pandemic. In this umbrella review, we aimed to synthesize global evidence on the epidemiologic burden and correlates of child and adolescent mental health (CAMH) problems during this pandemic from existing systematic reviews and meta-analyses. Adopting the Joanna Briggs Institute (JBI) methodology, we evaluated 422 citations and identified 17 eligible reviews with medium to high methodological quality. Most of the reviews reported a high prevalence of anxiety, depression, sleep disorders, suicidal behavior, stress-related disorders, attention-deficit/hyperactivity disorder, and other mental health problems. Also, factors associated with CAMH such as age, gender, place of residence, educational attainment, household income, sedentary lifestyle, social media and internet use, comorbidities, family relationships, parents' psychosocial conditions, COVID-19 related experiences, closure of schools, online learning, and social support were reported across reviews. As most studies were cross-sectional and used nonrepresentative samples, future research on representative samples adopting longitudinal and intervention designs is needed. Lastly, multipronged psychosocial care services, policies, and programs are needed to alleviate the burden of CAMH problems during and after this pandemic.
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Affiliation(s)
- M. Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, Houston, TX 77204, USA,Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77204, USA,Corresponding author at: Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, Houston, TX 77204, USA
| | - Fazilatun Nesa
- Research Initiative for Health Equity, Khulna, Bangladesh
| | - Jyoti Das
- Research Initiative for Health Equity, Khulna, Bangladesh
| | - Roaa Aggad
- School of Public Health, Texas A&M University, College Station, TX 77840, USA
| | - Samia Tasnim
- School of Public Health, Texas A&M University, College Station, TX 77840, USA
| | - Mohan Bairwa
- All Indian Institute of Medical Sciences, New Delhi, India
| | - Ping Ma
- School of Public Health, Texas A&M University, College Station, TX 77840, USA
| | - Gilbert Ramirez
- Robert Stempel College of Public Health and Social Work, Florida International University, FL 33174, USA
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26
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Chauvet-Gelinier JC, Roussot A, Vergès B, Petit JM, Jollant F, Quantin C. Hospitalizations for Anorexia Nervosa during the COVID-19 Pandemic in France: A Nationwide Population-Based Study. J Clin Med 2022; 11:jcm11164787. [PMID: 36013026 PMCID: PMC9409983 DOI: 10.3390/jcm11164787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has had a detrimental impact on mental health, including on food-related behaviors. However, little is known about the effect of the pandemic on anorexia nervosa (AN). We sought to assess an association between the COVID-19 pandemic and a potential increase in hospitalizations for AN in France. We compared the number of hospitalizations with a diagnosis of AN during the 21-month period following the onset of the pandemic with the 21-month period before the pandemic using Poisson regression models. We identified a significant increase in hospitalizations for girls aged 10 to 19 years (+45.9%, RR = 1.46[1.43−1.49]; p < 0.0001), and for young women aged 20 to 29 (+7.0%; RR = 1.07[1.04−1.11]; p < 0.0001). Regarding markers of severity, there was an increase in hospitalizations for AN associated with a self-harm diagnosis between the two periods. Multivariate analysis revealed that the risk of being admitted for self-harm with AN increased significantly during the pandemic period among patients aged 20−29 years (aOR = 1.39[1.06−1.81]; p < 0.05 vs. aOR = 1.15[0.87−1.53]; NS), whereas it remained high in patients aged 10 to 19 years (aOR = 2.40[1.89−3.05]; p < 0.0001 vs. aOR = 3.12[2.48−3.98]; p < 0.0001). Furthermore, our results suggest that the pandemic may have had a particular effect on the mental health of young women with AN, with both a sharp increase in hospitalizations and a high risk of self-harming behaviors.
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Affiliation(s)
- Jean-Christophe Chauvet-Gelinier
- Department of Psychiatry, Dijon University Hospital, 21000 Dijon, France
- INSERM, LNC-UMR 1231, University of Burgundy, 21078 Dijon, France
| | - Adrien Roussot
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France
| | - Bruno Vergès
- INSERM, LNC-UMR 1231, University of Burgundy, 21078 Dijon, France
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 21000 Dijon, France
| | - Jean-Michel Petit
- INSERM, LNC-UMR 1231, University of Burgundy, 21078 Dijon, France
- Department of Endocrinology, Diabetes and Metabolic Disorders, Dijon University Hospital, 21000 Dijon, France
| | - Fabrice Jollant
- Department of Psychiatry and Psychotherapy, Jena University Hospital, 07743 Jena, Germany
- GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, CMME, 75014 Paris, France
- McGill Group for Suicide Studies, McGill University, Montreal, QC H3A 0G4, Canada
- Nîmes Academic Hospital (CHU), 30900 Nîmes, France
- Moods Team, INSERM, UMR-1178, CESP, 94276 Le Kremlin-Bicêtre, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, 21000 Dijon, France
- INSERM, CIC 1432, Clinical Investigation Center, Clinical Epidemiology/Clinical Trials Unit, Dijon University Hospital, 21000 Dijon, France
- INSERM, CESP, UVSQ, Université Paris-Saclay, 94807 Villejuif, France
- Correspondence: ; Tel.: +33-38029-3629
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27
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D'Agostino A, Gritti ES, Gagliardi C. Generation COVID-19 and bodily disorders: Hyperbolic narratives and a developmental psychopathology perspective. Front Public Health 2022; 10:976584. [PMID: 36033739 PMCID: PMC9411854 DOI: 10.3389/fpubh.2022.976584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Abstract
Starting from spring 2020, newspapers headlines and studies have suggested that the COVID-19 pandemics had a negative impact especially on the mental health of children and adolescents, so that terms like "lost generation" or "generation COVID-19" have been used to define youth in time of pandemic crisis. Similarly, international health agencies reported an increase in depression and anxiety among adolescents in COVID-19 time, but also a rise in bodily disorders, such as non-suicidal self-injury and eating disorders. However, scientific data on this matter are not as clear as they seem and theoretical-clinical proposals regarding the processes involved are lacking. Focusing specifically on bodily disorders in adolescents during COVID-19, the aim of this perspective paper is to review this issue and propose a novel viewpoint on it. Firstly, data regarding frequency and phenomenology of bodily disorders in adolescence before and during the pandemic will be presented to underline possible discrepancies, gaps, or hyperbolic descriptions in the literature published after the COVID-19 outbreak. Secondly, a specific theoretical-clinical perspective will be proposed, that is, a developmental psychopathology perspective which attempts to frame these phenomena in a more nuanced and complex way, taking into account the role of developmental processes in adolescence age and its difficulties in the specific, subjective life-context of the individual, when intertwining with vulnerability factors and stressful life events. As such, the function of the body for the adolescent as a primary mean for regulating the self-other relationship and developing a greater sense of self-agency will be highlighted. The final objective is to help the clinician in developing both a critical thinking about the data that are shared in public outlets and an intervention that takes into account the complexity of contemporary psychopathological phenomena.
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Affiliation(s)
- Alessandra D'Agostino
- Department of Humanities, University of Urbino Carlo Bo, Urbino, Italy,*Correspondence: Alessandra D'Agostino
| | | | - Chiara Gagliardi
- Department of Humanities, University of Urbino Carlo Bo, Urbino, Italy
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