Mucci Maria, Lenzi Francesca, D'Acunto Giulia Maria, Gazzillo Marisa, Accorinti Ilaria, Boldrini Silvia, Distefano Giacomo, Falcone Francesca, Fossati Beatrice, Giurdanella Annina Roberto, Paese Silvia, Salluce Carmen, Troiano Irene, Fratoni Cinzia, Fabiani Deborah, Liboni Francesca, Masi Gabriele
IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56025 Pisa, Italy.
Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
Children (Basel). 2022 Dec 8;9(12):1921. doi: 10.3390/children9121921.
Dramatic events during the COVID-19 pandemic have acutely impacted the psychosocial environment worldwide, with negative implications for mental health, particularly for more vulnerable children and adolescents with severe psychiatric illnesses. Some data suggest that the pandemic waves may have produced different psychopathological consequences, further worsening in the second phase of the pandemic, compared to those in the first lockdown, soon after March 2020. To test the hypothesis of a further worsening of psychiatric consequences of COVID-19 in the second lockdown compared to the first lockdown, we focused our analysis on a consecutive sample of youth referred to a psychiatric emergency unit for acute mental disorders in the time period between March 2019-March 2021. The sample, consisting of 241 subjects (123 males and 118 females, ranging in age from 11 to 17 years), was divided into three groups: Pre-Lockdown Group (PLG, 115 patients); First Lockdown Group (FLG, 65 patients); and Second Lockdown Group (SLG, 61 patients). Patients in the SLG presented more frequently with non-suicidal self-injuries (NSSIs), suicidal ideation, and suicidal behavior, while no significant differences in self-harm were found between PLG and FLG. Eating disorders were more frequent in both the FLG and SLG, compared to the PLG, while sleep problems were higher only in the SLG. Furthermore, patients in the SLG presented with more frequent psychological maltreatments and neglect, as well as with psychiatric disorders in the parents. Adverse traumatic experiences and internalizing disorders were significantly associated with an increased risk of suicidality. Intellectual disability was less represented from the PLG to SLG, and similarly, the rate of ADHD was lower in the SLG. No differences were found for the other psychiatric diagnoses. This information may be helpful for a better understanding and management of adolescents with severe emotional and behavioral disorders after the exposure to long-lasting collective traumas.
新冠疫情期间的重大事件对全球社会心理环境产生了严重影响，对心理健康产生了负面影响，尤其是对患有严重精神疾病的更脆弱儿童和青少年。一些数据表明，疫情浪潮可能产生了不同的心理病理后果，与2020年3月后首次封锁时相比，在疫情的第二阶段情况进一步恶化。为了验证与首次封锁相比，第二次封锁期间新冠疫情精神后果进一步恶化的假设，我们将分析重点放在了2019年3月至2021年3月期间因急性精神障碍被转诊至精神科急诊室的连续青年样本上。该样本由241名受试者组成（123名男性和118名女性，年龄在11至17岁之间），分为三组：封锁前组（PLG，115名患者）；首次封锁组（FLG，65名患者）；第二次封锁组（SLG，61名患者）。SLG组患者出现非自杀性自伤（NSSIs）、自杀意念和自杀行为的频率更高，而PLG组和FLG组在自我伤害方面未发现显著差异。与PLG组相比，FLG组和SLG组的饮食失调更为常见，而睡眠问题仅在SLG组中更为严重。此外，SLG组患者遭受心理虐待和忽视的频率更高，其父母患有精神疾病的情况也更多。不良创伤经历和内化障碍与自杀风险增加显著相关。从PLG组到SLG组，智力残疾的比例降低，同样，SLG组中注意力缺陷多动障碍（ADHD）的发生率也较低。其他精神科诊断未发现差异。这些信息可能有助于更好地理解和管理经历长期集体创伤后的青少年严重情绪和行为障碍。
