Newcastle Hospital, Greystones, Wicklow, Ireland.
Department of Psychiatry, Beaumont Hospital, Beaumont, Dublin, Ireland.
Ir J Psychol Med. 2023 Sep;40(3):457-459. doi: 10.1017/ipm.2023.13. Epub 2023 Mar 1.
The COVID pandemic has been associated with poorer mental health in youth. This study aimed to evaluate any change in General Practitioner (GP) referral pattern to Child and Adolescent Mental Health (CAMH) services during the first 10 months of Covid-19 and compare with a similar time frame in 2019.
All accepted referrals to a CAMH Service in Dublin during the study time frame were reviewed. Referral letters were batch anonymised and clinical data extracted using a study specific proforma for analysis.
Referral numbers between the two time periods did not statistically differ. Proportionally more females were referred during the pandemic, increasing to 56.9%, = 99, compared to 43.1%, = 75 in 2019 ( = 0.01). Referrals were more often designated by the clinician as urgent during the pandemic (61.3%, = 98) than before (39%, = 62, < 0.001). Referrals outlining self-harm or suicidal ideation increased significantly, from 42.1% ( = 67) to 55.9% ( = 90) ( = 0.014). Referrals for externalising problems fell from 2019 rates; ADHD (21.4%, = 34 vs 11.1%, = 18; = 0.013), ASD (26.4%, = 42 vs 16.1%, = 26; = 0.038) and conduct problems (23.3%, = 37 vs 7.4%, = 12; < 0.001). Although numbers for psychosis in 2019 were low (10.7%, = 17), these also fell significantly in 2020 (2.5%, = 4; < 0.001).
The finding of reduced referrals for ADHD and ASD has not previously been reported. With concerns regarding educational loss linked to online learning, it is crucial that these youth are not doubly disadvantaged by delayed referral and education decline.
新冠疫情与年轻人心理健康状况恶化有关。本研究旨在评估新冠疫情期间全科医生（GP）向儿童和青少年心理健康（CAMH）服务机构转诊模式的任何变化，并与 2019 年同期进行比较。
回顾研究期间都柏林 CAMH 服务机构收到的所有转诊。将转诊信分批匿名，并使用专门的研究表格提取临床数据进行分析。
两个时间段的转诊数量没有统计学差异。在疫情期间，女性转诊比例更高，达到 56.9%（n=99），而 2019 年为 43.1%（n=75）（ = 0.01）。在疫情期间，临床医生更频繁地将转诊指定为紧急（61.3%（n=98），而不是 2019 年的 39%（n=62）（ < 0.001）。自我伤害或自杀意念的转诊明显增加，从 42.1%（n=67）增加到 55.9%（n=90）（ = 0.014）。外部化问题的转诊率从 2019 年的水平下降；ADHD（21.4%（n=34）与 11.1%（n=18）； = 0.013），自闭症谱系障碍（26.4%（n=42）与 16.1%（n=26）； = 0.038）和品行障碍（23.3%（n=37）与 7.4%（n=12）； < 0.001）。尽管 2019 年精神分裂症的人数较少（10.7%（n=17）），但 2020 年也显著下降（2.5%（n=4）； < 0.001）。
ADHD 和自闭症谱系障碍转诊减少的发现以前没有报道过。由于与在线学习相关的教育损失问题，这些年轻人不应因转诊延迟和教育水平下降而遭受双重不利影响，这一点至关重要。
