Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Laboratory of Psychological Heath and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Public Health. 2023 Mar 9;11:1129123. doi: 10.3389/fpubh.2023.1129123. eCollection 2023.
The COVID-19 pandemic has raised concerns about child and adolescent mental health issues, such as self-harm. The impact of society-wide isolation on self-harming behaviors among adolescents in China is unclear. In addition, adolescents of different ages and sexes have varying abilities to cope with environmental changes. However, these differences are rarely considered in self-harm studies. We aimed to characterize the age- and sex-dependent effects of COVID-19-related society-wide isolation on self-harm among adolescents in East China.
We collected 63,877 medical records of children and adolescents aged 8-18 who had an initial visit to Shanghai Mental Health Center in China between 2017 and 2021 and charted annual self-harm rates for each age and sex. Using interrupted time series analysis, we modeled global and seasonal trends and the effect of COVID-19-related society-wide isolation on self-harm rates.
Females aged 10-17 and males aged 13-16 exhibited significantly increasing trends in self-harm rate ( < 0.05) in the past 5 years. Eleven-year-old females in 2020 showed a self-harm rate (37.30%) that exceeded the peak among all ages in 2019 (age 13, 36.38%). The COVID-19-related society-wide isolation elevated self-harm rates in female patients aged 12 [RR 1.45 (95% CI 1.19-1.77); = 0.0031] and 13 years [RR 1.33 (95% CI 1.15-1.5); = 0.0031], while males were less affected. Further, females with emotional disorders dominated the increased self-harm rates.
Society-wide isolation has had a significant impact on early adolescent females in East China, especially for those with emotional disturbances, and has brought forward the peak in adolescent self-harm rates. This study calls for attention to the risk of self-harm in early adolescents.
COVID-19 大流行引发了人们对儿童和青少年心理健康问题的关注，例如自残。社会范围隔离对中国青少年自残行为的影响尚不清楚。此外，不同年龄和性别的青少年应对环境变化的能力不同。然而，这些差异在自残研究中很少被考虑。我们旨在描述 COVID-19 相关社会范围隔离对华东地区青少年自残的年龄和性别依赖性影响。
我们收集了 2017 年至 2021 年期间在中国上海精神卫生中心首次就诊的 8-18 岁儿童和青少年的 63877 份病历，并为每个年龄和性别绘制了年度自残率。使用中断时间序列分析，我们对全球和季节性趋势以及 COVID-19 相关社会范围隔离对自残率的影响进行了建模。
过去 5 年，10-17 岁女性和 13-16 岁男性的自残率呈显著上升趋势（ < 0.05）。2020 年 11 岁女性的自残率（37.30%）超过了 2019 年所有年龄段的峰值（年龄 13 岁，36.38%）。COVID-19 相关社会范围隔离使 12 岁[RR 1.45（95%CI 1.19-1.77）； = 0.0031]和 13 岁[RR 1.33（95%CI 1.15-1.5）； = 0.0031]女性患者的自残率升高，而男性患者则受影响较小。此外，情绪障碍女性患者的自残率升高更为明显。
社会范围隔离对中国华东地区的早期青少年女性产生了重大影响，尤其是对那些有情绪障碍的女性，提前了青少年自残率的峰值。本研究呼吁关注青少年早期的自残风险。
