Bittner Gould Jane, Walter Heather J, Bromberg Jonas, Correa Emily Trudell, Hatoun Jonathan, Vernacchio Louis
Pediatric Physicians' Organization at Children's, Boston Children's Hospital, Wellesley Hills, Massachusetts.
Department of Psychiatry and Behavioral Sciences.
Pediatrics. 2022 Dec 1;150(6). doi: 10.1542/peds.2022-057176.
Describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric primary care visits for 7 mental health categories before and during the COVID-19 pandemic.
This interrupted time series analysis compared the rate of mental health visits to pediatric primary care providers in Massachusetts before and during the COVID-19 pandemic. Three time periods were defined: prepandemic period (January 2019-February 2020), emergency pandemic period (March 2020-May 2020), and pandemic period (June 2020-September 2021). The 7 mental health visit diagnoses included alcohol and substance use disorders, anxiety disorders, attention-deficit hyperactivity disorders, behavior disorders, eating disorders, mood disorders (depressive and bipolar), and stress or trauma disorders.
Significant increases in slope (P < .001) were observed for eating disorder visits, with the annualized visit rate increasing from 9.3 visits per 1000 patients per year in the prepandemic period to 18.3 in the pandemic period. For mood disorder visits, the annualized visit rate increased from 65.3 in the prepandemic period to 94.0 in the pandemic period. Significant decreases in level and slope (both P < .001) were observed for alcohol and substance use disorder visits, with the annualized visit rate decreasing from 5.8 in the prepandemic period to 5.5 in the pandemic period.
Eating disorder visits and mood disorder visits significantly increased, whereas alcohol and substance use disorder visits significantly decreased during the pandemic period among pediatric patients, highlighting the need to identify and manage mental health conditions in the pediatric primary care setting.
描述2019冠状病毒病（COVID-19）大流行对COVID-19大流行之前和期间7种心理健康类别的儿科初级保健就诊的影响。
这项中断时间序列分析比较了COVID-19大流行之前和期间马萨诸塞州儿科初级保健提供者的心理健康就诊率。定义了三个时间段：大流行前时期（2019年1月至2020年2月）、紧急大流行时期（2020年3月至2020年5月）和大流行时期（2020年6月至2021年9月）。7种心理健康就诊诊断包括酒精和物质使用障碍、焦虑症、注意力缺陷多动障碍、行为障碍、饮食失调、情绪障碍（抑郁和双相）以及压力或创伤障碍。
饮食失调就诊的斜率显著增加（P <.001），年化就诊率从大流行前时期的每1000名患者每年9.3次就诊增加到大流行时期的18.3次。对于情绪障碍就诊，年化就诊率从大流行前时期的65.3次增加到大流行时期的94.0次。酒精和物质使用障碍就诊的水平和斜率均显著下降（均P <.001），年化就诊率从大流行前时期的5.8次下降到大流行时期的5.5次。
在大流行期间，儿科患者的饮食失调就诊和情绪障碍就诊显著增加，而酒精和物质使用障碍就诊显著减少，突出了在儿科初级保健环境中识别和管理心理健康状况的必要性。
