Leff Rebecca A, Setzer Erika, Cicero Mark X, Auerbach Marc
School of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer -Sheva, Israel.
Department of Emergency Medicine, Yale University, New Haven, CT, USA.
Clin Child Psychol Psychiatry. 2021 Jan;26(1):33-38. doi: 10.1177/1359104520972453. Epub 2020 Nov 13.
Limited early results indicate that the COVID-19 outbreak has had a significant impact on the mental health of children and adolescents. Pediatric emergency departments (PED) play a pivotal role in the identification, treatment, and coordination of care for children with mental health disorders, however, there is a dearth of literature evaluating the effects of the COVID-19 pandemic on mental health care provision in the PED.
We sought to evaluate whether changes in frequency or patient demographics among children and adolescents presenting to the PED has occurred.
This is a cross-sectional study conducted at the Yale New Haven Children's Hospital (YNHCH) PED. Data representing the early COVID-19 pandemic period was abstracted from the electronic medical record and compared using descriptive statistics to the same time period the year prior. Patient demographics including patient gender, ED disposition, mode of arrival, race-ethnicity, and insurance status were assessed.
During the pandemic period, 148 patients presented to the YNHCH PED with mental health-related diagnoses, compared to 378 in the pre-pandemic period, a reduction of 60.84%. Compared to white children, black children were 0.55 less likely to present with a mental health condition as compared to the pre-pandemic study period ( = 0.002; 95% CI 0.36-0.85).
Children with mental and behavioral health disorders who seek care in PEDs may be at risk for delayed presentations of mental health disorders. African American children may be a particularly vulnerable population to screen for mental health disorders as reopening procedures are initiated and warrants further study.
有限的早期结果表明，新冠疫情对儿童和青少年的心理健康产生了重大影响。儿科急诊科在识别、治疗和协调心理健康障碍儿童的护理方面发挥着关键作用，然而，缺乏评估新冠疫情对儿科急诊科心理健康护理影响的文献。
我们试图评估前往儿科急诊科就诊的儿童和青少年在就诊频率或患者人口统计学方面是否发生了变化。
这是一项在耶鲁纽黑文儿童医院儿科急诊科进行的横断面研究。从电子病历中提取代表新冠疫情早期的数据，并使用描述性统计方法与前一年同期进行比较。评估患者的人口统计学特征，包括患者性别、急诊科处置方式、到达方式、种族和保险状况。
在疫情期间，有148名患者因心理健康相关诊断前往耶鲁纽黑文儿童医院儿科急诊科就诊，而在疫情前这一数字为378名，减少了60.84%。与白人儿童相比，黑人儿童出现心理健康问题的可能性比疫情前研究期间低0.55（P = 0.002；95%置信区间0.36 - 0.85）。
在儿科急诊科寻求护理的心理和行为健康障碍儿童可能面临心理健康障碍延迟就诊的风险。随着重新开放程序的启动，非裔美国儿童可能是筛查心理健康障碍的特别脆弱人群，值得进一步研究。
